title: Cross cultural analysis of factors associated with age at natural menopause among Latin-American immigrants to Madrid and their Spanish neighbors.
abstract: OBJECTIVE
  In this study, age at menopause was examined in relation to demographic and life style factors among Latin-American immigrants to Madrid and their Spanish counterparts.
  
  
  METHODS
  Respondents were drawn from the Decisions at Menopause Study (2002-2003) and from a recent sample of Latin-American immigrants to Madrid (2010-2011). The final sample included 484 women after excluding women with induced menopause and use of HT. Probit analyses and Cox proportional hazard models were used to estimate median age at menopause and to identify factors associated with an early age at menopause.
  
  
  RESULTS
  Median estimated age at natural menopause was 52.0 years (51.2-53.0) for Spanish women and 50.5 years (49.9-51.2) for Latin-American women. Immigrant women were more likely to reach menopause at an earlier age after controlling for confounding factors. Nulliparity and lower levels of education were associated with an earlier age at menopause. A higher body mass index was associated with a later age at menopause in the Spanish model. Among the Latin-American sample, women from the Dominican Republic and women who underwent menopause before migrating were more likely to reach menopause at an earlier age.
  
  
  CONCLUSIONS
  The results reported here demonstrate that early life events, including place of birth, and later life events, such as timing of migration, were associated with age at menopause. This study highlights the importance of taking into account differences in the age of onset of menopause in the multicultural population of Madrid when considering the health of women at midlife and beyond.
authors.affiliation: Department of Sociology II (Human Ecology and Population Studies), Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Pérez-Alcalá
authors.forename: Lynnette Leidy
authors.initials: LL
authors.lastname: Sievert
authors.forename: Carla Makhlouf
authors.initials: CM
authors.lastname: Obermeyer
authors.forename: David Sven
authors.initials: DS
authors.lastname: Reher
mesh_terms: D017677:Age Distribution; D003431:Cross-Cultural Comparison; D003710:Demography; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007843:Latin America / Q000208:ethnology; D008019:Life Style; D008593:Menopause / Q000208:ethnology*; D008875:Middle Aged; D012959:Socioeconomic Factors; D013030:Spain; D011795:Surveys and Questionnaires