09/03/2024 | Press release | Distributed by Public on 09/03/2024 11:35
Key takeaways:
Women who have never been pregnant or have never given birth may have a higher risk of early menopause. Pregnancy history may also affect menopause symptoms like hot flashes, vaginal dryness, and mood.
Menopause before the age of 45 increases the risk of certain health conditions. Those include cardiovascular disease, osteoporosis, depression, and dementia.
Many factors affect the timing and symptoms of menopause. Some of these factors include pregnancy and childbirth. But genes, nutrition, social factors, and health history all play a role.
Your menstrual period can vary with age, hormones, family history, and health conditions. Some factors that affect your period also influence the age when menopause starts. Or the kinds of symptoms you have during menopause and perimenopause. And one of these factors is your pregnancy history.
Hormone changes during pregnancy affect all parts of a woman's body. And for some people, it can impact the age when menopause begins - and the symptoms they experience with it.
Pregnancy may affect the age at which you go through menopause.
What are the symptoms of perimenopause? If you're experiencing new changes in your body, it's important to know if this could be the start of perimenopause.
Menopause timeline: This guide walks you through the different stages and timeline of menopause - and how to know where you are on that timeline.
Hormone replacement therapy for menopause: There used to be safety concerns around hormone replacement. But newer research tells a different story.
For most women around the world, menopause happens between the ages of 45 and 55. In the U.S., the average age for menopause is 51. How old you are when your periods end depends on factors like:
Your genes
Whether you've taken oral contraceptives or hormone therapy
If you smoke or have smoked in the past
Social factors like income level and education
Nutrition
If a woman stops having periods before the age of 45, it's called early menopause. If she stops before the age of 40, it's called premature menopause. Pregnancy and breastfeeding seem to lower the risk of early and premature menopause.
The reason this happens is related to the number of eggs in your ovaries, which is a fixed number that you are born with. During pregnancy, ovulation stops and so the ovaries don't release eggs. Nursing may also put a pause on ovulation for some women. So women who have spent more time pregnant or nursing may ovulate later into life. And that could lead to menopause happening at a later age.
If you've never been pregnant, it doesn't mean you'll definitely experience early menopause. But the risk is higher.
Overall, about 5% of women in the U.S. go through menopause before the age of 45. Around 1% of women experience menopause before the age of 40.
One study looked at more than 50,000 women in different countries who had gone through menopause. They compared the age when menopause started for women who had never given birth with those who had two or more children. They found that:
Women who hadn't given birth had more than twice the risk of starting menopause before the age of 40.
If those women also had their first period before the age of 12, there was a fivefold risk of premature menopause.
The chance of starting menopause between the ages of 40 and 44 was also higher.
There are many reasons why women don't have biological children. It may be a matter of choice. Or circumstance. Or a health condition that results in infertility. But each reason may result in different factors that influence the age when a woman begins menopause.
Some of these include:
Oral contraceptive use:Birth control pills may delay the age when menopause begins. Especially if taken for many years. At the very least, oral contraceptives don't appear to increase the risk of early menopause.
Tubal ligation: Having a tubal ligation might increase the risk of early menopause. That's because after the procedure, a little less blood is supplied to the ovaries.
A history of infertility: Infertility, regardless of what causes it, may be a risk factor for early menopause. But the research hasn't figured out exactly why this is the case.
Pregnancy loss:Miscarriage and stillbirth are also associated with early menopause.
Endometriosis: People with endometriosis can have trouble getting pregnant. In one large study, women with endometriosis had a higher risk of early menopause. Especially if they never used oral contraceptives or had not given birth.
Polycystic ovarian syndrome (PCOS): The hormone imbalance of PCOS can also affect fertility. But unlike endometriosis, women with PCOS may begin menopause at a later age.
Hormones, pregnancy, and health conditions can all impact the age when menopause begins. But those factors may also affect the type and severity of perimenopausal and menopausal symptoms.
During midlife and menopause, women who have experienced infertility may have a higher risk of:
Depressed mood
Feeling irritable
Trouble sleeping
Vaginal dryness
Less interest in sex
Some studies suggest that women who have not been pregnant or have not had children are less likely to have hot flashes and vaginal dryness. But other studies found that they were more likely to experience menopausal symptoms.
It's likely that many aspects of physical and mental health come into play when it comes to menopause symptoms. For some women who have never been pregnant, certain symptoms may be worse. But that won't be true for everyone.
Most experts recommend treatment with hormone replacement therapy (HRT) for women who begin menopause before the age of 45. And to continue treatment at least until the age that menopause starts for most women. The goal is to help prevent some of the long-term health conditions that can occur with early menopause.
Menopause before the age of 45 is also a risk factor for:
Cardiovascular diseases like heart attack and stroke
Osteoporosis and osteopenia (fragile bones)
Depression and anxiety
Dementia symptoms, like trouble thinking and remembering
So HRT may help to lower the risk of things like cardiovascular disease and osteoporosis.
