Premature ovarian failure: frequency and risk factors among women attending a network of menopause clinics in Italy.

NOTA IMPORTANTE: Autore dello studio è il “Progetto Menopausa Italia Study Group”. Umberto Omodei è Coordinatore Nazionale, membro dello Steering Committee e partecipante al Progetto. La pubblicazione riporta come co-autori l’elenco dei partecipanti suddivisi per incarico specifico. La pubblicazione non viene quindi individuata automaticamente inserendo il nome dell’autore nei motori di ricerca in rete. Il Progetto Menopausa Italia, del quale Umberto Omodei è co-fondatore, è un grande studio epidemiologico che aveva come obiettivo la raccolta di informazioni sulla menopausa e le condizioni cliniche correlate, basato su un network nazionale connesso in rete di 268 Centri per la Menopausa, con circa 1.500 operatori sanitari coinvolti. Il Progetto si è svolto dal 1997 al 2004 ed ha reclutato un campione di circa 130.000 pazienti seguite per oltre 5 anni. OBJECTIVE: To determine the frequency and causes of preterm ovarian failure (menopause before 40 years of age) and early menopause (menopause between 40 and 45 years). DESIGN: Cross sectional study. SETTING: Menopause clinics in Italy. POPULATION: Women attending menopause clinics in Italy. METHODS: Between 1997 and 1999 we conducted a large cross sectional study on the characteristics of women around menopause attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. Eligible for the study were all women aged 45-75 years consecutively observed for the first time at the participating centres on randomly selected days during the study period. MAIN OUTCOME MEASURE: Factors associated with preterm ovarian failure. RESULTS: Out of 15,253 women aged 55 years or more with spontaneous menopause who entered the study, 269 (1.8%) reported preterm ovarian failure, and 1085 (7.1%) reported spontaneous menopause at age 40-45 years. The risk of preterm ovarian failure and of early menopause was higher in women reporting lifelong irregular menstrual cycles: in comparison with women reporting menopause at age > or =45 years, the OR (irregular vs regular menstrual cycles) of preterm ovarian failure was 1.3 (95% CI 1.0-1.7) and of early menopause of 1.2 (95% CI 1.0-1.5). Parous women reported less frequently preterm ovarian failure (chi(2) trend P < 0.05) and early menopause (OR 0.8, 95% CI 0.7-1.0). No significant association emerged between risk of preterm ovarian failure or menopause at age 40 to <45 and education, age at menarche, oral contraceptive use and smoking habits. CONCLUSION: Nulliparity and lifelong irregular menstrual cycles are associated with an increased risk of preterm ovarian failure.