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To systematically review the evidence on the association between age at natural menopause (NM) and reproductive factors such as age at menarche, parity and ever use of oral contraceptives.
A literature search was carried out in PubMed, Scielo, Scopus and LILACS databases, without restriction of publication year until July 6, 2017. We excluded clinical trials, case-control studies, case reports and studies using statistical methods other than Cox proportional hazard models to assess the factors associated with age at NM. Cross-sectional studies evaluating women aged <50 years were also excluded. Random-effects models were used
to pool the estimates. We registered the systematic review in the International Prospective Register of Systematic Review (PROSPERO) in August 2018, CRD42018099105. We identified 30 articles to include in the meta-analysis. We found that previous ever use of oral contraceptives (OC) (HR = 0.87, CI = 0.82, 0.93), age at menarche ≥13 years (HR = 0.90, CI = 0.84, 0.96), and having at least one live birth (HR = 0.79, CI =
0.74, 0.85) were associated with a later age of NM. Despite differences in results between countries and study design, our findings suggest that previous use of OC, age at menarche ≥13 and having at least one live birth are associated with later menopause. The results suggest that these factors could be markers of later ovarian aging. Natural menopause is defined as amenorrhea for at least 12 months after the last menstrual period without pathologic or surgical causes [1]. It is common to categorize age at natural menopause into premature (under 40 years) [2], early menopause (between 40 and 44 years) [3], normal menopause (usually between 45 and 55 years) [4] and late menopause (over 55 years) [5]. Premature and early menopause have been shown to increase all-cause mortality [6,7], while later
menopause has been associated with higher life expectancy [5] and also with adverse health outcomes such as an increased risk of breast cancer [8]. Different factors have been associated with the age at presentation of menopause: while smoking and underweight are associated with earlier menopause [9,10], high education is related to later menopause [11]. In addition, there are a few international studies that found associations of age at natural menopause with reproductive factors such as
menarche, parity [12] and use of oral contraceptives [13]. A better managements of determinants affecting age at menopause could prevent adverse outcomes in women's health. To our knowledge there are no pooled analyzes that summarize the evidence on the association of reproductive factors with age at natural menopause. In this study, we carried out a systematic review and meta-analysis on the associations of age at menarche, parity and ever use of oral contraceptives with age
at NM. Section snippetsMethodsWe conducted this review according to the guidelines of PRISMA [14] and Meta-analysis of Observational Studies in Epidemiology [15]. ResultsFig. 1 shows the study selection flow chart. In the literature search, we identified 27790 articles, 11936 from PubMed, 15487 from EMBASE and 367 from LILACS. After removing 6839 duplicated articles, 20951 were reviewed, of which we excluded 20860 due to not including a relevant exposure (n = 18665) or the relevant outcome (n = 597), and 1598 that were clinical trials, case-control, case reports, guidelines and reviews, or articles not fully available. Of the remaining 91 articles, we further DiscussionIn this meta-analysis, we observed that the ever use of oral contraceptives (OC), age at menarche ≥ 13 years and having one or more live births were associated with later age at natural menopause. Regarding OC, this is the first meta-analysis to summarize its association with age at NM. For the other two factors, while there is a previous meta-analysis that analyzed the association of nulliparous and early menarche with premature and early menopause [12], it was solely based on nine studies ContributorsAlejandra Andrea Roman Lay was responsible for study conception and design, analysis and interpretation of data, and drafting the article. Carla Ferreira do Nascimento was responsible for analysis and interpretation of data. Bernardo Lessa Horta was responsible for study design, analysis and interpretation of data. Alexandre Dias Porto Chiavegatto Filho was responsible for study design, analysis and interpretation of data. All authors contributed to revision of the article and approved the final Conflict of interestThe authors declare that they have no conflict of interest. FundingThis work was supported by CONICYT (Chilean National Commission for Scientific and Technological Research) “Becas Chile” Doctoral Fellowship program; Grant N° 72170038. Provenance and peer reviewThis article has undergone peer review. AcknowledgmentsWe acknowledge the assistance of PRO-AIM and SABE study in São Paulo city.
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© 2019 Elsevier B.V. All rights reserved. What are the factors associated with the early onset of natural menopause?Studies show that the onset age of menopause is affected by the age at the first menstrual period, the use of oral contraceptives, the number of pregnancies experienced, Body Mass Index (BMI), smoking, drinking alcoholic beverages, physical activity, blood lead levels and other factors(26,27,28,29,30,31,32,33,34).
What is the earliest onset of menopause?Most women reach menopause between the ages of 45 and 55, with the average age being around 51. However, about one per cent of women experience menopause before the age of 40 years. This is known as premature menopause. Menopause between 41 and 45 years of age is called early menopause.
What factors can cause premature menopause quizlet?What factors can cause premature menopause? Hot flashes are symptoms of the perimenopausal stage.. Sexual arousal.. Stimulation of parasympathetic nerves.. Release of NO (nitric oxide which causes dilation of blood vessels of vagina.. Leak of fluid from blood vessels to vaginal walls.. What factors affect menopause?Studies have shown many factors to affect the age of menopause, such as the mother's age at menopause, the age at menarche, gestational age, use of oral contraceptives, irregular menstrual cycle, number of pregnancies, body mass index, use of tobacco and alcohol, physical activity, unilateral oophorectomy, serum lead ...
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