The normal menopause transition.
Level 3 - non-randomized controlled study
Prospective observational cohort study with longitudinal follow-up
PubMed 19434875 · doi:10.1016/j.maturitas.2008.09.005
What was done
Data were analyzed from the Massachusetts Women's Health Study, a prospective cohort of 2,570 women aged 45 to 55 years at baseline who had menstruated within the prior 3 months and had intact uteri and ovaries. Participants were followed over 5 years via 6 telephone interviews conducted at 9-month intervals. A subset of 1,178 women who were strictly premenopausal at baseline was evaluated to determine the timing, duration, influencing factors, and symptoms of the natural menopausal transition.
What was found
Median age at natural menopause was 51.3 years, occurring 1.8 years earlier in current smokers compared to non-smokers. Median age at the onset of perimenopause was 47.5 years. The average duration of the perimenopausal transition was estimated at nearly 4 years. Smoking was associated with both an earlier onset and a shorter duration of perimenopause. Physician consultation rates were highest among women experiencing longer perimenopausal transitions. Symptom reporting increased during perimenopause and subsequently decreased postmenopause.
Why it matters
This study provides foundational longitudinal estimates for the onset and duration of the natural perimenopausal transition in a general population, highlighting smoking as a significant modifiable factor that accelerates and shortens this transition.
Limits
The study cohort was geographically restricted to Massachusetts and baseline data collection began in 1982. Menopausal status, menstrual patterns, and symptoms relied on subjective self-report via telephone surveys rather than biological or hormonal markers. Exact statistical confidence intervals and risk estimates for symptoms were not reported in the abstract.
Cited by
- supports The average age of natural menopause is 51.5 years, typically occurring between ages 45 and 55.