Since menopause symptoms can significantly affect a woman’s quality of life, much research has focused on identifying risk factors associated with menopause symptoms. A new study suggests that menstrual-cycle length may predict the severity of menopause symptoms, as well as the age at menopause. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).
The menopause transition is often accompanied by symptoms such as hot flashes, depression and anxiety, cognitive changes, and disturbances of sleep duration and quality. Traditional risk factors for menopause symptoms include demographic (age and ethnicity) and several modifiable lifestyle factors such as body mass index (BMI), smoking, and physical activity.
Emerging data suggest that reproductive traits and conditions during reproductive age may be associated with menopause symptoms, although study results are contradictory. For example, compared with postmenopausal women with regular menstrual-cycle lengths, a history of irregular cycles was associated with reduced late-life depressive symptoms in Chinese and higher severe depressive symptoms in French postmenopausal women.
Researchers in this new study involving more than 600 women sought to investigate the extent to which self-reported menstrual-cycle length during the reproductive years is associated with menopause symptoms in midlife women. Compared with women with normal menstrual-cycle length (26-34 days), those with short menstrual cycles (<25 days) during their reproductive years had a higher frequency of total menopause symptoms as well as certain menopause symptoms at midlife and reached menopause earlier. Specifically, women with short menstrual cycles had higher odds of midlife sleep problems, heart discomfort, and depressive symptoms. In addition, these same women had higher prepregnancy BMI.
Because of the limited literature on this topic, the researchers suggest that further studies are warranted, especially studies that separately evaluate women with usual cycle lengths of fewer than 21 days.
Objective: The aim of this study was to investigate the extent to which self-reported menstrual cycle length during reproductive years is associated with menopausal symptoms and age at natural menopause at midlife.
Methods: This analysis includes 634 women who enrolled in Project Viva during pregnancy (1999-2002) and completed the midlife visit approximately 18 years later. Women self-reported menstrual cycle length at enrollment (early pregnancy) and at midlife reported total and specific menopausal symptoms using the Menopause Rating Scale as well as age at natural menopause. We used linear and regression models to evaluate associations of cycle length with total and specific menopausal symptoms. We also applied a time-to-event Cox proportional hazards model to investigate the relationship between menstrual cycle length and onset of natural menopause. We adjusted models for age at midlife visit, prepregnancy body mass index, race/ethnicity, education, and parity.
Results: At enrollment (median age, 33.3 years), 90 (14%) women reported having short (≤25 days) and 39 (6%) reported long (≥35 days) menstrual cycles. Compared with women with a normal menstrual cycle length of 26 to 34 days, women whose cycles were short had a higher total Menopause Rating Scale at midlife ( β = 2.05; 95% confidence interval [CI], 0.73-3.38). Specifically, women with short menstrual cycles during their reproductive years had higher odds of midlife sleep problems (odds ratio [OR], 1.92; 95% CI, 1.10-3.37), heart discomfort (OR, 1.68; 95% CI, 1.03-2.73), and depressive symptoms (OR, 1.85; 95% CI, 1.16-2.96). In addition, compared with women with a normal cycle length of 26 to 34 days, women reporting short cycles had an earlier onset of natural menopause (hazard ratio, 1.67; 95% CI, 1.11-2.51).
Conclusions: Compared with women with normal menstrual cycle length, those with short menstrual cycles during their reproductive years had a higher frequency of total and certain menopausal symptoms at midlife and reached menopause earlier.
Lidia Mínguez-Alarcón, Sheryl L Rifas-Shiman, Diana C Soria-Contreras, Marie-France Hivert, Jan Shifren, Emily Oken, Jorge E Chavarro. Self-reported menstrual cycle length during reproductive years in relation to menopausal symptoms at midlife in Project Viva Menopause 2022 Oct 1;29(10):1130-1136. doi: 10.1097/GME.0000000000002042. Epub 2022 Aug 23.
Content updated 31 August 2022