title: Menopause in women with type 1 diabetes.
abstract: OBJECTIVE
  Our objective was to study age at menopause and the factors associated with it in a large population-based group of Finnish women with childhood-onset type 1 diabetes.
  
  
  METHODS
  We contacted a sample of 978 women with type 1 diabetes and mailed them a questionnaire on their gynecological and reproductive histories, diabetes and its management, other diseases, and lifestyle factors. The questionnaire survey was repeated 3 years later among those 641 who responded in the first round and were eligible to take part. Both cross-sectional and retrospective epidemiological cohort study designs were applied to study factors associated with the occurrence of menopause.
  
  
  RESULTS
  The median age at cessation of menstruation observed in women with type 1 diabetes was 52.5 years, not lower than that of the general Finnish population (median, 51 y). Women with end-stage renal disease (prevalence ratio, 2.22; 95% CI, 1.22-4.02; P = 0.009) or proliferative retinopathy (prevalence ratio, 1.89; 95% CI, 1.11-3.21; P = 0.02) were more likely than others to have entered menopause by the time of the study. Both associations remained statistically significant after age adjustment.
  
  
  CONCLUSIONS
  Age at menopause in women with type 1 diabetes is not lower than that in the general population in Finland. The only statistically significant factors independently associated with earlier menopause in our study were microvascular complications, that is, end-stage renal disease and proliferative retinopathy.
authors.affiliation: Hjelt-institute, Department of Public Health, University of Helsinki, Helsinki, Finland. lena.sjoberg@helsinki.fi
authors.forename: Lena
authors.initials: L
authors.lastname: Sjöberg
authors.forename: Janne
authors.initials: J
authors.lastname: Pitkäniemi
authors.forename: Valma
authors.initials: V
authors.lastname: Harjutsalo
authors.forename: Laura
authors.initials: L
authors.lastname: Haapala
authors.forename: Aila
authors.initials: A
authors.lastname: Tiitinen
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: Risto
authors.initials: R
authors.lastname: Kaaja
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000209:etiology; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008593:Menopause; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires