Early menarche, nulliparity and the risk for premature and early natural menopause.

Mishra, GD; Pandeya, N; Dobson, AJ; Chung, H-F; Anderson, D; Kuh, D; Sandin, S; Giles, GG; Bruinsma, F; Hayashi, K; Lee, JS; Mizunuma, H; Cade, JE; Burley, V; Greenwood, DC; Goodman, A; Simonsen, MK; Adami, H-O; Demakakos, P; Weiderpass, E

Early menarche, nulliparity and the risk for premature and early natural menopause.

Mishra, GD Pandeya, N Dobson, AJ Chung, H-F Anderson, D

Kuh, D Sandin, S Giles, GG Bruinsma, F Hayashi, K Lee, JS Mizunuma, H Cade, JE Burley, V Greenwood, DC Goodman, A Simonsen, MK Adami, H-O Demakakos, P Weiderpass, E

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Publisher:: Oxford University Press (OUP)
Publication Type:: Journal Article
Citation:: Human reproduction (Oxford, England), 2017, 32, (3), pp. 679-686
Issue Date:: 2017-03

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Field	Value	Language
dc.contributor.author	Mishra, GD
dc.contributor.author	Pandeya, N
dc.contributor.author	Dobson, AJ
dc.contributor.author	Chung, H-F
dc.contributor.author	Anderson, D https://orcid.org/0000-0001-8996-9624
dc.contributor.author	Kuh, D
dc.contributor.author	Sandin, S
dc.contributor.author	Giles, GG
dc.contributor.author	Bruinsma, F
dc.contributor.author	Hayashi, K
dc.contributor.author	Lee, JS
dc.contributor.author	Mizunuma, H
dc.contributor.author	Cade, JE
dc.contributor.author	Burley, V
dc.contributor.author	Greenwood, DC
dc.contributor.author	Goodman, A
dc.contributor.author	Simonsen, MK
dc.contributor.author	Adami, H-O
dc.contributor.author	Demakakos, P
dc.contributor.author	Weiderpass, E
dc.date.accessioned	2021-05-10T02:15:31Z
dc.date.available	2016-12-09
dc.date.available	2021-05-10T02:15:31Z
dc.date.issued	2017-03
dc.identifier.citation	Human reproduction (Oxford, England), 2017, 32, (3), pp. 679-686
dc.identifier.issn	0268-1161
dc.identifier.issn	1460-2350
dc.identifier.uri	http://hdl.handle.net/10453/148803
dc.description.abstract	<h4>Study question</h4>Are parity and the timing of menarche associated with premature and early natural menopause?<h4>Summary answer</h4>Early menarche (≤11 years) is a risk factor for both premature menopause (final menstrual period, FMP <40 years) and early menopause (FMP 40-44 years), a risk that is amplified for nulliparous women.<h4>What is known already</h4>Women with either premature or early menopause face an increased risk of chronic conditions in later life and of early death. Findings from some studies suggest that early menarche and nulliparity are associated with early menopause, however overall the evidence is mixed. Much of the evidence for a direct relationship is hampered by a lack of comparability across studies, failure to adjust for confounding factors and inadequate statistical power.<h4>Study design, size, duration</h4>This pooled study comprises 51 450 postmenopausal women from nine observational studies in the UK, Scandinavia, Australia and Japan that contribute to the International collaboration for a Life course Approach to reproductive health and Chronic disease Events (InterLACE).<h4>Participants/materials, setting, methods</h4>Age at menarche (categorized as ≤11, 12, 13, 14 and 15 or more years) and parity (categorized as no children, one child and two or more children) were exposures of interest. Age at FMP was confirmed by at least 12 months of cessation of menses where this was not the result of an intervention (such as surgical menopause due to bilateral oophorectomy or hysterectomy) and categorized as premature menopause (FMP before age 40), early menopause (FMP 40-44 years), 45-49 years, 50-51 years, 52-53 years and 54 or more years. We used multivariate multinomial logistic regression models to estimate relative risk ratio (RRR) and 95% CI for associations between menarche, parity and age at FMP adjusting for within-study correlation.<h4>Main results and the role of chance</h4>The median age at FMP was 50 years (interquartile range 48-53 years), with 2% of the women experiencing premature menopause and 7.6% early menopause. Women with early menarche (≤11 years, compared with 12-13 years) were at higher risk of premature menopause (RRR 1.80, 95% CI 1.53-2.12) and early menopause (1.31, 1.19-1.44). Nulliparity was associated with increased risk of premature menopause (2.26, 1.84-2.77) and early menopause (1.32, 1.09-1.59). Women having early menarche and nulliparity were at over 5-fold increased risk of premature menopause (5.64, 4.04-7.87) and 2-fold increased risk of early menopause (2.16, 1.48-3.15) compared with women who had menarche at ≥12 years and two or more children.<h4>Limitations, reasons for caution</h4>Most of the studies (except the birth cohorts) relied on retrospectively reported age at menarche, which may have led to some degree of recall bias.<h4>Wider implications of the findings</h4>Our findings support early monitoring of women with early menarche, especially those who have no children, for preventive health interventions aimed at mitigating the risk of adverse health outcomes associated with early menopause.<h4>Study funding/competing interest(s)</h4>InterLACE project is funded by the Australian National Health and Medical Research Council project grant (APP1027196). G.D.M. is supported by Australian Research Council Future Fellowship (FT120100812). There are no competing interests.
dc.format	Print
dc.language	eng
dc.publisher	Oxford University Press (OUP)
dc.relation	http://purl.org/au-research/grants/nhmrc/1027196
dc.relation.ispartof	Human reproduction (Oxford, England)
dc.relation.isbasedon	10.1093/humrep/dew350
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences, 16 Studies in Human Society
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.mesh	Humans
dc.subject.mesh	Menopause, Premature
dc.subject.mesh	Risk Factors
dc.subject.mesh	Age Factors
dc.subject.mesh	Parity
dc.subject.mesh	Pregnancy
dc.subject.mesh	Menopause
dc.subject.mesh	Menarche
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	Child
dc.subject.mesh	Female
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Age Factors
dc.subject.mesh	Child
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Menarche
dc.subject.mesh	Menopause
dc.subject.mesh	Menopause, Premature
dc.subject.mesh	Middle Aged
dc.subject.mesh	Parity
dc.subject.mesh	Pregnancy
dc.subject.mesh	Risk Factors
dc.title	Early menarche, nulliparity and the risk for premature and early natural menopause.
dc.type	Journal Article
utslib.citation.volume	32
utslib.location.activity	England
utslib.for	11 Medical and Health Sciences
utslib.for	16 Studies in Human Society
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2021-05-10T02:15:29Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	32
utslib.citation.issue	3

