title: Age at natural menopause in three central and eastern European urban populations: the HAPIEE study.
abstract: OBJECTIVE
  To investigate the age at menopause in three urban populations in Central and Eastern Europe and to assess whether the (suspected) differences can be explained by a range of socioeconomic, reproductive and behavioural factors.
  
  
  METHODS
  The Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) Study examined random samples of populations aged 45-69 years in Novosibirsk (Russia), Krakow (Poland) and six Czech towns. Participants completed a questionnaire and attended an examination in clinic. A total of 12,676 of women were included in these analyses.
  
  
  RESULTS
  The median age at menopause was 50 years in Novosibirsk, 51 years in Czech towns and 52 years in Krakow; the Cox regression hazard ratios of menopause, compared with Krakow, were 1.47 (95% CI 1.40-1.55) for Novosibirsk and 1.10 (1.04-1.16) for Czech women. In multivariate analyses, higher education, using vitamin and mineral supplements and ever use of oral contraceptives were associated with later menopause, while smoking, abstaining from alcohol and low physical activity were associated with earlier menopause. These factors, however, did not explain the differences between populations; the multivariate hazard ratios of menopause, compared with Krakow, were 1.48 (1.40-1.57) for Novosibirsk and 1.11 (1.05-1.17) for Czech women.
  
  
  CONCLUSIONS
  In this large population based study, differences in age at menopause between Central and Eastern Europe populations were substantial and unexplained by a range of risk factors. Associations of age at menopause with risk factors were largely consistent with studies in other populations.
authors.affiliation: Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland. mxbiela@cyf-kr.edu.pl
authors.forename: U
authors.initials: U
authors.lastname: Stepaniak
authors.forename: K
authors.initials: K
authors.lastname: Szafraniec
authors.forename: R
authors.initials: R
authors.lastname: Kubinova
authors.forename: S
authors.initials: S
authors.lastname: Malyutina
authors.forename: A
authors.initials: A
authors.lastname: Peasey
authors.forename: H
authors.initials: H
authors.lastname: Pikhart
authors.forename: A
authors.initials: A
authors.lastname: Pająk
authors.forename: M
authors.initials: M
authors.lastname: Bobak
mesh_terms: D000375:Aging / Q000502:physiology*; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data