title: Life course socioeconomic adversity and age at natural menopause  in women from Latin America and the Caribbean.
abstract: OBJECTIVE
  The aim of this study was to assess the association between life course socioeconomic adversity and age at menopause in Latin America and the Caribbean.
  
  
  METHODS
  Data from 4,056 women aged 60 to 79 years randomly selected from seven cities in Latin America and the Caribbean were analyzed. Cox proportional hazards models were used to estimate the probability of age at menopause by indicators of life course socioeconomic adversity.
  
  
  RESULTS
  Median age at menopause was 50 years. The following life course socioeonomic indicators were associated with earlier age at menopause: low education (hazard ratio [HR], 1.16; 95% CI, 1.07-1.26) and manual occupation/housewives (HR, 1.12; 95% CI, 1.03-1.20). Other factors associated with earlier age at menopause were current smoking (HR, 1.14; 95% CI, 1.03-1.27), nulliparity (HR, 1.14; 95% CI, 1.02-1.28), and multiparity (five children or more; HR, 1.15; 95% CI, 1.06-1.24). There was a cumulative effect of socioeconomic adversities across the life course. The median age at menopause was lower for women with six indicators of life course socioeconomic adversity compared with women with no adversities (HR, 1.40; 95% CI, 1.10-1.77).
  
  
  CONCLUSIONS
  Median age at menopause occurs several years earlier in women from Latin America and the Caribbean compared with women from high-income countries. The results support the association between life course socioeconomic adversity and age at menopause.
authors.affiliation: Département de médecine sociale et préventive, Université de Montréal, Montréal, Québec, Canada. mdp.velez.gomez@umontreal.ca
authors.forename: Maria P
authors.initials: MP
authors.lastname: Vélez
authors.forename: Beatriz
authors.initials: B
authors.lastname: Alvarado
authors.forename: Catherine
authors.initials: C
authors.lastname: Lord
authors.forename: Maria-Victoria
authors.initials: MV
authors.lastname: Zunzunegui
mesh_terms: D017677:Age Distribution; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D017691:Caribbean Region / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008019:Life Style; D008593:Menopause / Q000208:ethnology*; D008875:Middle Aged; D011203:Poverty; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D016387:Women's Health / Q000208:ethnology*