Early menopause, association with tobacco smoking, coffee consumption and other lifestyle factors: a cross-sectional study (original) (raw)

Alcohol, caffeine and smoking in relation to age at menopause

Maturitas, 2006

Objectives: Exposures which might influence age at natural menopause have been extensively studied but, with the exception of cigarette smoking, results have been inconsistent. We sought to determine: (i) whether alcohol and caffeine intake are associated with age at menopause; (ii) whether the association of cigarette smoking with age at menopause is confined to current smokers. Methods: Analyses drew on longitudinal data from 494 women, aged 44-60 in 1993, of whom 159 experienced menopause before intake or during follow-up. We used parametric logistic survival analysis to estimate shifts in median age at menopause for women who drink alcohol or caffeine or who smoke cigarettes. Results: The estimated median age at menopause was 2.2 (95% confidence interval (CI) 0.5, 3.9) years later for women who drank alcohol 5-7 days/week (13% of the sample) than for women who did not drink alcohol (54%). For women who drank at least 1 day/week, the estimated shift was 1.3 (95% CI 0.2, 2.3) years. Caffeine intake in approximate quartiles of mg/day-0-100, >100-200, >200-400, 400+-was not related to age at menopause. Current smokers of 14+ cigarettes/day (6%) experienced menopause 2.8 (95% CI −4.8, −0.8) years earlier than women who never smoked (51%). Current smokers of 1-13 cigarettes/day (5%) and former smokers (38%) experienced menopause at about the same age as women who never smoked. Conclusions: The results are compatible with a pro-estrogenic effect of moderate alcohol intake and an anti-estrogenic effect of current cigarette smoking of 14+ cigarettes/day.

Current Smoking at Menopause Rather Than Duration Determines the Onset of Natural Menopause

Epidemiology, 2004

Smoking has frequently been associated with early menopause. However, studies of this association have been inconclusive with regard to duration and intensity of smoking. A major problem in analyzing the effect of smoking duration on menopausal age is that both exposure and outcome are age-dependent. Methods: We calculated age-specific rates for categories of smoking duration and subsequently computed the rate ratios for occurrence of menopause. We were thus able to model the effect of smoking duration on 2 time scales without assumptions of linearity. We used data from a Dutch population-based cohort comprising 5544 women age 49 -70 years who had experienced natural menopause. Results: The rate ratio (RR) for occurrence of menopause was increased in women who smoked in the year of menopause (RR ϭ 1.41; 95% confidence interval ϭ 1.32-1.50). The rate ratio of former smokers was similar to women who never smoked (0.95; 0.89 -1.02). Prolonged exposure of smoking did not materially affect the risk of menopause, although the daily number of cigarettes currently smoked could increase the risk. Conclusion: Perimenopausal smoking is apparently more important than smoking history in explaining an earlier age of onset of menopause among women who smoke.

Cigarette smoking and age of menopause: A large prospective study

Maturitas, 2012

Objectives: One of the possible consequences of tobacco consumption is that it contributes to an earlier age of menopause, though the causal relationship is yet to be confirmed. This study aimed to examine the prospective association between smoking and earlier age of menopause in a cohort of middle age Australian women after adjustment for a number of potential confounders. Study design: 21-Year follow-up of a cohort prospective study, Brisbane, Australia. Main outcome measures: Age of menopause measured at the 21-year follow-up. Smoking and menopausal status were assessed by self-report. Other covariates were measured prospectively in the previous followups.

Does menopause start earlier in smokers? Evidence from the Pro-Saude Study

Revista Brasileira De Saude Materno Infantil, 2013

OBJECTIVES: cigarette smoking has been the modifiable risk factor most consistently associated with earlier menopause. This preliminary study based on cross-sectional data aimed to analyze the association between smoking status and age of onset of menopause in a Brazilian population. METHODS: a cross-sectional study was carried out with 1,222 female employees of Rio de Janeiro university campuses aged over 35 years who were at risk of natural menopause. A Cox proportional hazards model was used to investigate the association between smoking status and age at the onset of menopause, adjusting for education, parity and alcohol consumption. RESULTS: current smokers showed a 56% increase in the risk of menopause, being 1.8 years younger at menopause onset compared with women who had never smoked. However, no differences were observed between former smokers and women who had never smoked. The adjusted median age at menopause was 49.5 years for current smokers and 51.3 years for women who had never smoked (p<0.05). CONCLUSIONS: the results suggest a deleterious but potentially reversible effect of smoking on the age of onset of menopause, which should receive greater attention in tobacco control efforts. Longitudinal analyses of this association will be carried out in the future in a follow-up study of this population.

