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IMS Menopause Live

Association of oral contraceptives and tubal ligation with risk of early natural menopause

27 September 2021


Langton et al. [1] have examined the association of oral contraceptive (OC) use and tubal ligation (TL) with natural menopause before the age of 45 years in a population-based study within the prospective Nurses’ Health Study II (NHSII) cohort. Participants were followed from 1989 to 2017 and response rates were 85-90% for each cycle. A total of 106,633 NHSII participants were included who were premenopausal (aged 25-42) at the initiation of the study. The use, duration and type of OC and TL were recorded at the beginning of the study and every 2 years. Menopausal status and age were evaluated every 2 years. Follow-up continued until early menopause, age 45, hysterectomy, oophorectomy, death, cancer diagnosis, or loss to follow-up occurred. Authors used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals adjusted for lifestyle, dietary, and reproductive factors. Over 1.6 million person-years, 2,579 participants of the analytic cohort experienced early natural menopause. In multivariable models, the duration, timing, and type of OC use were not associated with the risk of early menopause. Compared to women who never used OCs, those reporting 120+ months of OC use did not have a significant risk for early menopause (HR 1.01 95% CI: 0.87-1.17; p for trend=0.71). Contrary to this, TL was associated with a modest increased risk of early menopause (HR = 1.17, 95% CI, 1.06-1.28).

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