Age at menarche, age at menopause, reproductive years and risk of fatal stroke occurrence among Chinese women: the Guangzhou Biobank Cohort Study

Abstract

Background The relationship between women’s reproductive characteristics and stroke events is unclear. We aimed to investigate age at menarche, age at menopause and number of reproductive years in relation to fatal stroke occurrence in the Guangzhou Biobank Cohort Study. Methods In total, 16,504 postmenopausal women without stroke, heart disease or a cancer history at baseline were included and followed up for a median of 12.0 years. After review of available records, 222 stroke deaths were recorded. Cox proportional hazards regression was used to assess the associations between the risk of fatal stroke occurrence and age at menarche, age at menopause and number of reproductive years. Results In the whole cohort, compared with those aged 15 years at menarche, an increased risk of fatal stroke among women at menarche showed respectively in those aged 12 years (aHR (adjusted hazard ratio) = 1.86, 95% confidence interval (CI) 0.96–3.60), aged 13 years (aHR = 1.69, 95% CI 0.98–2.92), aged 17 years (aHR = 1.83, 95% CI 1.10–3.05) and aged ≥ 18 years (aHR = 1.66, 95% CI 1.03–2.70), wherein the associations revealed an atypically U-shaped; similar U-shaped association to the cohort of postmenopausal women born before 1940 released a range of incremental risks of fatal stroke in women at menarche aged ≤ 12 years (aHR = 3.68, 95% CI 1.68–8.05), aged 13 years (aHR = 2.11, 95% CI 1.02–4.34), aged 14 years (aHR = 2.07, 95% CI 1.04), aged 17 years (aHR = 2.30, 95% CI 1.20–4.39) and aged 18 years (aHR = 2.50, 95% CI 1.37–4.57), respectively. Compared with menopausal women aged 51–52 years, those aged < 43 years at menopause had an increased risk for fatal stroke among postmenopausal women born in and after 1940 (aHR = 1.64, 95% CI 0.97–2.78) and postmenopausal women born before 1940 (aHR = 1.97, 95% CI 1.05–3.69). Additionally, compared with those with 32–34 reproductive years, women with ≤ 28 reproductive years had an increased risk for fatal stroke in the whole cohort (aHR = 1.91, 95% CI 1.28–2.86) and the cohort of postmenopausal women born before 1940 (aHR = 1.79, 95% CI 1.15–2.80). Conclusions Younger and older age at menarche, younger age at menopause and fewer reproductive ages were related to an increased risk of fatal stroke in postmenopausal women.

Early Menarche as a Protective Factor Against Cardiovascular Events: A Systematic Review and Meta-analysis

“…All subjects were women. Among the 13 eligible cohorts, the studies took place in a variety of countries including China, 15 , 19 , 24 Japan, 16 United States, 17 , 25 UK, 18 , 27 Korea, 20 , 23 , 26 Mexico, 21 and Norway. 22 The sample sizes ranged from 647 25 to 1 224 547 23 women .…”

“…Total stroke was reported in 5 cohorts, which included a total of 2 941 321 patients. 15 , 17 , 18 , 20 , 24 Within the early menarche group, total stroke occurred in 11 469 (0.90%) patients among a total of 1 267 617 patients. On the other hand, within the normal and late menarche group, total stroke occurred in 33 533 (2.00%) patients among a total of 1 673 704 patients.…”

Age at menopause and risk of ischemic stroke: a systematic review and meta-analysis

“…There are two articles, one defines menopause age before 43 years old as early menopause [23] , and the other defines menopause age before 49 years old as early menopause [26] . Considering that there are cases of premature menopause due to iatrogenic factors or delayed menopause due to the use of hormone replacement therapy in the age at menopause group between 43 and 49 years old, there may be both early menopause and delayed menopause relative to the body’s physiological menopause age.…”

Reproduction Period Of Javanese Women

“…Beberapa studi menunjukkan adanya asosiasi antara periode reproduksi dengan penyakit dan panjang harapan hidup wanita. Periode reproduksi berasosiasi dengan beberapa penyakit seperti diabetes, stroke, fungsi renal dan kardiovaskular (Brand et al, 2013;Ley et al, 2017;Hu et al, 2021;Yu et al, 2021). Studi lain menjelaskan usia menopause dan periode reproduksi yang lambat kemungkinan dapat meningkatkan harapan hidup seseorang (Shadyab et al, 2017).…”