Body mass index and age at natural menopause: an international pooled analysis of 11 prospective studies

Abstract

Current evidence on the association between body mass index (BMI) and age at menopause remains unclear. We investigated the relationship between BMI and age at menopause using data from 11 prospective studies. A total of 24,196 women who experienced menopause after recruitment was included. Baseline BMI was categorised according to the WHO criteria. Age at menopause, confirmed by natural cessation of menses for ≥ 12 months, was categorised as < 45 years (early menopause), 45-49, 50-51 (reference category), 52-53, 54-55, and ≥ 56 years (late age at menopause). We used multinomial logistic regression models to estimate multivariable relative risk ratios (RRRs) and 95% confidence intervals (CI) for the associations between BMI and age at menopause. The mean (standard deviation) age at menopause was 51.4 (3.3) years, with 2.5% of the women having early and 8.1% late menopause. Compared with those with normal BMI (18.5-24.9 kg/m), underweight women were at a higher risk of early menopause (RRR 2.15, 95% CI 1.50-3.06), while overweight (1.52, 1.31-1.77) and obese women (1.54, 1.18-2.01) were at increased risk of late menopause. Overweight and obesity were also significantly associated with around 20% increased risk of menopause at ages 52-53 and 54-55 years. We observed no association between underweight and late menopause. The risk of early menopause was higher among obese women albeit not significant (1.23, 0.89-1.71). Underweight women had over twice the risk of experiencing early menopause, while overweight and obese women had over 50% higher risk of experiencing late menopause.

Premenopausal cardiovascular disease and age at natural menopause: a pooled analysis of over 170,000 women

“…Smoking leads to early menopause and overweight/obese has been linked to later menopause [31,24]. Our results showed the significant associations between CVD events <35 years and early menopause were mainly observed in ever smokers and women with normal weight.…”

“…Fourth, to guarantee the temporal direction from premenopausal CVD events to menopause, we performed an analysis by only including premenopausal CVD events which occurred at least two years before menopause. Fifth, smoking and BMI are two important factors that may influence age at menopause [31,24]. We thus analysed the combined effects of premenopausal CVD events and smoking status, premenopausal CVD events and BMI levels on age at menopause.…”

“…For some women, use of MHT and oral contraceptive pills (OCPs) made it difficult to ascertain their menopausal status; hence MHT or OCP users were excluded unless their age at natural menopause had been reported and the assumption of only post-menopausal MHT use could be made. Age at menopause was categorised as <45 (early menopause), 45-49, 50-51 (reference category), 52-53, and 54 years and above (late menopause), according to the clinical recommendation [4] and also as defined in our previous papers [24,25]. CVD events were acertained by self-report or/and hospital diagnosis, and were defined as the occurrence of coronary heart disease (CHD, including heart attack and angina) or stroke (including ischemic strokes and haemorrhagic strokes).…”

Sexual frequency is associated with age of natural menopause: results from the Study of Women's Health Across the Nation

“…Additional variables were selected based on existing research looking at what influences ANM. Timevarying covariates included the woman's smoking habits (never smoked; ever smoked) [7][8][9][10][11][12][13][14][15][16][17][18][19][20] and body mass index (BMI) [10,11,14,16,17,[19][20][21]48,49]. Race (self-identified as black or African American; Chinese; Japanese; non-Hispanic Caucasian; Hispanic) [12-14,18,50], educational attainment (less than high school education; high school education; some college/technical school; college degree; post-graduate education) [9][10][11][12]14,[18][19][20][21][22]48], parity [7,[9][10][11][12]14,15,[18][19][20][21][22]48,…”

Current ecology, not ancestral dispersal patterns, influences menopause symptom severity

“…Covariates were held constant in each analyses and selected based on existing literature on the demographic correlates of menopause symptoms and timing, and also based on the data we had available. These included parity (Li et al, ; Mishra et al, ; Parazzini, ; Wang et al, ), whether the woman was financially secure over the past year (as a measure of socioeconomic position/financial stress; Lawlor, Ebrahim, & Smith, ; Schoenaker, Jackson, Rowlands, & Mishra, ), body mass index (BMI; Ahuja, ; Li et al, ; Maru, Verma, Verma, & Shrimal, ; Parazzini, ; Sapre & Thakur, ; Tao et al, ; Wang et al, ; Zhu et al, ), and smoking habits (Ayatollahi, Ghaem, & Ayatollahi, ; Bjelland, Hofvind, Byberg, & Eskild, ; Gold et al, , ; McKnight et al, ; Nagel, Altenburg, Nieters, Boffetta, & Linseisen, ; Özdemir & Çöl, ; Parazzini, ; Sapre & Thakur, ; Tao et al, ; Wang et al, ). In addition, age was included in the model when looking at symptom duration and symptom severity, and menopause status when looking at symptom severity, to control for the possibility that retrospective accounts of menopause may differ to current reporting.…”