The Timing of the Age at Which Natural Menopause Occurs
Section snippets
Methodologic Concerns
Most studies of the menopausal transition have been cross-sectional, rather than longitudinal, in design, providing an opportunity for distortion of the true picture of the timing of the final natural menstrual period, particularly for understanding factors that precede and may affect the timing of menopause. Further, definitions of menopause or the final menstrual period have varied from study to study in terms of the number of months of amenorrhea considered to represent in retrospect the
Summary of Underlying Physiology
Menopause is defined as the cessation of menstruation which reflects cessation of ovulation owing to a loss of ovarian follicles, which in turn results in reduced ovarian production of estradiol, the most biologically active form of estrogen,37, 38 as well as increased circulating concentrations of follicle-stimulating hormone (FSH) and decreased concentrations of inhibin, which inhibits the release of FSH.37 Age at menopause may be more sensitive to varying rates of atresia of ovarian follicles
Conclusion
Despite important methodologic differences, the limitations in the study designs used and the populations studied in the accumulating literature regarding factors that affect the age at which the natural final menstrual period is experienced, an interesting and complex picture is emerging. A number of demographic (eg, education, employment, race/ethnicity), menstrual and reproductive (eg, parity and OC use), familial and genetic, and lifestyle (eg, smoking, weight, physical activity and diet)
Acknowledgments
The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH) (Grants NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495). Dr Gold was supported by AG012554. The content of this article is solely the responsibility of the author and does not
References (162)
- et al.
Age at natural menopause and mortality
Ann Epidemiol
(1998) - et al.
Age at menopause as a risk factor for cardiovascular mortality
Lancet
(1996) - et al.
Does age at natural menopause affect mortality from ischemic heart disease?
J Clin Epidemiol
(1997) - et al.
Lifetime estrogen exposure versus age at menopause as mortality predictor
Maturitas
(2002) - et al.
Age at natural menopause and total mortality and mortality from ischemic heart disease: the Adventist Health Study
J Clin Epidemiol
(1999) - et al.
Population-based study of age at menopause and ultrasound assessed carotid atherosclerosis: the Tromso Study
J Clin Epidemiol
(2000) - et al.
Age at menarche and menopause of uterine cancer patients
Eur J Obstet Gynecol Reprod Biol
(1978) - et al.
The association between early menopause and risk of ischaemic heart disease: influence of hormone therapy
Maturitas
(2006) - et al.
The evolution of menopausal symptoms
Baillieres Clin Endocrinol Metab
(1993) - et al.
Predicting age at menopause
Maturitas
(1996)
Effect of oocyte number and rate of atresia on the age of menopause
Repro Toxicol
Ovarian pituitary hormone interactions during the menopause
Maturitas
Endometrium and plasma hormone profile in the peri-menopause and post-menopause
Maturitas
The normal menopause transition
Maturitas
Factors influencing the age at natural menopause
J Chron Dis
Age at natural menopause in a population-based screening cohort: the role of menarche, fecundity, and lifestyle factors
Fertil Steril
Is there a secular trend in age of menopause
Maturitas
Factors associated with onset of menopause in women aged 45–49
Maturitas
A prospective study of factors affecting age at menopause
J Clin Epidemiol
The prevalence of symptoms in menopausal women in the Far East: Singapore segment
Maturitas
Health of Indonesian women, city-dwellers of perimenopausal age
Maturitas
Characteristics of menopause in three groups in Karachi, Pakistan
Maturitas
The menopausal age and climacteric complaints in Thai women in Bangkok
Maturitas
The association of socio-economic position across the life course and age at menopause: the British Women's Heart and Health Study
Br J Obstet Gynecol
A new way of looking at environmental variables that may affect the age at menopause
Maturitas
Relation of parity to age at menopause
Am J Obstet Gynecol
The age of menopause and the menopause transition in a multiracial population: a nation-wide Singapore study
Maturitas
Reproductive and general lifestyle determinants of age at menopause
Maturitas
Smoking, obesity, and the menopause
Lancet
Menopause: the aging of multiple pacemakers
Science
Is early natural menopause a biologic marker of health and aging?
Am J Public Health
Age at menopause, cause-specific mortality and total life expectancy
Epidemiology
Age at natural menopause and all-cause mortality: a 37-year follow-up of 19,731 Norwegian women
Am J Epidemiol
Endogenous estrogen exposure and cardiovascular mortality risk in postmenopausal women
Am J Epidemiol
Age at natural menopause and risk of cardiovascular disease
Arch Intern Med
Postmenopausal status and early menopause as independent risk factors for cardiovascular disease: a meta-analysis
Menopause
Relationships of age at menarche and menopause, and reproductive year with mortality from cardiovascular disease in Japanese postmenopausal women: the JACC study
J Epidemiol
Age at natural menopause and risk of ischemic stroke The Framingham Heart Study
Stroke
Early menopause predicts angina after myocardial infarction
Menopause
Menopause, menstrual and reproductive history, and bone density in northern Italy
J Epidemiol Community Health
Early menopause, number of reproductive years, and bone mineral density in postmenopausal women
Am J Public Health
Early menopause: increased fracture risk at older age
Osteoporos Int
Reproductive factors and breast cancer
Epidemiol Rev
Early age at menopause and breast cancer: are leaner women more protected?A prospective analysis of the Dutch DOM cohort
Breast Cancer Res Treat
Pooled analysis of 3 European case-control studies of ovarian cancer: IIAge at menarche and at menopause
Int J Cancer
Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review
Cancer Epidemiol Biomarkers Prev
Menstrual and reproductive factors and endometrial cancer risk: results from a population-based case-control study in urban Shanghai
Int J Cancer
Increased cardiovascular mortality after early bilateral oophorectomy
Menopause
Memory functioning among midlife women: observations for the Seattle Midlife Women's health Study
Menopause
Influence of gonadal hormones on neurotransmitters, receptor, cognition and mood
Clin Neuropharmacol
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