Lifestyle factors that may influence the age you’ll reach menopause

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Menopause marks the point in time when a woman’s body stops producing and releasing eggs and is, therefore, the time when they stop having periods. Doctors often define the menopause as when a woman has not had any vaginal bleeding for 12 months or more.

Symptoms of menopause, which can start before the menopause and end some years after, vary quite a lot between individuals but may include a change in menstrual cycle (periods cease), hot flushes, night sweats, and mood swings. Some women may also notice headaches, weight gain, vaginal dryness, or a loss of interest in sex. Certain women experience many different menopausal symptoms, whereas others have very few.

The average age of the menopause in the UK is 51 years, with most women going through it between the ages of 49 to 52 years. The average woman now spends over a third of her life (38%) after the menopause, and as such it is an important topic to be aware of.1

In reality, like many other normal physiological processes, there is a wide variety in what is classed as “normal”. In the UK, reaching menopause between the ages of 45 and 55 falls within this category. Interestingly, an association has been found between the age at which a woman goes through the menopause and the age that her mother went through the it.2 While genetics play a big role, there are a number of other factors that can influence this process as well. All these factors result in the natural variety in the age menopause is experienced.

Premature menopause, also known as premature ovarian insufficiency (POI), is when a woman goes through the menopause before the age of 40. It affects about 1% of women and in many individuals a specific cause is not known.3 It is important to speak to your doctor if you believe you are going into early menopause as there are certain factors that need to be reviewed, such as looking at your bone health.4

What influences the age a woman reaches the menopause?

The age at which a woman’s mother and close female relatives naturally reach the menopause is the single biggest predictor of the age a woman should expect to reach the menopause.

Women from certain ethnic groups appear to go through the menopause at slightly different ages. Typically, Hispanic and African-American women reach the menopause a little earlier than their Caucasian counterparts. Chinese and Japanese women on the other hand tend to reach the menopause a little later. Why this is, we do not know.5

Women who smoke are more likely to go through the menopause earlier than non-smokers.6 Therefore, if you smoke and your mother did not, there is a good chance you may go through the menopause at a younger age than she did.

Surgery can also have an effect. Following hysterectomy (removal of the uterus), women tend to reach the menopause slightly earlier than women that still have a uterus, even though their ovaries remain present. A 2011 study found a nearly twofold increase in risk for ovarian failure in women who had had a hysterectomy compared to women who had not.7 The study estimates that 14.8% of women will experience ovarian failure within four years of hysterectomy.8

Cancer treatments often affect the age at which a women reaches the menopause. Chemotherapy drugs are designed to damage and kill rapidly growing cells. Unfortunately, this results in damage to healthy cells, too. As a result, many women go through a temporary menopause whilst having chemotherapy. For some, their cycles may return following treatment, however, in some they do not — this depends on a woman’s age at treatment and the specific type of treatment she receives.9

Certain autoimmune disorders, such as Addison’s disease and thyroid disorders can result in an earlier menopause. So can certain infections, such as mumps, as these cause damage to the ovaries.10

Women with eating disorders may reach menopause at an earlier age,11 as may those under extreme stress.12 Some experts believe that anything that causes your ovaries to produce less oestrogen and progesterone may result in an accelerated menopause.

Research suggests a link between the age that a woman has her first period (menarche) affects the age she reaches menopause. One study of over 336,788 women in Norway from 2006-2014 found that girls aged 16 or older had menopause one year later than girls who got their period at age 13.13 Another study of 51,450 women across the UK, Scandinavia, Australia, and Japan found that women with early menarche were at a higher risk of premature and early menopause.14

The surgical menopause

This is slightly different in that women enter this if they have their ovaries surgically removed. This may have been done at the same time as hysterectomy, as a result of several ectopic pregnancies, or to protect a woman who is at increased risk of ovarian cancer.

Factors that don’t seem to affect the age of menopause

Hormonal contraception appears to have no significant effect on age of menopause.15 Why is this? It is thought that although contraception and breastfeeding usually stop ovulation (release of the egg), they don’t affect the age-related loss of follicles from the ovary. Follicles contain oocytes (immature egg cells), and a certain number of follicles are lost each month simply due to the normal aging process, irrespective of pregnancy or ovulation.

The best way to look at the age of menopause is as a spectrum. There is very little that we can do to delay it, but certain factors may bring it forward. However, many of these are outside our control, so it is neither worth worrying about it, nor trying to predict the age at which you will go through menopause.

Last updated June 2019
Next update due 2021

References

  1. Lee, K.A., and Moe, K.E., ‘Menopause’, M.E. Kryger et al., Principles and Practice of Sleep Medicine, 5th edn, Saunders – Elsevier, Missouri US, 2011, p 1592
  2. Gold, Ellen B., The timing of the age at which natural menopause occurs, Obstetrics and Gynecology Clinics of North America, September 2012, vol 28, no. 3, pp 425-440
  3. Okeke, T.C., et al., ‘Premature Menopause’, Annals of Medical & Health Sciences Research, Vol. 3, No. 1, 2013, pp. 90-95.
  4. Ibid.
  5. Butts, S.F., and Seifer, D.B., Racial and ethnic differences in reproductive potential across the life cycle, Fertility and Sterility, February 2010, vol 93, no. 3, pp 681-690
  6. Okeke, T.C., et al., ‘Premature Menopause’, Annals of Medical & Health Sciences Research, Vol. 3, No. 1, 2013, pp. 90-95.
  7. Moorman, P.G., et al., Effect of hysterectomy with ovarian preservation on ovarian function, Obstetrics and Gynecology, December 2011, vol 118, no. 6, pp 1271-1279
  8. Ibid.
  9. Okeke, T.C., et al., ‘Premature Menopause’, Annals of Medical & Health Sciences Research, Vol. 3, No. 1, 2013, pp. 90-95.
  10. Ibid.
  11. Szegda, K.L., et al., Adult adiposity and risk of early menopause, Human Reproduction, December 2017, vol 32, no. 12, pp 2522-2531
  12. Koukouliata, A.,et al., Correlation of age at natural menopause with occupational status and other epidemiologic factors in women from Prefecture of Kavala, Greece, Hippokratia, Jan-March 2017, vol 21, no.1., pp 32-37
  13. Bjelland, E.K., et al., The relation of age at menarche with age at natural menopause: a population study of 336 788 women in Norway, Human Reproduction, June 2018, vol 33, no. 6., pp 1149-1157
  14. Mishra, G.D., et al., Early menarche, nulliparity and the risk for premature and early natural menopause, Human Reproduction, March 2017, vol 32, no.2., pp 679-686
  15. de Vries, E., et al., Oral contraceptive use in relation to age at menopause in the DOM cohort, Human Reproduction, August 2001, vol 16., issue 8., pp 1657-1662

Dr. Jennifer Kelly MBChB(hons) MRCGP DRCOG

Jennifer is a General Practitioner, medical writer, parent, and founder of the Grace Kelly Ladybird Trust, registered charity for childhood cancer awareness and research. She also has a particular interest in women’s and children’s health, and enjoys medical writing, particularly helping make medical information easily accessible to those who want to find out more.

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