Longevity Linked to Late Menarche, Late Menopause

Marcia Frellick

August 02, 2016

Chances of living to age 90 years increased significantly for women who started menstruation and menopause late, according to a new study.

The authors studied an ethnically diverse cohort of 16,251 postmenopausal women from the Women's Health Initiative (WHI) to investigate the associations of ages of first periods and beginning of menopause and length of reproductive years with survival to age 90 years. WHI is a prospective study investigating major determinants of chronic diseases in postmenopausal women recruited from 1993 to 1998 and followed until 2014.

Of the 16,251 women, 8892 (55%) survived to age 90 years. Women who started menstruating when they were at least 12 years old had slightly higher odds of longevity (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.00 - 1.19) than those who started before age 12 years. Those who had a later age at menopause (natural or surgical; Ptrend = .01) were significantly more likely to live longer, with ORs of 1.19 (95% CI, 1.04 - 1.36) and 1.18 (95% CI, 1.02 - 1.36) for ages 50 to 54 and at least 55 years compared with less than 40 years, respectively.

"Longer reproductive lifespan was significantly associated with increased longevity (Ptrend = 0.008). The odds of longevity were 13% (OR 1.13; 95% CI, 1.03-1.25) higher in women with more than 40 compared with less than 33 reproductive years," the authors write.

Findings were independent of lifestyle behaviors, body mass index, reproductive factors, or past oral contraceptive or hormone therapy use.

Possible Reasons for Link

Several factors may help explain the associations, the authors note.

Early menstruation has been linked to higher risk for adult obesity, diabetes, and cardiovascular disease (CVD). Later menopause and longer reproductive years also have been linked to decreased CVD risk.

Women who started their periods and entered menopause at a later age were also less likely to be smokers or have a history of age-related diseases.

"It is also possible that the association of later age at menopause with longevity may be partly explained by lower odds of survival due to comorbidities and adverse health status among women who experienced premature menopause, irrespective of the cause," the authors write.

A common set of genetic factors may also play a role.

"For example, a genome-wide association study of age at natural menopause identified genetic variants involved in DNA replication and repair pathways, which are pathways central to aging," the authors write.

One limitation of the study was that authors did not have information on family history of longevity, occupation, stress, or diet, which may also predict longevity.

Future studies will be needed to better determine mechanisms for the link between longevity and the biological events. The number of women reaching age 90 years has increased rapidly during the last century, reaching about 1.3 million. That number is expected "to quadruple by 2050," the authors write.

"With secular trends showing decreasing age at menarche, increasing age at menopause, and a concurrent rise in longevity, additional studies in younger birth cohorts will be needed in the future to precisely define the relationship between the timing of reproductive events and a woman's length of life," they conclude.

This study was supported by the National Institutes of Health. The WHI Program is funded by the National Institutes of Health's National Heart, Lung, and Blood Institute, which has representation on the WHI Steering Committee, which governed the design and conduct of the study, the interpretation of the data, and preparation and approval of manuscripts. The authors have disclosed no relevant financial relationships.

Menopause. Published online July 25, 2016. Abstract

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