Childhood influences may shape risk for dozens of adult health conditions

Researchers analyzing data from more than 165,000 women found evidence that childhood influences may contribute to a broad range of adult health conditions, including tobacco use disorder and disorders affecting the digestive system, cardiovascular system, bladder, joints, and brain. The findings were presented at ENDO 2026, the Endocrine Society’s annual meeting in Chicago.^1,2

The study builds on previous research examining the relationship between age at menarche and adult disease risk. Investigators focused on later age at menarche, which can be influenced by adverse health or environmental factors during childhood. Rather than viewing the timing of menarche as a direct cause of disease, the researchers used it as an indicator of underlying childhood exposures that may have lasting effects on health.

“This work greatly expands the number of adult health conditions that are linked to childhood influences. Later timing of menarche can act as an indicator of these childhood influences that can then lead to health problems in adulthood. There is a lot of focus on earlier menarche and what causes it, but our research highlights that the occurrence of later menarche, too, should alert us and can be a signal of underlying issues,” said Ambreen Sonawalla, MD, of Boston Children’s Hospital.

Why did researchers study age at menarche as a marker of childhood influences?

Sonawalla and colleagues analyzed data from 165,832 women enrolled in the UK Biobank, a large database that includes medical diagnoses, genetic information, and self-reported age at menarche. The investigation was designed to determine whether childhood influences associated with delayed menarche could also contribute to a wider range of adult diseases beyond coronary artery disease.

Previous work by the group demonstrated that later menarche attributable to environmental or acquired factors was associated with increased coronary artery disease risk, whereas later menarche driven by genetic factors was associated with lower risk. Those findings suggested that delayed menarche itself was not responsible for disease development. Instead, childhood influences that delay menarche may also increase the likelihood of adverse health outcomes later in life.

To explore this hypothesis, the researchers evaluated relationships between age at menarche and 1,295 diagnoses available within the UK Biobank. Because genetics play a significant role in determining age at menarche, the investigators adjusted for known genetic influences to better isolate the impact of other childhood factors. They then conducted phenome-wide association studies, which allow researchers to examine associations across hundreds of diagnoses simultaneously.

What adult health conditions were linked to childhood influences?

The analysis identified evidence that 85 adult diagnoses may be influenced by childhood factors reflected through delayed menarche. Conditions included tobacco use disorder, ischemic heart disease, urinary incontinence, headaches, gastritis and duodenitis, functional digestive disorders, and type 1 diabetes, among others. The findings also revealed associations involving disorders affecting the digestive system, cardiovascular system, urinary tract, and nervous system.

What do these findings mean for pediatric and preventive health research?

The results support the concept that many adult diseases may have origins that extend back to childhood, even when symptoms do not emerge until decades later. While socioeconomic conditions are often considered important drivers of long-term health, Sonawalla noted that the factors influencing these outcomes likely extend beyond socioeconomic status alone.

“We don’t yet know the exact identities of these influences in childhood that affect adult health. However, we know that these childhood influences seem to be beyond just socioeconomic effects,” Sonawalla said.

Could identifying childhood risk factors improve lifelong health outcomes?

The investigators emphasized that identifying these childhood exposures represents the next phase of research. A better understanding of the environmental, biological, and acquired factors that influence development before menarche could help inform prevention strategies aimed at reducing disease risk across the lifespan.

“We need a shift in perspective. We need to move from thinking that these health conditions emerge in adulthood to recognizing that they represent a culmination of influences that start in childhood. It is now up to us to figure out what these childhood influences are, and more research and funding towards understanding them will allow us to target specific aspects of childhood health to improve lifelong health outcomes,” Sonawalla said.

The authors concluded that genetics-adjusted age at menarche may serve as a useful tool for identifying childhood antecedents of adult disease and for advancing research into the early-life origins of chronic health conditions in women.

References

1. Endocrine Society. Later Menarche May Signal Childhood Factors Linked to Adult Health Risks. Newswise. June 15, 2025. Accessed June 23, 2026. https://www.newswise.com/articles/later-menarche-may-signal-childhood-factors-linked-to-adult-health-risks

2. Sonawalla A, Chan YM. Analysis of age at menarche reveals childhood antecedents for a multitude of adult health outcomes. Presented at: ENDO 2026, the Endocrine Society Annual Meeting; June 13, 2026; Chicago, IL. Abstract.