Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents

Danielle A. J. M. Schoenaker*, Caroline A Jackson, Jemma V. Rowlands, Gita D. Mishra

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Age at natural menopause (ANM) is considered a marker of biological ageing and is increasingly recognized as a sentinel for chronic disease risk in later life. Socioeconomic position (SEP) and lifestyle factors are thought to be associated with ANM.

Methods: We performed a systematic review and meta-analyses to determine the overall mean ANM, and the effect of SEP and lifestyle factors on ANM by calculating the weighted mean difference (WMD) and pooling adjusted hazard ratios. We explored heterogeneity using meta-regression and also included unpublished findings from the Australian Longitudinal Study on Women's Health.

Results: We identified 46 studies across 24 countries. Mean ANM was 48.8 years [95% confidence interval (CI): 48.3, 49.2], with between-study heterogeneity partly explained by geographical region. ANM was lowest among African, Latin American, Asian and Middle Eastern countries and highest in Europe and Australia, followed by the USA. Education was associated with later ANM (WMD middle vs low education 0.30, 95% CI: 0.10, 0.51; high vs low education 0.64, 95% CI 0.26, 1.02). A similar dose-response relationship was also observed for occupation. Smoking was associated with a 1-year reduction of ANM (WMD: -0.91, 95% CI: -1.34, -0.48). Being overweight and moderate/high physical activity were modestly associated with later ANM, but findings were less conclusive.

Conclusions: ANM varies across populations, partly due to differences across geographical regions. SEP and some lifestyle factors are associated with ANM, but further research is needed to examine the impact of the associations between risk factors and ANM on future health outcomes.

Original languageEnglish
Pages (from-to)1542-1562
Number of pages21
JournalInternational Journal of Epidemiology
Volume43
Issue number5
Early online date26 Apr 2014
DOIs
Publication statusPublished - 1 Oct 2014

Keywords

  • Menopause
  • smoking
  • body mass index
  • physical activity
  • socioeconomic factors
  • systematic review
  • meta-analysis
  • CAUSE-SPECIFIC MORTALITY
  • BODY-MASS INDEX
  • WOMENS HEALTH
  • INTERNATIONAL VARIABILITY
  • PREDICTIVE FACTORS
  • JAPANESE WOMEN
  • OVARIAN-CANCER
  • CHINESE WOMEN
  • SMOKING
  • COHORT

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