Determinants of age at menopause in women attending 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: We analysed the mean age at menopause and its determinants in 31,000 women attending menopause clinics in Italy. DESIGN: Between 1997 and 2003 we conducted a large cross-sectional study on the characteristics of peri- and post-menopausal women attending a network of first-level outpatient menopause clinics in Italy for general counseling or treatment of menopausal symptoms. Spontaneous menopause was defined as natural cessation of menses for 12 or more months. A total of 31,834 women with spontaneous menopause entered the study. RESULTS: The mean age at spontaneous menopause was 51.2. The age at menopause did not markedly changed with cohort of birth. Higher education was associated with lower age at menopause (51.1 in women with low education versus 51.3 for women with high school or university degree, p<0.05). A higher body mass index (BMI) was associated with later age at menopause. Smokers reported a lower age at menopause (51.2 in nonsmokers versus 51.1 in smokers, p<0.05). A later age at menarche was associated with a later age at menopause. Likewise, lifelong irregular menstrual cycles and higher parity were related with later age at menopause. No association emerged between ever oral contraceptive use and age at menopause. CONCLUSIONS: Low educational level, lower BMI, smoking, early menarche, nulliparity and regular cycles are independently associated with lower age at natural menopause in a large sample of women attending menopause clinics in Italy. However, in absolute terms the effect of these factors in our sample is very small.