Intra-population age variation at natural menopause and underlying past reproductive events: a case of Polish women
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Abstract:
Introduction. Menopause in the human female is a developmental stage that should be understood within the context of normal aging. This paper describes the intrapopulation variation in the age of natural menopause among Polish women and identifies the female reproductive characteristics associated with the menopause. Materials and Methods. Data from 2147 naturally postmenopausal women, participants of a crosssectional population-based survey conducted in 2000–2003 in all but Eastern parts of Poland, were analyzed to determine the mean and median ages at natural menopause. Results. The mean recalled age of natural menopause among Polish women was 49.90 years and the median age obtained by probit estimate was 50.92 years. Women from small towns were likely to experience menopause earlier compared to women from the cities. The timing of menopause among rural women was very close to their counterparts from the cities (median age 50.91 and 50.98 years, respectively). The positive education gradient of the age at menopause showed the 0.87 year difference in median menopausal age between women having high and low levels of education. Moreover, rural women having the primary/vocational level of education were distinguished from their urban counterparts by a later age at menarche (13.96 and 13.44 years, respectively), earlier age at the first child-birth (21.45 years vs. 25.59 years) and earlier age at the last birth (28.96 years vs. 31.05 years). The multivariate explanatory model of a stepwise multiple regression with forward elimination revealed that the age at menarche and the length of menstrual cycle were significantly associated with the age at menopause. Along with these variables, age at first birth and the number of days of bleeding as well as the urbanization factor contributed to the variation of age at menopause. Conclusions. Age at menarche, peculiarities of menstrual cycle, age of women at first child-birth, also the education and urbanization factors could influence the variation of the age at menopause.Keywords:
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Abstract Objectives Worldwide data on age at menarche suggest a gradually earlier maturation, which is stabilizing in some societies. The interplay between socioeconomic, behavioral, and environmental factors generates uncertainty about the current status and future trend of age at menarche in most societies. Therefore, we aimed to describe trends in age at menarche during the 20th century in Portugal. Methods A sample of 11 274 women born between 1920 and 1992 in northern Portugal, recruited to participate in three population‐based cohorts (EPIPorto, EPITeen, and Generation XXI) was evaluated. Age at menarche across birth year categories was compared using ANOVA and the rate of change over time using linear regression. Results Age at menarche decreased with birth year (−31.1 days per 5 years; β = −.017, P < .001), women born before 1930 having a significantly higher age at menarche than those who were born after 1990 (mean (SD) = 13.1 (1.83) vs 12.0 (1.25), P < .001). Conclusions The decrease in age at menarche in northern Portugal suggests that a plateau is yet to be reached. Attention to time trends in age at menarche is relevant for health promotion since there is a possible relationship between pubertal timing and the later development of the metabolic syndrome.
Menarche
Secular Variation
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Objective
To analyze the effects of different menarche ages on women’s natural menopausal age and perimenopausal syndrome.
Methods
A multistage cluster random sampling method was used to study the cross-sectional survey between 40 and 55 years old women living in Gansu province for more than one year from March to November in 2016.
Results
A total of 8 500 people were surveyed and eventually included in the analysis of 7 236 people. There were 461 cases (6.4%) at the menarche age ≤12 years old, 2 335 cases (32.3%) at the menarche age 13-14 years old, 2 838 cases (39.2%) at the menarche age 15-16 years old, and 1 602 cases (22.1%) at the menarche age ≥17 years old. A total of 1 673 cases of female menopause, the average age of menopause was (47.9±3.3) years old. Univariate ANOVA analysis showed statistically significant differences among groups (F=12.741, P=0.000). Multivariate Cox regression analysis showed that earlier menarche age was the risk factor for menopausal age. With the increased age of menarche, the rate of perimenopausal syndrome increased, and the incidence of moderate and severe perimenopausal syndrome increased (P=0.000). Multivariate logistic regression analysis showed that the menarche age was not associated with the severity of perimenopausal syndrome.
Conclusion
In Gansu province, women with earlier menarche age may be earlier menopause; with the age of menarche increased, the incidence of perimenopausal syndrome increased. The age of menarche had no correlation with the severity of perimenopausal syndrome.