Cigarette Smoking and Risk of Early Natural Menopause

American Journal of Epidemiology

Menopause before 45 years of age affects roughly 5%-10% of women and is associated with a higher risk of adverse health conditions. Although smoking may increase the risk of early menopause, evidence is inconsistent, and data regarding smoking amount, duration, cessation, associated risks, and patterns over time are scant. We analyzed data of 116,429 nurses from the Nurses' Health Study II from 1989 through 2011 and used Cox proportional hazards models to estimate hazard ratios adjusted for confounders. Compared with never-smokers, current smokers (hazard ratio (HR) = 1.90, 95% confidence interval (CI): 1.71, 2.11) and former smokers (HR = 1.10, 95% CI: 1.00, 1.21) showed an increased risk of early menopause. Increased risks were observed among women who reported current smoking for 11-15 pack-years (HR = 1.72, 95% CI: 1.36, 2.18), 16-20 pack-years (HR = 1.72, 95% CI: 1.38, 2.14), and more than 20 pack-years (HR = 2.42, 95% CI: 2.11, 2.77). Elevated risk was observed in former smokers who reported 11-15 pack-years (

The relationship between smoking and age at the menopause: a systematic review

Maturitas, 2008

Context and objective: Increasing life expectancy has made it ever more important to study the factors that influence the age at the menopause, given that when it is reached outside of the normal range, it is associated with increased risk of osteoporosis and cardiovascular diseases, among other conditions. Among the factors studied in relation to early menopause, smoking is prominent. Destruction of the ovarian follicles is one of the mechanisms postulated for this effect. The aim of this study was to review and describe the associations between age at the menopause and the habit of smoking, its duration and its intensity. Method: A systematic review of the literature indexed in the MEDLINE and LILACS databases was conducted, without restriction on publication date. After initially identifying 1325 articles and preselecting 161 articles for consideration of their complete texts, 96 articles reporting on the results from 109 studies were selected for analysis. Results: A great majority of the studies reported an association between the habit of smoking and early menopause, but there was no clear evidence that the duration of smoking and quantity of cigarettes smoked had any association with age at the natural menopause. Conclusion: Additional studies are needed, preferably of prospective nature and with a large number of women, in order to deepen the knowledge of the effects of various aspects of smoking on age at the menopause. Experimental studies on animals may also contribute towards clarifying the physiopathological mechanisms through which smoking influences age at the menopause.

Factors associated with onset of menopause in women aged 45–49

Maturitas, 1994

This paper uses a cross-sectional sample of women aged 45-49 to investigate factors that might be associated with an early menopause. Using logistic regression analysis we found that age, smoking, age of maternal menopause, parity, social class, meat and alcohol consumption were all independently associated with an early natural menopause. Meat, alcohol consumption and maternal menopausal age do not seem to have been previously noted as associated with the timing of the menopause. These associations would merit further study, preferably using prospective data. However, this study in line with much previous work shows that smoking is associated with a reduction in menopausal age.

Factors associated with onset of menopause ln women aged 45-49

This paper uses a cross-sectional sample of women aged 45-49 to investigate factors that might be associated with an early menopause. Using logistic regression analysis we found that age, smoking, age of maternal menopause, parity, social class, meat and alcohol consumption were all independently associated with an early natural menopause. Meat, alcohol consumption and maternal menopausal age do not seem to have been previously noted as associated with the timing of the menopause. These associations would merit further study, preferably using prospective data. However, this study in line with much previous work shows that smoking is associated with a reduction in menopausal age.

[Influence of Selected Reproductive Factors and Smoking on Age at Menopause.]

Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)), 2015

Introduction: Early menopause may be associated with serious health risks resulting from, for example, decreased oestrogen levels. This may occur despite hormone replacement therapy. Aim: The aim of this study was the determination of the effect of selected reproductive factors and smoking on age at the onset of menopause in women from Szczecin and surrounding areas. Material and Methods: 305 women after natural menopause were asked to complete a questionnaire, and blood samples were collected from them to test for the levels of follicle stimulating hormone (FSH) and oestradiol (E2). Results: Smoking women experienced menopause on average more than a year earlier than non-smokers, but this difference was not statistically significant. There was no statistically significant effect of age at menarche or first birth on age at the last menstrual period. Conclusions: Age at menarche and first birth were not related to age at menopause. In smoking women, menopause occurred earlier but the...

Life course exposure to smoke and early menopause and menopausal transition

Menopause, 2015

Objective-Early age at menopause is associated with increased risk of cardiovascular disease, stroke, osteoporosis and all-cause mortality. Cigarette smoke exposure in adulthood is an established risk factor for earlier age at natural menopause and may be related to age at menopausal transition. Using data from two U.S. birth cohorts, we examined the association between smoke exposure at various stages of the life course (prenatal, childhood exposure to parental smoking and adult smoke exposure) with menopause status in 1,001 women aged 39-49 years at follow-up. Methods-We used logistic regression analysis, adjusting for age at follow-up, to estimate odds ratios (ORs) and 95% confidence intervals (CI) relating smoke exposure to natural menopause and menopausal transition. Results-The magnitudes of the associations for natural menopause were similar, but not statistically significant after adjustment for confounders for i) women with prenatal smoke exposure who did not smoke at adult follow-up (OR= 2.7 [95% CI 0.8, 9.4]) and ii) current adult smokers who were not exposed prenatally (OR= 2.8 [95% CI 0.9, 9.0]). Women who had been exposed to prenatal smoke and were current smokers had three times the risk of experiencing natural menopause (adjusted OR=3.4 [95% CI 1.1, 10.3]) compared to women without smoke