The age at the final menstrual period holds intrinsic clinical and public health interest
because the age at which natural menopause occurs may be a marker of aging and health.
1
,
2
,
3
Later age at natural menopause has been associated with:
- •longer overall survival and greater life expectancy4and reduced all-cause mortality5;
- •reduced risk of cardiovascular disease4,6,7,8,9,10,11and mortality from cardiovascular12and ischemic heart disease,13stroke,14angina after myocardial infarction,15and atherosclerosis16;
- •less loss of bone density,17and a reduced risk of osteoporosis18and fracture19;
- •but an increased risk of breast,20,21endometrial, and ovarian4,22,23,24,25cancers.
26
However, women who underwent natural menopause before age 45 years had an increased
risk of ischemic heart disease that was not attenuated by use of hormone therapy.
27
Further, early menopause has been associated with earlier decline in cognitive function.
28
,
29
,
30
Because 40 million women in the United States alone and several hundred million worldwide
31
experienced the menopausal transition between 1990 and 2010 due to the aging of the
baby boomer generation,
32
millions of women are undergoing or have recently undergone the menopause transition,
and the timing of their final natural menstrual periods could have important clinical
and health implications, because one third of women's lives is spent postmenopause.Keywords
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