27 April, 2020
Summary
Using data from women who were 45 – 50 years old in 1996 followed through the Australian Longitudinal Study of Women’s Health (ALSWH) [1]. Xu et al. studied the association between age at natural menopause and the burden of chronic disease assessed by prevalence in 2010 and incidence from 2010 through 2016 [2]. Participants provided data at 3-year intervals in the ALSWH. After exclusions for missing eligibility data, and loss to follow-up prior to 2010, 11258 women were available for the study. Of those, 4196 were excluded for surgical menopause, and 1420 were excluded for missing outcome data, leaving 5107 women for analysis. Age at natural menopause (ANM) was categorized as < or = 40, 41-45, 46-49, 50-51, 52-53 and > or = 54 years. Premature menopause was defined as natural menopause at the age of < or = 40, and the prevalence was 2.3% (N=119). Multi-morbidity was defined as the occurrence of 2 or more of the following chronic conditions: diabetes, hypertension, heart disease, stroke, arthritis, osteoporosis, asthma, chronic obstructive pulmonary disease, depression, anxiety and breast cancer. Using ANM of 50-51 as the reference group, women with premature menopause had a crude Odds Ratio (OR) for the prevalence of multimorbidity of 3.57; 95% CI 1.39 – 9.19 that was reduced to 1.98; 95% CI 1.31 – 2.98, after adjusting for a variety of confounders including parity, education, BMI, physical activity, smoking status and ever use of menopausal hormone therapy (MHT). In the adjusted model, the OR for the incidence of multimorbidity during the 6-year follow-up was 3.03; 95% CI 1.62 – 5.64 in women with premature menopause. Of the 11 conditions, women with premature menopause had significant increased risks for diabetes, stroke, osteoporosis and COPD, but not for hypertension, heart disease, arthritis, asthma, depression, anxiety or breast cancer. The association between ANM and multimorbidity was not linear, and significant findings were limited to the women with ANM < or = 40 compared with women having ANM at 50-51 years.
