Age at menopause and determinants of hysterectomy and menopause in a multi-ethnic community: the Hilo Women's Health Study.
OBJECTIVE
A lifespan approach was used to evaluate age at menopause, and determinants of surgical and natural menopause, in the multi-ethnic community of Hilo, Hawaii.


METHODS
Participants aged 40-60 years (n=898) were drawn from a larger, randomly generated sample recruited by postal questionnaires. Median age at natural menopause was computed by probit analysis. Logistic regression analysis was applied to examine determinants of hysterectomy, and Cox regression analysis was used to examine risk factors for an earlier age at menopause.


METHODS
History of hysterectomy, age at menopause.


RESULTS
Frequency of hysterectomy was 19.2% at a mean age of 40.5 years. The likelihood of hysterectomy increased with older ages, lower education, mixed ancestry, having been overweight at age 30, and married 20 years prior to survey. Median age at natural menopause was 53.0 years. Smoking and not being married 10 years before survey were associated with an earlier age at menopause.


CONCLUSIONS
Median age at menopause was later than the national average. Ethnicity and education were determinants of hysterectomy, but not associated with age at natural menopause. Events later in the lifespan (e.g., smoking and not being married 10 years prior to the survey) were more important than earlier events (e.g., childhood residence) in relation to age at menopause. The timing of weight gain and marital status appear to be important in relation to surgical menopause, and the timing of marital status appears to be important in relation to the timing of natural menopause.
Department of Anthropology, UMass Amherst, Amherst, MA 01003, USA. Electronic address: leidy@anthro.umass.edu.
Lynnette Leidy
LL
Sievert
Lorna
L
Murphy
Lynn A
LA
Morrison
Angela M
AM
Reza
Daniel E
DE
Brown
D000328:Adult; D000367:Age Factors; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006254:Hawaii; D006801:Humans; D007044:Hysterectomy; D016015:Logistic Models; D017533:Marital Status; D008593:Menopause / Q000208:ethnology; D008594:Menopause, Premature; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D015430:Weight Gain; D016387:Women's Health
Age at menopause; BMI; Ethnicity; Hawaii; Hysterectomy; Smoking