Key words:
Age at menarche; Age at menopause; Perimenopausal syndrome; Cross-sectional study
Menarche
Cross-sectional study
Univariate analysis
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Background: Several aspects of living conditions and behaviour may influence the age at menarche.Aim. The present study investigated the relation of variables concerning the reproductive period and the socio-economic conditions on the recalled age at menarche of rural Portuguese women, born in the first half of the 20th century.Subjects and method: Recalled menarche age of a sample of 771 adult women over 44 years old, from a rural municipality (Oleiros) in central Portugal was analysed.Results: The mean menarcheal age was 14.34±1.98 years. Menarcheal age increased significantly with the chronological age and age at marriage, and was negatively correlated with the duration of the period between menarche and marriage and with the biological reproductive span. The mean menarcheal age was lower (13.59±1.95 years) in women with an order of birth ≥7 than in those of birth order ≤3 (14.41±2.16 years). The mean menarcheal age was lower in women with a surname (14.26±1.91) than in those without it (14.81±2.28). Child labour began at the age of 11.87±32.72 years. Women subject to early child labour had delayed menarches (14.53±2.18) when compared with women who had not worked before 17 years old (14.03±1.91). The menarcheal age varied with the birth decade, decreasing from 14.64±2.61 (1910s) to 13.98±1.46 (1950s).Conclusion: The variation of age at menarche was related to changes in family behaviour towards children, reduction of age at child labour and increasing access to schools. The secular decrease in menarcheal age from 1910 to 1980 was related to living condition factors such as illiteracy, female life expectancy and infant mortality rates.
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Menstruation
Age groups
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The mean age of the menopause by probit analysis in a group of apparently healthy Australian women was 50.4 years. No relationship was found between this value and the age of the menarche or the number of children born or the age at the time of birth of the first child. The mean duration of the menstruating life was 26 3 years with a range of from 17 to 44 years.
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Menstruation
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Mean age of menopause of 744 Whites and 1319 Bantu with differing rates of cancer of the uterus were compared in a survey of the Johannesburg hospital patients. For the former group the mean age was 51.44 while for the latter it was 50.70. The difference was significant at the 5% level. Another survey of 4838 Bantu urban school girls was made to establish whether nutrition affects the mean age at menarche. The two groups of poor versus average nutritional status did not significantly differ in terms of the mean age of the menarche.
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Bantu languages
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In Brief Objective: To study the reproducibility of self-reported age at natural menopause, reported by women in their 70s, compared with menopause age reported in the initial postmenopausal period. Design: A prospective study conducted in Göteborg, Sweden, based on a random sample of the total female population, started in 1968-1969, with follow ups in 1974-1975, 1980-1981, and 1992-1993. A total of 1,009 women born in 1922, 1918, or 1914 (participation rate 90.3%), representative of women of the respective ages in the general population, participated in the initial examination in 1968-1969. Of those women reporting natural menopause some time between 1968 and 1981, 565 women recalled their menopause age in 1992. Results: The mean interval between the first and second reports was 18.3 years. The mean difference between first-reported and recalled menopause was 0.05 years. When menopause age was recalled in 1992-1993, 55.6% of the women with a natural menopause recalled their age at menopause correctly within 1 year, 22.6% underestimated their menopause age by more than 1 year, and 21.8% overestimated their menopause age by more than 1 year. Women undergoing early menopause (<45 years) tended to overestimate menopause age, whereas women undergoing late menopause (>55 years) tended to underestimate menopause age. These differences could not be explained by age, interval since menopause, smoking, exercise, education, or socioeconomic status. Conclusions: Menopause ages reported at an interval of almost 20 years showed a significant correlation. However, a regression tendency of the values toward the mean was observed, suggesting that strong correlation at the group level does not imply precision at the extremes. In this prospective population study of women in Gothenburg, Sweden, menopause ages reported at an interval of almost 20 years showed a significant correlation. The reproducibility of initially reported menopause age was acceptable at ages 70 to 78 years, but women with early and late menopause ages were likely to recall values closer to the mean. This is of potential importance in risk assessments on the individual level (ie, screening studies involving self-reported menopause age in relation to different endpoints such as breast cancer, cardiovascular disease, and osteoporosis).
