Get started
Work

Menarche onset is an inflection point for mental health and brain development

Year: 2026
Type: preprint
Abstract: Menarche is a normative milestone of female puberty, yet its role in adolescent mental health and brain development remains poorly understood. Using longitudinal data from 5,016 females (7 annual visits, ages 10-16 years) in the Adolescent Brain Cognitive Development Study, we found that menarche onset functions as an inflection point for the development of internalizing symptoms and gross brain morphometry. The onset of menarche, largely independent of timing and socio-environmental factors, preceded a significant spike in internalizing symptoms, while altering the rate of ongoing structural brain development. Following menarche onset, individuals with faster declines in gray matter volume and surface area also had heightened internalizing symptoms. These findings suggest that menarche is not only a reproductive milestone but a neuroendocrine driver of adolescent brain and mental health trajectories. This normative and easily identifiable marker could define a critical window for mental health screenings with greater precision than current age-based guidelines.
DOI: 10.64898/2026.04.13.718198
Authors: Carina Heller, Holly Sullivan-Toole, Martin Gell, Sanju Koirala, John McClellan France, Ran Barzilay, Tyler M. Moore, Ka I Ip, Damien A. Fair, Brenden Tervo-Clemmens, Arielle S. Keller, Adriene M. Beltz, Emily G. Jacobs, Bart Larsen
Institutions: University of Minnesota, University of California, Santa Barbara, Jena University Hospital, Children's Hospital of Philadelphia, University of Pennsylvania, University of Connecticut, Connecticut Institute for the Brain and Cognitive Sciences, University of Michigan
Language: English
Field: Medicine
Open Access status: green
Funders: Brain and Behavior Research Foundation, Deutsche Forschungsgemeinschaft, National Institutes of Health, National Institute of Mental Health, National Institute on Drug Abuse, Common Fund
Awards: G1020259976, G1569016918, G2943261222, G4066048162, G4097005334, G4495653095, G5081895789, G5909182340, G6667901327, G687916792, G694884348, G7271102572, G7345505113, G7652160222, G771167098, G8098060306, G8281824583, G8762171721, G8762821959, G9000008241, G9000034221, G9000108491, G9000112882, G9000163168, G9000168535, G9000205938, G9000241459, 9/21 ABCD-USA CONSORTIUM: RESEARCH PROJECT SITE AT U MICHIGAN, 8/21 ABCD-USA CONSORTIUM: RESEARCH PROJECT SITE AT CHLA, 6/21 ABCD-USA CONSORTIUM: RESEARCH PROJECT SITE AT OHSU, Brain iron as a neurodevelopmental mechanism for transdianostic executive dysfunction, 2/21 ABCD-USA CONSORTIUM: RESEARCH PROJECT SITE AT UMB, G923039674
OpenAlex ID: W7154238696
Cites:
Cited by:
Related to: