title: Cross-sectional study of determinants of menopausal age and hormone replacement therapy use in Italian women.
abstract: OBJECTIVE
  The aim of the study was to analyze determinants of age at menopause and hormone replacement therapy (HRT) use. Women included were identified in a large cross-sectional study into epidemiology of the menopause among a sample of women visiting their general practitioners, conducted in Italy.
  
  
  METHODS
  Eligible women were identified among consecutive patients, aged 44-66 years, who visited their general practitioner for a general health check-up during the period May-November 1997. A total of 16,916 postmenopausal women were identified by 1123 general practitioners.
  
  
  RESULTS
  Overall, the mean age at menopause was 50.2 (SD 3.8) years. Ever-married women reported a slightly higher age at spontaneous menopause than that of never-married women. The finding was significant, but the difference was small. Smoking women reported a younger age at menopause. No clear association emerged between age at menopause, physical activity and body mass index (BMI). A total of 3515 women (20.8%) reported HRT ever-use; the mean duration of use was 3.6 years. HRT use was more frequent among women of higher socioeconomic status, those with a lower BMI and smokers. In particular, in comparison with women reporting a BMI of < 25 kg/m2, the odds ratio (OR) of HRT use was 0.7 (95% confidence interval (CI) 0.7-0.8) and 0.5 (95% CI 0.4-0.6), respectively, in women with a BMI of 25-28 kg/m2 and > or = 29 kg/m2. No association emerged between alcohol consumption, level of physical activity and HRT use. Diabetic women reported HRT use less frequently than non-diabetic women. Likewise, hypertensive women, and those with a history of cardiovascular disease, were less likely to be HRT users than those not reporting these conditions. Women with a diagnosis of osteoporosis/osteopenia reported HRT use more frequently.
  
  
  CONCLUSIONS
  This study, using a large dataset from an Italian population, has confirmed that smoking is related to age at menopause. It has also demonstrated that HRT is more frequently used by women of higher socioeconomic status, those with low BMI and smokers. Diabetes is associated with less frequent use of HRT; conversely, osteoporosis/osteopenia is associated with more frequent HRT use.
authors.affiliation: Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, 20157 Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Amigoni
authors.forename: P
authors.initials: P
authors.lastname: Morelli
authors.forename: L
authors.initials: L
authors.lastname: Chatenoud
authors.forename: F
authors.initials: F
authors.lastname: Parazzini
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D017533:Marital Status; D008593:Menopause; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology; D012959:Socioeconomic Factors; D013997:Time Factors