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Menstrual Cycle Characteristics in Adolescence and Early Adulthood Are Associated With Risk of Early Natural Menopause.


ABSTRACT:

Context

Early natural menopause (i.e., before age 45 years) is associated with increased risk of adverse outcomes. Associations of earlier menopause with younger age at menarche and short and/or regular cycle length are suggested, but study findings are inconsistent and few address early menopause risk.

Objective

To evaluate the relationship between menstrual cycle characteristics in early life with incident early natural menopause.

Design

The prospective Nurses' Health Study 2 (1989 to 2011).

Setting and participants

Women ages 25 to 42 years and premenopausal in 1989 (N = 108,811).

Main outcome measure(s)

Risk of early natural menopause not due to surgery, radiation, or chemotherapy (n = 2794) was evaluated with Cox proportional hazards models. Anti-Müllerian hormone (AMH) levels were considered in a nested case-control sample (n = 820).

Results

In adjusted models, risk was associated with earlier age at menarche (P for trend = 0.05), shorter (P for trend < 0.0001), and more-regular cycles (P for < 0.0001). The hazard ratio (HR) for women with age at menarche ?9 (vs. 12) years was 1.28 (95% CI, 0.99 to 1.67). Women reporting usual menstrual cycle lengths <25 days at ages 18 to 22 years had substantially higher risk of early menopause (HR, 1.70; 95% CI, 1.47 to 1.96) than women with 26- to 31-day cycles, whereas women with ?40 day cycles had lower risk (HR, 0.44; 95% CI, 0.34 to 0.58). Women with irregular cycle length had lower risk compared with women with regular cycles (HR, 0.51; 95% CI, 0.43 to 0.60). Associations with AMH concentrations among the nested case-control subset were consistent with these findings.

Conclusion

Results from this large prospective study of early menopause suggest an influence of accelerated oocyte depletion on risk and may help clarify the etiology of early menopause.

SUBMITTER: Whitcomb BW 

PROVIDER: S-EPMC6179161 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Menstrual Cycle Characteristics in Adolescence and Early Adulthood Are Associated With Risk of Early Natural Menopause.

Whitcomb Brian W BW   Purdue-Smithe Alexandra A   Hankinson Susan E SE   Manson JoAnn E JE   Rosner Bernard A BA   Bertone-Johnson Elizabeth R ER  

The Journal of clinical endocrinology and metabolism 20181001 10


<h4>Context</h4>Early natural menopause (i.e., before age 45 years) is associated with increased risk of adverse outcomes. Associations of earlier menopause with younger age at menarche and short and/or regular cycle length are suggested, but study findings are inconsistent and few address early menopause risk.<h4>Objective</h4>To evaluate the relationship between menstrual cycle characteristics in early life with incident early natural menopause.<h4>Design</h4>The prospective Nurses' Health Stu  ...[more]

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