BACKGROUND AND PURPOSE:

• Age at natural menopause appears to be on an upward trend worldwide, which has the potential to influence a variety of health conditions
• Later age at natural menopause is associated with
  • Reduced all-cause and cardiovascular mortality
  • Increased risk for breast, endometrial, and ovarian cancer
• Appiah et al. (JAMA, 2021) investigated 60-year trends in age at natural menopause and reproductive life span among US women

METHODS:

• Data sources
  • Survey data: National Health Examination Survey I (NHES I; 1959 to 1962) | National Health through to the Nutrition Examination Survey (NHANES; 2017 to 2018)
• Population
  • All women, 40 to 74 years
  • Natural menopause
  • Exclusion: Menopause due to medical treatment or other reasons | Age at natural menopause <40 years or >62 years | Reported race/ethnicity other than Black, White, or Hispanic
• Study design
  • Ages at menarche and menopause were self-reported
  • Linear regression was used to assess trends in age at natural menopause and reproductive life span over time
  • Logistic regression was used to evaluate factors associated with higher age at menopause and longer reproductive life span

RESULTS:

• 7773 women
• Between the periods of 1959 to 1962 and 2015 to 2018, the mean age at natural menopause increased (P < 0.001 for trend)
  • 1959 to 1962: mean age 48.4 years
  • 2015 to 2018: mean age 49.9 years
• Mean reproductive life span also increased over this interval (P < 0.001 for trend)
  • 1959 to 1962: mean length 35.0 years
  • 2015 to 2018: mean length 37.1 years
• Mean age at menarche declined over this time period (P < 0.001 for trend)
  • 1959 to 1962: mean age 13.5 years
  • 2015 to 2018: mean age 12.7 years
• The following were associated with earlier age at natural menopause and a shorter reproductive life span
  • Black or Hispanic race/ethnicity
  • Poverty
  • Current and former smoking status
  • Hormone therapy use
• The following were associated with later age at natural menopause and a longer reproductive life span
  • Greater years of education
  • Oral contraceptive use

CONCLUSION:

• In the past 60 years, age at natural menopause and mean reproductive life span has increased
  • Mean age at natural menopause has increased by 1.5 years
  • Mean reproductive life span has increased by 2.1 years
• Reproductive life span increase attributable to both later age at natural menopause and earlier age at menarche
• Socioeconomic and lifestyle factors were associated with age at menopause and overall reproductive lifespan

Learn More – Primary Sources:

Trends in Age at Natural Menopause and Reproductive Life Span Among US Women, 1959-2018

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