Abstract:

Study question

Are parity and the timing of menarche associated with premature and early natural menopause?

Summary answer

Early menarche (≤11 years) is a risk factor for both premature menopause (final menstrual period, FMP <40 years) and early menopause (FMP 40-44 years), a risk that is amplified for nulliparous women.

What is known already

Women with either premature or early menopause face an increased risk of chronic conditions in later life and of early death. Findings from some studies suggest that early menarche and nulliparity are associated with early menopause, however overall the evidence is mixed. Much of the evidence for a direct relationship is hampered by a lack of comparability across studies, failure to adjust for confounding factors and inadequate statistical power.

Study design, size, duration

This pooled study comprises 51 450 postmenopausal women from nine observational studies in the UK, Scandinavia, Australia and Japan that contribute to the International collaboration for a Life course Approach to reproductive health and Chronic disease Events (InterLACE).

Participants/materials, setting, methods

Age at menarche (categorized as ≤11, 12, 13, 14 and 15 or more years) and parity (categorized as no children, one child and two or more children) were exposures of interest. Age at FMP was confirmed by at least 12 months of cessation of menses where this was not the result of an intervention (such as surgical menopause due to bilateral oophorectomy or hysterectomy) and categorized as premature menopause (FMP before age 40), early menopause (FMP 40-44 years), 45-49 years, 50-51 years, 52-53 years and 54 or more years. We used multivariate multinomial logistic regression models to estimate relative risk ratio (RRR) and 95% CI for associations between menarche, parity and age at FMP adjusting for within-study correlation.

Main results and the role of chance

The median age at FMP was 50 years (interquartile range 48-53 years), with 2% of the women experiencing premature menopause and 7.6% early menopause. Women with early menarche (≤11 years, compared with 12-13 years) were at higher risk of premature menopause (RRR 1.80, 95% CI 1.53-2.12) and early menopause (1.31, 1.19-1.44). Nulliparity was associated with increased risk of premature menopause (2.26, 1.84-2.77) and early menopause (1.32, 1.09-1.59). Women having early menarche and nulliparity were at over 5-fold increased risk of premature menopause (5.64, 4.04-7.87) and 2-fold increased risk of early menopause (2.16, 1.48-3.15) compared with women who had menarche at ≥12 years and two or more children.

Limitations, reasons for caution

Most of the studies (except the birth cohorts) relied on retrospectively reported age at menarche, which may have led to some degree of recall bias.

Wider implications of the findings

Our findings support early monitoring of women with early menarche, especially those who have no children, for preventive health interventions aimed at mitigating the risk of adverse health outcomes associated with early menopause.

Study funding/competing interest(s)

InterLACE project is funded by the Australian National Health and Medical Research Council project grant (APP1027196). G.D.M. is supported by Australian Research Council Future Fellowship (FT120100812). There are no competing interests.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/148803