eprintid: 10159041 rev_number: 7 eprint_status: archive userid: 699 dir: disk0/10/15/90/41 datestamp: 2022-11-14 17:42:30 lastmod: 2022-11-14 17:42:30 status_changed: 2022-11-14 17:42:30 type: article metadata_visibility: show sword_depositor: 699 creators_name: Peycheva, Darina creators_name: Sullivan, Alice creators_name: Hardy, Rebecca creators_name: Bryson, Alex creators_name: Conti, Gabriella creators_name: Ploubidis, George title: Risk factors for natural menopause before the age of 45: evidence from two British population-based birth cohort studies ispublished: pub divisions: UCL divisions: B02 divisions: D13 divisions: G25 keywords: Early menopause, Risk factors, Life course, Birth cohort, Social class, Breastfeeding, Cognition, Smoking, Alcohol, Exercise, Gynaecological problems note: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. abstract: BACKGROUND: Menopause that occurs before the age of 45 and is not medically induced (referred to here as 'early natural menopause') affects around one in 10 women and has serious health consequences. These consequences include increased risk of all-cause mortality, cardiovascular disease, osteoporosis, and type 2 diabetes. METHODS: We investigate risk factors for the onset of natural menopause before the age of 45 in two population-based prospective cohort studies in Britain: the 1958 cohort following 8959 women and the 1970 cohort following 8655 women. These studies follow women from birth to adulthood, and we use harmonized data on birth and early life characteristics, reproductive health, health behaviour, and socioeconomic characteristics for 6805 women who were pre-menopausal, peri-menopausal or had undergone natural menopause. Of these 6805 women, 3614 participated in the 1958 cohort (of which 368 had early menopause) and 3191 participated in the 1970 cohort (of which 206 had early menopause). Taking a life course approach, we focus on three distinct life stages - birth/early life, childhood, and early adulthood - to understand when risk factors are most harmful. Respecting the temporal sequence of exposures, we use a series of multivariable logistic regression models to estimate associations between early menopause and each potential risk factor adjusted for confounders. RESULTS: We find that early menopause is influenced by circumstances at birth. Women born in lower social class families, whose mother smoked during the pregnancy or who were breastfed 1 month or less were more likely to undergo early menopause. Early menopause is also associated with poorer cognitive ability and smoking in childhood. Adult health behaviour also matters. Smoking is positively correlated with early menopause, while regular exercise and moderate frequency of alcohol drinking in women's early thirties are associated with reduced risk of early menopause. The occurrence of gynaecological problems by women's early thirties is also linked to early menopause. CONCLUSIONS: We demonstrate that characteristics at different periods of life are associated with early menopause. Some of these associations relate to modifiable behaviours and thus the risks of early menopause and the adverse health outcomes associated with it may be preventable. date: 2022-11-08 date_type: published official_url: https://doi.org/10.1186/s12905-022-02021-4 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1987340 doi: 10.1186/s12905-022-02021-4 medium: Electronic pii: 10.1186/s12905-022-02021-4 lyricists_name: Peycheva, Darina Nikolaeva lyricists_id: DNPEY52 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner funding_acknowledgements: 546608 [Health foundation] full_text_status: public publication: BMC Women's Health volume: 22 article_number: 438 event_location: England issn: 1472-6874 citation: Peycheva, Darina; Sullivan, Alice; Hardy, Rebecca; Bryson, Alex; Conti, Gabriella; Ploubidis, George; (2022) Risk factors for natural menopause before the age of 45: evidence from two British population-based birth cohort studies. BMC Women's Health , 22 , Article 438. 10.1186/s12905-022-02021-4 <https://doi.org/10.1186/s12905-022-02021-4>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10159041/1/s12905-022-02021-4.pdf