Menarche: onset and management in London schools.

Arch Dis Child January 2011 Vol 96 No 1 111 illustrates that black girls, but also probably Turkish girls and those of mixed ethnicities, are likely to have early pubertal maturation compared to white girls. Girls could access sanitary towels in 91% of schools but only on asking, with none available in toilets. Most schools (95%) provided sanitary bins but mainly only in designated toilets. Interestingly, cost did not infl uence sanitary facility provision in 77% of schools. Teaching about puberty was provided by 91% of schools in year 6, and by 77% in year 5. Strikingly in this large cohort, menarche is achieved by one in six girls in year 6 at primary school. This study strongly suggests that early menarche is common in culturally diverse populations. Individual girls and schools therefore need to be prepared, but this is not appropriately refl ected in current school provision and educational policies. Notably, we report similar statistics for sanitary facilities to those documented in UK primary schools a decade ago.2 Although most children will be taught about puberty during primary school, approximately a quarter of schools do not include such teaching in year 5, no schools provided sanitary items without the child needing to ask, and 5% of schools had no sanitary bins available for pupils. We acknowledge the limitations of our study, especially that information was requested from teachers. However, considering only few schools provide easily accessible sanitary facilities, teachers are likely to know which children are menstruating, and we suspect that our fi gures may even be an underestimate. This study suggests the need for further national work, especially as there has been no large epidemiological study across the whole multi-cultural UK population in the last generation. Primary schools need to be aware that a signifi cant proportion of girls will start having periods in year 6. We suggest that a nationally agreed policy is formulated to encourage universal education, Menarche: onset and management in London schools