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. 2022 Mar 2;20(1):e120438. doi: 10.5812/ijem.120438

Table 1. Factors Related to the Menstrual Cycle Developmental Trajectory in Adolescents.

Factors Possible Effect References
Direct Effects Indirect Effects
Genetic Androgen-regulating genes, maternal menarche age Geographic genetics (18-22)
Race and ethnicity Birth weight and childhood obesity - (23-25)
Intrauterine and childhood factors - Being firstborn child, maternal age, maternal exposure to gestational hypertension and pre-pregnancy diabetes, smoking exposure (26-30)
Social factors Anthropometric factors Birth in urban areas, family size, insufficient income, education (31-33)
Geographical factors Menarche age Temperature, humidity, altitude latitude, annual ultraviolet (UV) radiation, exposure to particles with a diameter of 10 microns, climate change, and pollution (34-36)
Lifestyle Anthropometric factors Diet, physical activity, sleep, stress (37-41)
Diseases and medication Hormonal and metabolic disorders - (42-44)