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he most important event in the whole process of female puberty is the onset of cyclic menses (menarche). The age of the menarche varies in different part of the world and is known to be influenced by genetic, socio-economic status, and environmental conditions, body status and level of education,1 age at menarche was first calculated in mid 19th century in Denmark,2 since then, many authors have used different methods to calculate age at menarche in different parts of the world. Since age of menarche is an important factor in health planning, we reported here the distribution of age at menarche among Jordanian students and compare it to Jordanian women who was born 40 years ago, to look for secular trend on any difference between menarche age now and 20 years ago. Female university students and their female relatives were haphazardly invited from first of June until 30th December 2001 to participate in this study. The student population of the 3 major universities; University of Jordan, Jordan University of Science and Technology and Yarmouk University, Jordan roughly represent the population in Jordan with the exception of the age. The system for university admissions provides allocation for each district according to its population density, and all socio-economic stratum are represented. Those who participated in the study, filled in a self-administered questionnaire that includes date of birth and date of the first menstrual period. We chose only girls who were between 18 and 24 years of age, (born between 1977 1983). For comparison, we also chose women above 40 years of age born before 1960, to find out if there is any T difference at age of menarche between both group. In this study, 1823 girls aged between 18 24 (born between 1977 1983) responded to the questionnaire. The mean age of menarche for these girls was 13.79 ± 1.23 years. Minimum age of menarche was 9 years old and maximum age was 17 years old, only 0.1% having their menarche at age of 9 years and 1.2% having at age of 17 years, approximately 60% of this group having their menarche at the age of 13 and 14 years (Table 1). Seven hundred eighty-nine women with the age of 40 years and above, has the mean menarche age of 13.64 ± 1.32 years and a menarche age of 10-17 years. Only 0.9% having their menarche age at 10 years and 2% at age of 17 years, and approximately 60% at age of 13 and 14 years (Table 1). These results was not statistically significant and indicating that there are no change in menarche age in Jordanian girls now and 20 years ago. The calculated age at menarche in this study is comparable to the age at menarche reported on countries of similar culture and geographical location.3-5 However, it is higher than the age at menarche reported from European and North American societies. The age at menarche for the 2 groups is not different, indicating that there is a trend toward a decrease in the age at menarche in the last few decades. The sampling procedure allow some bias to occur. The invited haphazard participation allows bias due to non-responders. In the second group, a bias due to recall could occur due to a longer period. The aim of this study was to determine the average age at menarche in Jordan, which is an important issue in school health planning among females. The presence of a decreasing trend with time is an important observation that require periodic revision of health plan. However, this was not demonstrated in this study.
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Menstruation
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In Brief Objective: The objective of this study was to examine in an observational, cross-sectional, community-based study the secular trend of age at menopause among women in a rural Chuvashian population and to identify factors associated with age at menopause. Design: The sample included 316 postmenopausal women born between 1920 and 1950 with mean age at menopause of 48.47 ± 4.63 (34-58) years. Statistical analyses included simple and multiple linear regression and "whiskers" plots. Results: Significant association was found between year of birth and age at menopause (β = 0.194, P < 0.001) and reproduction period (β = 0.193, P < 0.001). Mean values of age at menopause increased from 47.0 years (born during 1920-1925) to maximal values of 49.7 years (born during 1940-1945) and 49.3 years (born during 1945-1950). Mean values of their reproductive period increased from 30.7 (born during 1920-1925) to maximal values of 34.1 (born during 1940-1945) and to 33.7 (born during 1945-1950). Multiple linear regression analysis demonstrated that year of birth was the only statistically significant (β = 0.19, P < 0.01) predictor of age at menopause. Age at menarche can also be a possible predictor of age at menopause (β = −0.12, P = 0.04). Conclusions: The study confirmed certain secular trends of age at menopause and reproductive periods in Chuvashian women. The authors also observed a negative association between age at menarche and age at menopause. The number of children and medical abortions as well as body mass index showed no association with age at menopause. The present study shows an increasing trend of age at menopause and reproductive period in Chuvashian women born between 1920 and 1950. A negative association between age at menarche and age at menopause was also observed.
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Objective
To describe and analyse the trend in age at menarche and menopause of women who have attended the breast cancer-screening program in the Valencian Community (VC) from 1992 to 2009 (born between 1927 and 1964).Materials and Methods
Between 1992 and 2009, a retrospective cohort of participants in a population-based breast cancer-screening program in the VC was assessed. The study population was 695 313 women, 45–69 years. Trends in menarche and menopause aged by educational level (EL), nationality and territory by born cohorts were analysed. A regression analysis by the Joint-Point for the tendency was calculated.Results
The age of menarche is earlier every cohort, 13.31 years (1927–1929) 12.59 years (1960–1964) (p<0.00001) by EL, mean 12 997 low EL vs 12 492 university EL (p<0001), being Spanish 12 722 vs 13 076 (p<0.0001) and living in urban area (12 717 vs 12 788) (p<0.0001). While these differences were very marked at the beginning of the period under study these being reduced in the last cohort. Joint point regression analysis shows significant differences in trend by varibles analysed. The age of natural menopause was 49.262 years in the 1927–1929 cohort, and 49.866 years in 1945–1949 (p<0.0001). Women with a low EL have an average age of menopause earlier than women of higher EL (49.531 vs 49.822) (p<0.001). Regression analysis of the trend shows that the delay was more pronounced for women with no education and primary studies (p<0.0001).Conclusions
Menarche has advanced age and menopause is delayed, making broader reproductive cycles exist and different by the social variables studied.Menarche
Menstrual period
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