Menopause is a significant life event for many women. Some have dramatic symptoms during menopause. There are changes to a woman's body. Fertility declines and ends. Because of this, or just because they are curious, many women wonder what impacts the age that they will go through natural menopause.
They say things like “my mother was (insert age) yrs old so I guess I’ll be the same.” but, it turns out that this isn’t the case, a lot of things can make a difference. The age of menopause varies and is related in part to lifestyle, socioeconomic and health factors. Keeping in mind that early natural menopause occurs before age 45; menopause on average occurs at age 52 and late menopause is after age 54, here are a few insights.
Ethnicity can be a factor. White, Japanese and Asian women are often older at menopause compared to Black and Hispanic women (1,2). On the other hand, working shift work during reproductive years is associated with later age of menopause. This is thought to be a result of the disruption of circadian rhythms (3).
Research shows mixed results for using oral contraceptives and age of menopause. However, menarche (the age you have your first period) before age 11 is associated with a high risk (80%) of early menopause. The likelihood of early menopause increases with women who had never had children. Women with early menarche and who have never had children are five times more likely to have early menopause (4). In comparison, a first full term pregnancy after age 30 is associated with later menopause (5). Given all of this, it seems that hormones do play a part but it’s not straightforward since, for example, the length of time a woman breastfeeds during her reproductive years has no association with the age at which she reaches menopause (6). In addition, hypertension during pregnancy or gestational diabetes are not associated with either age of onset of menopause or severity of menopausal symptoms (7)
Dietary intake may influence age of menopause. High carbohydrate, vegetables, fiber, and cereal intake is associated with earlier menopause while higher fat, protein and meat is associated with later menopause (5). However, there is conflicting evidence in other studies. The link between diet and timing of menopause isn’t certain (8). In a study that examined plant-based diets there was no association with early menopause except for those who had an unhealthy plant-based that was high in sugary and processed foods. (9)
Alcohol consumption is linked to later menopause (10). However, cigarette smoking is associated with earlier menopause (5,6). Interestingly, the presence of cardiovascular risk factors (higher cholesterol, higher blood pressure and higher BMI) in premenopause is associated with earlier age of menopause (11).
The evidence related to weight and age of menopause varies. Some studies show that higher weight and greater body mass index (BMI) lead to delayed onset of menopause and that being underweight during premenopause or low BMI is associated with early menopause. However, these findings were not shown in other studies. Current research and theories point to the possibility that there is an added genetic component that, along with weight and BMI, determines age of onset of menopause (8).
So, you can see that answering the question about which factors will impact the age at which a woman goes through menopause is very complex. Because menopause is associated with things like slower metabolism and increased risk for diabetes and heart disease, it would be nice to have a better idea of what we can do to tweak the timing. Some factors are out of our control, but maintaining a healthy lifestyle is the best way to offset the impact of an early menopause. Stop smoking, eat well, get enough sleep and exercise, all the things that will lead us to better quality of life regardless of the age of your final menstrual period.
If you’re struggling with changes you can make toward a healthier life, then check out the new feature in the Virtual Menopause Clinic, Wellness 10-12-12.
1. Henderson KD, Bernstein L, Henderson B, Kolonel L, Pike MC. Predictors of the Timing of Natural Menopause in the Multiethnic Cohort Study. American Journal of Epidemiology. 2008 Mar 25;167(11):1287–94.
2. Bromberger JT, Matthews KA, Kuller LH, Wing RR, Meilahn EN, Plantinga P. Prospective Study of the Determinants of Age at Menopause. American Journal of Epidemiology. 1997 Jan 15;145(2):124–33.
3. Khan D, Rotondi M, Edgell H, Tamim H. The association between shift work exposure and the variations in age at natural menopause among adult Canadian workers: results from the Canadian Longitudinal Study on Aging (CLSA). Menopause. 2022 Jul;29(7):795–804
4. Mishra GD, Pandeya N, Dobson AJ, Chung HF, Anderson D, Kuh D, et al. Early menarche, nulliparity and the risk for premature and early natural menopause. Hum Reprod. 2017 Jan 24;humrep;dew350v1.
5. Nagel G, Altenburg HP, Nieters A, Boffetta P, Linseisen J. Reproductive and dietary determinants of the age at menopause in EPIC-Heidelberg. Maturitas. 2005 Nov;52(3–4):337–47.
6. Scime NV, Shea AK, Faris PD, Brennand EA. Association of lifetime lactation and age at natural menopause: a prospective cohort study. Menopause. 2022 Oct;29(10):1161–7.
7. Soria-Contreras DC, Perng W, Rifas-Shiman SL, Mínguez-Alarcón L, Hivert MF, Shifren J, et al. Associations of hypertensive disorders of pregnancy and gestational diabetes mellitus with menopausal symptoms at midlife in Project Viva. Menopause. 2022 Sep;29(9):1021–7.
8. El Khoudary SR, Aggarwal B, Beckie TM, Hodis HN, Johnson AE, Langer RD, et al. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation [Internet]. 2020 Dec 22 [cited 2022 Dec 9];142(25). Available from: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000912
9. Grisotto G, Langton CR, Li Y, Bertone-Johnson ER, Baden MY, Franco OH, et al. Association of plant-based diet and early onset of natural menopause. Menopause. 2022 Jul;29(7):861–7.
10. Taneri PE, Kiefte-de Jong JC, Bramer WM, Daan NMP, Franco OH, Muka T. Association of alcohol consumption with the onset of natural menopause: a systematic review and meta-analysis. Human Reproduction Update. 2016 Jun 1;22(4):516–28.
11. Kok HS, van Asselt KM, van der Schouw YT, van der Tweel I, Peeters PHM, Wilson PWF, et al. Heart Disease Risk Determines Menopausal Age Rather Than the Reverse. Journal of the American College of Cardiology. 2006 May;47(10):1976–83.
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