title: Age at natural menopause and mortality.
abstract: OBJECTIVE
  The purpose of this study was to examine the association between age at menopause and mortality in a population-based sample of women in the United States.
  
  
  METHODS
  This study was based on data from the National Health and Examination Survey (NHANES) Epidemiologic Follow-up Study; 3191 women aged 50-86 years were included. There were 345 deaths over a mean follow-up time of 4.0 years. We used age-stratified and Poisson regression procedures to assess mortality risk by age at natural menopause, with adjustment for age, duration of follow-up, race, education, smoking, and use of hormone replacement therapy. We conducted a separate analysis for surgical menopause with bilateral oophorectomy.
  
  
  RESULTS
  Compared with women who were menstruating to age 50 or later, the adjusted mortality rate ratios (RR) were 1.50 (95% confidence interval (CI), 0.97-2.34) for women with a natural menopause at age < 40, 1.04 (95% CI, 0.72-1.51) for those with menopause at age 40-44, and 0.96 (95% CI, 0.72-1.26) for those with menopause at age 45-49. Women with a natural menopause at age 40-44 years experienced an increased risk of cancer-related mortality (adjusted RR 2.34, 95% CI, 1.20-4.58). No age-related increased mortality risk was seen among women who had surgical menopause with bilateral oophorectomy.
  
  
  CONCLUSIONS
  This study provides some support for the concept that age at natural menopause serves as a biological marker of health and aging, with potential implications extending beyond cardiovascular diseases.
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA.
authors.forename: G S
authors.initials: GS
authors.lastname: Cooper
authors.forename: D P
authors.initials: DP
authors.lastname: Sandler
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002561:Cerebrovascular Disorders / Q000401:mortality; D003327:Coronary Disease / Q000401:mortality; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D009026:Mortality; D009369:Neoplasms / Q000401:mortality; D016012:Poisson Distribution; D018709:Statistics, Nonparametric; D014481:United States