The relationship between smoking and age at the menopause: A systematic review

Parente, Raphael C.; Faerstein, Eduardo; Celeste, Roger Keller; Werneck, Guilherme L.

doi:10.1016/j.maturitas.2008.09.021

« Previous Next »Maturitas
Volume 61, Issue 4 , Pages 287-298, 20 December 2008

The relationship between smoking and age at the menopause: A systematic review

Raphael C. Parente
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- Corresponding author at: Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro Rua São Francisco Xavier 524, 7° andar, blocos D e E Rio de Janeiro – RJ, CEP 20550-90, Brazil. Tel.: +55 21 2587 7303; fax: +55 21 2264 1142.
Eduardo Faerstein
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
Roger Keller Celeste
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Biostatistics and Epidemiology, Universidade Federal Fluminense, Rio de Janeiro, Brazil
Guilherme L. Werneck
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- Center for Public Health Studies, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

Received 23 January 2008; received in revised form 15 August 2008; accepted 20 September 2008. published online 23 October 2008.

Abstract

Context and objective

Increasing life expectancy has made it ever more important to study the factors that influence the age at the menopause, given that when it is reached outside of the normal range, it is associated with increased risk of osteoporosis and cardiovascular diseases, among other conditions. Among the factors studied in relation to early menopause, smoking is prominent. Destruction of the ovarian follicles is one of the mechanisms postulated for this effect. The aim of this study was to review and describe the associations between age at the menopause and the habit of smoking, its duration and its intensity.

Method

A systematic review of the literature indexed in the MEDLINE and LILACS databases was conducted, without restriction on publication date. After initially identifying 1325 articles and preselecting 161 articles for consideration of their complete texts, 96 articles reporting on the results from 109 studies were selected for analysis.

Results

A great majority of the studies reported an association between the habit of smoking and early menopause, but there was no clear evidence that the duration of smoking and quantity of cigarettes smoked had any association with age at the natural menopause.

Conclusion

Additional studies are needed, preferably of prospective nature and with a large number of women, in order to deepen the knowledge of the effects of various aspects of smoking on age at the menopause. Experimental studies on animals may also contribute towards clarifying the physiopathological mechanisms through which smoking influences age at the menopause.

Keywords: Menopause, Smoking, Epidemiology