Usually means: Before onset of first menstruation.
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We found 5 dictionaries that define the word premenarchal:

General (2 matching dictionaries)
  1. premenarchal: Wiktionary
  2. premenarchal: Dictionary.com

Medicine (3 matching dictionaries)
  1. premenarchal: Merriam-Webster Medical Dictionary
  2. Dorland's Illustrated Medical Dictionary (No longer online)
  3. premenarchal: Medical dictionary

Definitions from Wiktionary (Premenarchal)

adjective:  Alternative form of premenarcheal. [Before the menarche (advent of menses).]

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