Abstract
Objectives
Exposures which might influence age at natural menopause have been extensively studied
but, with the exception of cigarette smoking, results have been inconsistent. We sought
to determine: (i) whether alcohol and caffeine intake are associated with age at menopause;
(ii) whether the association of cigarette smoking with age at menopause is confined
to current smokers.
Methods
Analyses drew on longitudinal data from 494 women, aged 44–60 in 1993, of whom 159
experienced menopause before intake or during follow-up. We used parametric logistic
survival analysis to estimate shifts in median age at menopause for women who drink
alcohol or caffeine or who smoke cigarettes.
Results
The estimated median age at menopause was 2.2 (95% confidence interval (CI) 0.5, 3.9)
years later for women who drank alcohol 5–7 days/week (13% of the sample) than for women who did not drink alcohol (54%). For
women who drank at least 1 day/week, the estimated shift was 1.3 (95% CI 0.2, 2.3) years. Caffeine intake in
approximate quartiles of mg/day—0–100, >100–200, >200–400, 400+—was not related to
age at menopause. Current smokers of 14+ cigarettes/day (6%) experienced menopause 2.8 (95% CI −4.8, −0.8) years earlier than
women who never smoked (51%). Current smokers of 1–13 cigarettes/day (5%) and former smokers (38%) experienced menopause at about the same
age as women who never smoked.
Conclusions
The results are compatible with a pro-estrogenic effect of moderate alcohol intake
and an anti-estrogenic effect of current cigarette smoking of 14+ cigarettes/day.
Keywords
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References
- Cigarette smoking and age at natural menopause.Am J Publ Health. 1980; 70: 420-422
- Cigarette smoking and the age at menopause.Ann Hum Biol. 1982; 9: 121-130
- Cigarette smoking, relative weight, and menopause.Am J Epidemiol. 1983; 117: 651-658
- Smoking and age at menopause in women.Ann Intern Med. 1985; 103: 350-356
- Effect of passive exposure to smoking on age at natural menopause.Br Med J (Clin Res Ed). 1986; 293: 792
- Smoking, menopause, and breast cancer.J Natl Cancer Inst. 1986; 76: 833-838
- A prospective study of factors affecting age at menopause.J Clin Epidemiol. 1989; 42: 1031-1039
- Reproductive and general lifestyle determinants of age at menopause.Maturitas. 1992; 15: 141-149
- Prospective study of factors influencing the onset of natural menopause.J Clin Epidemiol. 1998; 51: 1271-1276
- Active and passive smoking and the occurrence of natural menopause.Epidemiology. 1999; 10: 771-773
- Associations with menopause and menopausal transition in a nationally representative US sample.Maturitas. 2003; 45: 89-97
- Current smoking at menopause rather than duration determines the onset of natural menopause.Epidemiology. 2004; 15: 634-639
- Determinants of basal follicle-stimulating hormone levels in premenopausal women.J Clin Endocrinol Metab. 1994; 79: 1105-1109
- Follicle-stimulating hormone concentrations in relation to active and passive smoking.Obstet Gynecol. 1995; 85: 407-411
- Early follicular phase hormone levels in relation to patterns of alcohol, tobacco, and coffee use.Fertil Steril. 2001; 76: 723-729
- The normal menopause transition.Maturitas. 1992; 14: 103-115
- Smoking, body mass index, socioeconomic status and the menopausal transition in a British national cohort.Int J Epidemiol. 2000; 29: 845-851
- Predictors of ovarian follicle number.Fertil Steril. 2000; 74: 624-628
- Relation between smoking and age of natural menopause. Report from the Boston Collaborative Drug Surveillance Program, Boston University Medical Center.Lancet. 1977; 1: 1354-1355
- Natural history of menopause: the Framingham study.Medical Digest Inc., 1978 (pp. 27–35)
- Menopausal age in relation to smoking.Acta Med Scand. 1979; 205: 73-77
- Is cigarette smoking a promotor of the menopause?.Acta Med Scand. 1982; 212: 137-139
- Cross-sectional and case-controlled analyses of the association between smoking and early menopause.Maturitas. 1995; 22: 79-87