If you've never been pregnant, here are some additional options to consider:
Nutrition: Certain foods, in particular oily fish and legumes, may help to delay the age you begin menopause. On the other hand, processed foods made with refined wheat and rice may increase the risk of early menopause.
Not smoking: On average, people who smoke go through menopause 1-2 years earlier than those who don't. Quitting also lowers the risk of health conditions like heart disease that can happen with early menopause.
Exercise: Regular physical activity can help to balance hormones. And along with a nutritious diet and not smoking, exercise improves the health of your heart, bones, and brain.
Healthy sleep habits: Menopause can affect your sleep. But not getting enough quality sleep can also make some menopause symptoms worse. Develop a regular sleep routine to get the best rest you can.
Mind-body practices: Try yoga, mindfulness-based stress reduction, or cognitive behavioral therapy (CBT). All of these may help ease menopause symptoms.
Vitamins and supplements: Evidence varies for how well different vitamins and supplements work for symptoms like hot flashes. But talk with a healthcare professional before starting over-the-counter (OTC) medications, herbal remedies, or supplements.
Hormonal treatments:Oral contraceptives may help to prevent early menopause. They can also help regulate menstrual periods and treat symptoms during perimenopause.
Mental well-being: Tend to your mental health. This is helpful advice for all women who are approaching or experiencing menopause. But it may be especially important for those who have gone through infertility treatments or experienced pregnancy loss
Menopause may occur earlier for some women who have never been pregnant or given birth. For those who start menopause before the age of 45, there's a higher risk of chronic health conditions that can affect the heart, bones, and brain. A woman's pregnancy history might also increase the risk for menopausal symptoms like hot flashes and vaginal dryness. But there are many factors that affect the timing and symptoms of menopause. Genetics, diet and exercise, social factors, and health conditions all play a role in the age you begin menopause, and your experience with it.
Appiah, D., et al. (2021). Trends in age at natural menopause and reproductive life span among US women, 1959-2018. JAMA.
British Menopause Society. (2021). BMS & WHC's 2020 recommendations on hormone replacement therapy in menopausal women.
Cortés, Y. I., et al. (2020). Impact of nulliparity, hypertensive disorders of pregnancy, and gestational diabetes on vasomotor symptoms in midlife women. Menopause.
Dunneram, Y., et al. (2018). Dietary intake and age at natural menopause: Results from the UK women's cohort study.
Fitz, V. W., et al. (2023). Exploring the relationship between history of infertility and the experience of menopausal symptoms. Menopause.
Gold, E. B. (2011). The timing of the age at which natural menopause occurs. Obstetrics and Gynecology Clinics of North America.
Hess, R., et al. (2008). Pregnancy and birth history influence women's experience of menopause. Menopause.
Kronemyer, B. (2021). Risk of early natural menopause from oral contraceptives or tubal ligation. Contemporary OB/GYN.
Langton, C. R., et al. (2020). Association of parity and breastfeeding with risk of early natural menopause. JAMA Network Open.
Liang, C., et al. (2023). Is there a link between infertility, miscarriage, stillbirth, and premature or early menopause? Results from pooled analyses of 9 cohort studies. American Journal of Obstetrics and Gynecology.
Mishra, G. D., et al. (2017). Early menarche, nulliparity and the risk for premature and early natural menopause. Human Reproduction.
Nakano, K., et al. (2012). Reproductive history and hot flashes in perimenopausal women. Journal of Women's Health.
National Cancer Institute. (n.d.). Premature menopause.
National Health Service. (2021). Early menopause.
National Institute on Aging. (2021). Sleep problems and menopause: What can I do?
Nelson, D. B., et al. (2011). Effects of reproductive history on symptoms of menopause: A brief report. Menopause.
Office on Women's Health. (2022). Early or premature menopause.
Palmer, J. R., et al. (2003). Onset of natural menopause in African American women. American Journal of Public Health.
Scime, N. V., et al. (2023). Association of infertility with type and timing of menopause: A prospective cohort study. Human Reproduction.
The Menopause Society. (n.d.). Menopause 101: A primer for the perimenopausal.
Thombre Kulkarni, M., et al. (2022). Association between laparoscopically confirmed endometriosis and risk of early natural menopause. JAMA Network Open.
Wang, X. et al. (2021). Prevalence and risk factors for menopausal symptoms in middle-aged Chinese women: A community-based cross-sectional study. Menopause.
Welt, C. K., et al. (2013). Lifecycle of polycystic ovary syndrome (PCOS): From in utero to menopause. The Journal of Clinical Endocrinology & Metabolism.
World Health Organization. (2022). Menopause.
Zhu, D., et al. (2019). Age at natural menopause and risk of incident cardiovascular disease: A pooled analysis of individual patient data. The Lancet Public Health.
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