The decreasing age of menarche in Turkey: global warming, socioeconomic development, and environmental factors.

OBJECTIVE: The age at menarche varies over time in line with the development level of society. The aim of the present study was to assess and compare secular trends of the age of menarche in Ankara, Turkey. PATIENTS AND METHODS: One thousand thirty-five patients who presented for regular gynecological control were examined retrospectively between 2011 and 2015. The patients were asked when they had experienced their first period. The data were evaluated in 10-year periods (<1964, 1965-1974, 1975-1984, and 1985-2000). The mean age at menarche presents trends that have changed over the years. RESULTS: The mean age at menarche decreased from 13.29 years in < 1964 to 13.24 years in 1965-1974, 13.20 years in 1975-1984, and 13.10 years in 1985-2000. When the < 1964 and 1985-2000 groups were compared, there was a two-fold increase in young age (≤ 11 years) at menarche. CONCLUSIONS: There is a continuing secular trend (a two-fold increase) in earlier age at menarche (i.e., ≤ 11 years). The effects of global warming and rising socioeconomic levels in Turkey may be implicated in the increase in earlier age at menarche.

A sarcomatous-type peritoneal malign mixed mullerian tumor implant in association with ovarian adenocarcinoma: a case report.

A rare case of a patient with a histopathological diagnosis of a sarcomatous-type peritoneal malign mixed müllerian tumor implant in association with ovarian adenocarcinoma is reported. A 52-year-old patient was referred to our clinic for an adnexal mass. At pelvic examination, an irregular, fixed, approximately 7-8 cm in size mass was detected in the right adnexal area. At transvaginal ultrasonographic examination, it was observed that there was an 80 x 70 mm sized, irregularly contoured, semisolid mass with hyperechogenous areas inside originating from the ovary in the right adnexal area. At laboratory examination tumor marker CA-125 was 280.4 U/ml (< 35), CA-15-3 was 146.5 U/ml (< 25), whereas other markers were within normal range. The patient was operated on for a right adnexal mass. A staging laparatomy procedure was applied. Postoperative histopathological diagnosis was reported as malignant mixed mullerian tumor of the ovary, with the ovarian component as poorly differentiated adenocarcinoma, and the metastatic foci over serosal surfaces as a sarcomatous component. Postoperatively six courses of adjuvant and consolidation chemotherapy were administered to the patient. Further studies are needed to set a consensus about evaluation of treatment and prognosis for this kind of pathology.