January 25, 2017
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Timing of menarche linked to premature, early menopause risk

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The risk for premature or early menopause is increased among women who experienced menarche at an early age and did not give birth to any children, according to findings published in Human Reproduction.

“In this study, women were of reproductive age when fertility rates were still relatively high, so we can speculate that childlessness may reflect underlying fertility problems, which might then lead to early menopause,” Gita D. Mishra, PhD, of the School of Public Health at the University of Queensland in Australia, said in a press release. “In general, we know that women who do not become pregnant have an earlier menopause than women with children. It is also the case that common factors could explain the relationship and influence fertility, the timing of the first period and menopause; these range from genetic factors to environmental factors in childhood, such as obesity, psychosocial stress and the social environment.”

Gita Mishra
Gita D. Mishra

Mishra and colleagues evaluated data from the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events (InterLACE) on 51,450 postmenopausal women to determine whether early menarche (age 11 years or younger) is a risk factor for premature menopause (final menstrual period at age 40 years or younger) and early menopause (final menstrual period at age 40-44 years).

Participants were divided into groups based on age at first menopause (11 years or younger; 12 years; 13 years; 14 years or at least 15 years) and parity (no children, one child or at least two children).

Participants with early menarche had a higher risk for experiencing premature menopause (RR = 1.8; 95% CI, 1.53-2.12) and early menopause (RR = 1.31; 95% CI, 1.19-1.44) compared with participants who experienced menarche at age 13 years. Participants who never gave birth had a higher risk for premature menopause (RR = 2.26; 95% CI, 1.84-2.77), early menopause (RR = 1.32; 95% CI, 1.09-1.59) and menopause when aged 45 to 49 years (RR = 1.13; 95% CI, 1.03-1.23) compared with participants who gave birth to two or more children.

Age at the final menstrual period was associated with age at menarche and parity (P < .0001). Compared with participants with menarche at age 12 years or older and those with two or more children, participants with early menarche and no children had five times the risk for premature menopause (RR = 5.64; 95% CI, 4.04-7.87) and twice the risk for early menopause (RR ratio = 2.16; 95% CI, 1.48-3.15).

“Women should be informed of their elevated risk of premature menopause if they began menstruating at a young age, especially those with fertility problems, so that they can make informed decisions,” Mishra told Endocrine Today. “This evidence strengthens the case for clinical surveillance for these women in order to address the increased risks of chronic diseases. It is important to collect data on reproductive histories and especially on the reasons for not having children.” – by Amber Cox

For more information:

Gita D. Mishra, PhD, can be reached at School of Public Health, The University of Queensland, Herston Qld 4006, Australia; email: g.mishra@sph.uq.edu.au.

Disclosure: The researchers report no relevant financial disclosures.