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What Factors Affect Timing of Menopause?

COMBINING multiple health surveys in a meta-analysis, Duke Appiah, Texas Tech University, Lubbock, Texas, USA, has produced interesting insights for the duration of a woman’s reproductive span. Lifestyle factors were analysed to show associations with the date women reach natural menopause. 

Comparing the analyses, it became clear that over time mean reproductive lifespan has been increasing, from 35.0 to 37.1 years. Appiah found that Black and Hispanic ethnicities, poverty, smoking, and hormone therapy all associated with earlier menopause. Meanwhile, factors increasing lifespan included more years in education and use of oral contraceptives. 

Understanding in this field has profound impact upon the lives of all women, as it may provide information as to when they are most able to bear children. Examining the lifestyle factors that lead to disparity in the age of menopause may prove life-changing, with knowledge allowing future planning for an individual based on their characteristics and life situation. 

Appiah broadened the influence of his findings, explaining that women who enter menopause aged 40–45 years have a higher risk of developing cardiovascular disease, whereas those entering after the age of 50 experience higher risk of breast cancer. In this way, these findings can prove helpful to weigh risk or predict concurrent or future conditions.  

The data for this study were taken from the Centers for Disease Control and Prevention (CDC)-run National Health Examination Survey (NHES) of 1958–1962 through to the NHANES of 2017–2018, used to evaluate the health of the population in the USA. This provided a very large sample size of 7,773 women aged 40-74 years and detailed cross-sectional information, including physical examination and laboratory testing. 

Limitations in the study, acknowledged by Appiah, relate to the lack of assessment of lifestyle factors like nutrition, healthcare access, and environmental influences. He suggests that these have relation with the trend in increasing age at natural menopause, and so greater reproductive lifespan. 

The critical message from this research lies with the observation that menopause is associated with metabolic conditions, and these may influence the development of diseases. It also importantly highlights that researchers may be too concerned with the age that women arrive at menopause, and should focus more on the factors that are causing them to reach this stage prematurely.  

Future directives will follow this framework, and Appiah shared that in his coming work, “I’ll look at whether age at menopause and length of reproductive span is a marker for overall health in women.”