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Age at menopause, cause-specific mortality and total life expectancy
Marlies E Ossewaarde1, Michiel L Bots, André L M Verbeek
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Epidemiology (Cambridge, Mass.)
|June 14, 2005
Summary
A later menopause is linked to longer life expectancy and reduced cardiovascular disease mortality. Despite a slight increase in gynecological cancer risk, the overall effect of delayed menopause is increased longevity.
Area of Science:
- Reproductive endocrinology
- Epidemiology
- Gerontology
Background:
- Later age at menopause is associated with reduced cardiovascular disease risk but increased risk for certain cancers.
- The overall impact of menopausal age on mortality remains unclear.
Purpose of the Study:
- To investigate the association between age at menopause and longevity.
- To analyze the balance between cardiovascular and cancer mortality in relation to menopausal age.
Main Methods:
- Analysis of a breast cancer screening cohort of 12,134 postmenopausal women.
- Utilized Cox proportional hazards models and life tables to assess longevity and mortality risks.
Main Results:
- A later menopause correlated with decreased ischemic heart disease risk (HR=0.98 per year) and longer overall survival (HR for total mortality=0.98 per year).
- Women experiencing menopause after age 55 had a 2.0-year longer life expectancy compared to those with menopause before age 40.
- Increased risk for fatal uterine or ovarian cancer was observed with later menopause (1.07 per year).
Conclusions:
- Each additional year of age at menopause is associated with a 2% reduction in age-adjusted mortality, primarily driven by lower ischemic heart disease mortality.
- Despite a 5% increase in uterine or ovarian cancer mortality risk, a later menopause results in a net increase in lifespan.