[Determinants of the age at natural menopause]

The age at natural menopause (ANM) varies due to environmental and genetic factors. Smoking accelerates ANM by about 1.5-2 years. Other factors which accelerate ANM are: nulliparity, short-length menstrual cycles and unilateral oophorectomy. In contrast, factors such as irregular menstrual cycles, height socioeconomic status, parity and giving birth before the age 25 all delay ANM. Nutritional factors also affect ANM. For example, vegetarian diet accelerates ANM by about 2 years; a high intake of fat, cholesterol, coffee also accelerate menopause, while moderate alcohol consumption delays it. However, the influence of dietary factors has not been adequately documented due to a relatively small number of studies. Moreover, genetic factors seem to influence ANM: for example, early menopausal age of the mother correlates with early menopausal age of her daughter. Factors such as the age at menarche, spontaneous abortions, passive smoking, weight and height, breast feeding, using of oral contraceptives, employment and depression, have all been suggested to influence menopausal age, but their impact needs to be established. Therefore, there is a need for longterm, follow-up studies which would allow to evaluate the impact of life style factors, including dietary factors on ANM. The knowledge of factors influencing ANM is crucial for medical practice, public health and reproductive biology. Menopause is the period during which serious health problems such as cardiovascular diseases and osteoporosis occur with increasing frequency. Knowing the factors which determine menopausal age may lead to lifestyle changes (such as not smoking), which would result in delaying menopause, and therefore prolonging natural estrogen protection.