(PS5-65) Beyond Reproductive Organs: An Exploration of Menarcheal Timing, Depression Onset, and Mental Health Symptoms in Youth with Mood Disorders

Background: The observable occurrence of cyclic physiological uterine bleeding, known as menstruation, results from the shedding of endometrial tissue and is intricately controlled by hormones, predominantly through the hypothalamic-pituitary-ovarian axis (Leenaars et al., 2009). Menarche, characterized by the onset of the first menstruation, marks the initiation of the fertile age, as defined by Krisanits et al. (2020). Premature puberty onset in individuals assigned female at birth consistently appears as a notable precursor to adolescent mental health issues, including depression and anxiety (Mendle et al., 2018). With that, existing literature indicates a correlation between the age at menarche and both the severity and risk of depression (Hirtz et al., 2002). 

Objective: Our study aimed to evaluate the relationship between age of menarche and age at the onset of the first depressive episode. Additionally, we sought to examine the relationship between age of menarche and current depressive, anxiety, and suicidality symptoms.

Methods: We examined data on 167 participants (ages 10-24) with a history of a mood disorder who were assigned female at birth in the Texas Resilience Against Depression study (T-RAD). Participants self reported on their demographics, age of first depressive episode, age of menarche, regularity of menstrual cycle, symptoms of depression (Patient Health Questionnaire; PHQ-9), anxiety (Generalized Anxiety Disorder scale; GAD-7), and suicidality (Concise Health Risk Tracking scale; CHRT-SR). 

Results: Linear regressions revealed that, while controlling for race and age, age of menarche (β = .178 p < .05) was a significant predictor of age of first depressive episode such that adolescents with earlier onset puberty are more likely to experience earlier first depressive episode. These predictors explained 23.6% of the variance. Age of menarche was not significantly related to current depression, suicidality, or anxiety symptoms. 

Conclusions/ Implications: Our findings indicate that menarche could contribute to the initiation of depressive episodes in adolescents assigned female at birth. These findings suggest that screening for depressive symptoms around the onset of menstruation in adolescents could enhance early detection and intervention for adolescent depression. Subsequent research should longitudinally investigate these effects to gain insights into the trajectory of mood disorders among youth entering pubertal development.