There is data suggesting that puberty is starting earlier than in previous generations. However, there is minimal information on menarche and its management in UK primary schools. We present a population study, performed in Islington: a London borough with wide ethnic diversity, conducted using written questionnaires to all primary schools. Data collected included: information on menarche, provision and disposal of sanitary towels and teaching on puberty. 22 (50%) replies were received, incorporating data on 867 year 5&6 girls (435 year 6 girls; 432 year 5 girls).
In year 6, 17% of girls had achieved menarche [35% Black (Black Caribbean, Black Other, Somali, Other Black African ethnicity codes); 20% British White; 14% Mixed; 12% Turkish; 8% other white; 5% Bangladeshi; 4% other Asian; 2% unknown]. In year 5, 3% had started menstruation [33% Mixed; 17% Black; 17% British White; 17% Turkish; 8% Bangladeshi; 8% unknown].
Girls had access to sanitary towels in 91% of schools, (with some overlap: 55% from the school office; 36% from teachers; 18% from the sickroom). Most schools (95%) provided sanitary bins but only one had bins in all toilets. Cost was not a factor in the provision of sanitary facilities in 77% of schools.
Ninety one % of schools included teaching on puberty and periods in year 6; 76% in year 5; 41% had no designated teaching in earlier years.
This study demonstrates the large proportion of menarchal girls in London primary schools (over a third of Black ethnicity). Almost all schools provided sanitary bins. Pubertal education occurred in most but not all schools.
Menarche, a late sign of pubertal development, is achieved by 1 in 6 girls in their final year of primary school in Islington. Provision in schools needs to reflect this and education on puberty should start earlier and take place in all primary schools.
10 - 12 Nov 2009
British Society for Paediatric Endocrinology and Diabetes