Early Life Circumstances and Their Impact on Menarche and Menopause

Gita D. Mishra; Rachel Cooper; Sarah E. Tom; Diana Kuh

Disclosures

Women's Health. 2009;5(2):175-190. 

In This Article

Abstract and Introduction

Abstract

Ages at menarche and menopause have been shown to be associated with adverse health outcomes in later life. For example, earlier menarche and later menopause have been independently linked to higher risk of breast cancer. Earlier menarche may also be associated with an increased risk of endometrial cancer, menstrual problems and adult obesity. Given the associations of ages at menarche and menopause with future health outcomes, it is important to establish what factors across life, and generations, may influence these. This article examines the associations of early life factors, namely birthweight, bodyweight and growth during childhood, childhood socioeconomic circumstances and psychosocial factors with ages at menarche and menopause. It examines possible explanations of the associations found, including life history theory, and discusses areas for future research.

Introduction

Reproductive health, from menarche to menopause, is not only understood as being integral to women's overall health and wellbeing, but is increasingly recognized as a sentinel of chronic disease in later life.[1,2,3] For example, both earlier menarche and later menopause are independently associated with higher risk of breast cancer,[4,5] and may also be associated with an increased risk of endometrial cancer.[6,7,8] When examined together, the length of time between menarche and menopause, which provides a crude indicator of lifetime estrogen exposure, has also been shown to be associated with these outcomes.[9] Earlier menarche may also be a risk factor for adult obesity.[10] By contrast, age at menarche has little bearing on cardiovascular risk, and only premature age at menopause is associated with significantly higher risk of heart disease.[1,11]

There is growing evidence that the physical and social environment in previous generations, and from preconception to midlife, influence both reproductive health[1] and, later, chronic disease.[12,13] Menarche and menopause are the two major components of women's reproductive lives, since the interval between them determines the natural reproductive phase.[14] Therefore, the aim of this article is to update information on the role that early life factors play on these key aspects of reproductive health, namely age at menarche and the timing of menopause.

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