Duration of the menopausal transition is longer in women with young age at onset: the multiethnic Study of Women's Health Across the Nation.
The menopausal transition (MT) is a critical period associated with physiologic changes that influence women's long-term health and longevity. Information is, however, limited regarding factors that influence age at the onset of the MT and its duration (ie, time from MT onset to the final menstrual period).



We analyzed data for 1,145 women from four sites of the Study of Women's Health Across the Nation who participated in the menstrual calendar substudy, had the start of the MT identified, and had no missing covariate information. Participants included from four racial/ethnic groups: African American, white, Chinese, and Japanese. Women completed daily menstrual calendars from 1996 to 2006 and questions on hormone therapy use monthly. Baseline measures included education, economic strain, and menstrual cycle characteristics. Annual measures included height, weight, and smoking status. Cox proportional hazards models were used to analyze the data.



The adjusted median duration of the MT ranged from 4.37 years among the oldest age-at-onset quartile to 8.57 years among the youngest age-at-onset quartile (P < 0.001). Cigarette smoking was associated with an earlier onset (P < 0.001) and a shorter duration (P < 0.001). African American women had a longer duration (P = 0.012) than white women. Body mass index was associated with a later onset of the MT (P = 0.001) but not its duration.



The duration of the MT was largely influenced by the age at which it began: earlier onset was associated with a longer transition. This finding provides a strong rationale for developing improved markers of the onset of the early MT.
1Department of Epidemiology 2Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 3Division of Geriatrics, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA 4Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO 5Division of Preventive & Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA 6Department of Public Health Sciences, University of California Davis, Davis, CA 7Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 8Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI.
Pangaja
P
Paramsothy
Siobán D
SD
Harlow
Bin
B
Nan
Gail A
GA
Greendale
Nanette
N
Santoro
Sybil L
SL
Crawford
Ellen B
EB
Gold
Ping G
PG
Tepper
John F
JF
Randolph
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D017668:Age of Onset; D001213:Asian / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008593:Menopause / Q000208:ethnology / Q000502:physiology*; D008597:Menstrual Cycle / Q000502:physiology; D008875:Middle Aged; D013997:Time Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data
Ann N Y Acad Sci. 2010 Mar;1192:66-71
20392219
Obstet Gynecol. 2000 Sep;96(3):351-8
10960625
J Clin Endocrinol Metab. 2012 Apr;97(4):1159-68
22344196
Menopause. 2009 Mar-Apr;16(2):378-84
19057415
Menopause. 2007 Jan-Feb;14(1):74-88
17075433
Fertil Steril. 2013 Jan;99(1):12-17
23273984
Maturitas. 2008 Apr 20;59(4):304-14
18406083
Biometrics. 2011 Dec;67(4):1573-82
21361886
J Clin Endocrinol Metab. 2011 Mar;96(3):746-54
21159842
Int J Obes Relat Metab Disord. 2002 Jul;26(7):883-96
12080440
Hum Reprod Update. 2006 May-Jun;12(3):193-207
16449360
J Bone Miner Res. 2012 Jan;27(1):111-8
21976317
Menopause. 2009 Nov-Dec;16(6):1218-27
19512950
Am J Epidemiol. 2007 Aug 15;166(4):429-38
17557899
Am J Epidemiol. 2012 Jan 1;175(1):74-83
22138039
Maturitas. 2007 Jun 20;57(2):139-53
17307314
Fertil Steril. 2012 Dec;98(6):1400-6
22959451
JAMA Intern Med. 2015 Apr;175(4):531-9
25686030
Br J Obstet Gynaecol. 1992 May;99(5):422-9
1622917
Am J Epidemiol. 1999 Apr 1;149(7):612-20
10192308
J Am Coll Cardiol. 2009 Dec 15;54(25):2366-73
20082925
J Clin Epidemiol. 2004 May;57(5):484-96
15196619
Am J Epidemiol. 2001 Jun 15;153(12):1159-65
11415950
Int J Epidemiol. 2000 Oct;29(5):845-51
11034967
Climacteric. 2007 Apr;10(2):112-9
17453859
Am J Public Health. 2003 Feb;93(2):299-306
12554590
Menopause. 2013 Jul;20(7):727-35
23481122
Contraception. 1988 Aug;38(2):129-56
3048871
Am J Epidemiol. 1998 Jun 1;147(11):1071-80
9620051
Am J Epidemiol. 2001 May 1;153(9):865-74
11323317
Am J Epidemiol. 1997 Jan 15;145(2):124-33
9006309
Arch Gen Psychiatry. 2010 Jun;67(6):598-607
20530009
Maturitas. 1981 Dec;3(3-4):249-64
7334935
Maturitas. 1998 Jun 3;29(2):115-23
9651900
J Clin Endocrinol Metab. 2012 Aug;97(8):2872-80
22659249
Am J Epidemiol. 2013 Jul 1;178(1):70-83
23788671
Menopause. 2010 Jul;17(4):718-26
20216473
Am J Hum Biol. 1992;4(1):37-46
28524413
J Epidemiol Community Health. 2002 Nov;56(11):851-60
12388578
Am J Public Health. 2006 Jul;96(7):1226-35
16735636