- Social and biological predictors of early menopause: a model for premature aging.J Intern Med. 1997; 242: 299-305
- Factors associated with age at natural menopause in a multiethnic sample of midlife women.Am J Epidemiol. 2001; 153: 865-874
- Smoking and industrial pollution, and their effects on menopause and ovarian cancer.Lancet. 1978; 1: 187-188
- Cigarette smoking and urinary estrogens.N Engl J Med. 1982; 307: 1062-1065
- Nicotine, cotinine, and anabasine inhibit aromatase in human trophoblast in vitro.J Clin Invest. 1986; 77: 1727-1733
- Cigarette smoking and prolactin in women.Br Med J (Clin Res Ed). 1986; 293: 482-483
- Increased 2-hydroxylation of estradiol as a possible mechanism for the anti-estrogenic effect of cigarette smoking.N Engl J Med. 1986; 315: 1305-1309
- Diluted mainstream cigarette smoke condensates activate estrogen receptor and aryl hydrocarbon receptor-mediated gene transcription.Environ Res. 1999; 80: 9-17
- Onset of natural menopause in African American women.Am J Publ Health. 2003; 93: 299-306
- Effects of alcohol on endocrine function in postmenopausal women: a review.J Stud Alcohol. 1985; 46: 495-516
- Fat distribution and steroid hormones in women with alcohol abuse.J Intern Med. 1990; 228: 311-316
- Exposure-dependent effects of ethanol on serum estradiol and uterus mass in sexually mature oophorectomized rats: a model for bilaterally ovariectomized-postmenopausal women.J Stud Alcohol. 1987; 48: 295-303
- The effects of moderate alcohol consumption on female hormone levels and reproductive function.Alcohol Alcohol. 2000; 35: 417-423
- Association of diet and other lifestyle with onset of menopause in Japanese women.Maturitas. 1998; 29: 105-113
- Factors related to late menopause and early menarche as risk factors for breast cancer.Jpn J Cancer Res. 1988; 79: 165-172
- Alcohol consumption and age of maternal menopause are associated with menopause onset.Maturitas. 1997; 26: 21-25
- Measures of menopausal status in relation to demographic, reproductive, and behavioral characteristics in a population-based study of women aged 35–49 years.Am J Epidemiol. 2001; 153: 1159-1165
- Release of norepinephrine in the central nervous system by theophylline and caffeine.Eur J Pharmacol. 1970; 10: 64-71
- Alcohol and other dietary factors in relation to serum hormone concentrations in women at climacteric.Am J Clin Nutr. 1991; 53: 166-171
- Cigarette smoking and spontaneous abortion of known karyotype. Precise data but uncertain inferences.Am J Epidemiol. 1995; 141: 417-427
- Trisomic pregnancy and earlier age at menopause.Am J Hum Genet. 2000; 67: 395-404
- Moderate alcohol consumption and estrogen levels in postmenopausal women: a review.Alcohol Clin Exp Res. 1998; 22: 994-997
- Caffeine consumption.Food Chem Toxicol. 1996; 34: 119-129
The Coca-Cola Company. Accessed September 9, 2004. Available at http://ww2.coca-cola.com/contactus/faq/ingredients_include.html.
The Pepsi Cola Company. Accessed November 2, 2004. Available at http://www.pepsi.com/pepsi_brands/product_info.
Beverage Digest, 1996 Top-10 U.S. CSD Numbers. Accessed December 19, 1996. Available at http://www.beverage-digest.com/editorial/97027.html.
- Age at menopause United States—1960–1962.Vital Health Stat. 1966; 11: 1-20
- Can alcohol promote aromatization of androgens to estrogens? A review.Alcohol. 2000; 22: 123-127
- Association of physical and behavioural characteristics with menstrual cycle patterns in women age 29–31 years.Epidemiology. 1996; 7: 624-628
- Diet and urine estrogens among postmenopausal women.Oncology. 1991; 48: 490-494
- Prevalence of fractures among 10,000 women from the 1900 to 1940 birth cohorts resident in Gothenburg.Maturitas. 1991; 14: 65-74
- Factors associated with onset of menopause in women aged 45–49.Maturitas. 1994; 19: 83-92
- An event history analysis of age at last menstrual period: correlates of natural and surgical menopause among midlife Wisconsin women.Soc Sci Med. 1998; 46: 1381-1396
- The empirical distribution function with arbitrarily grouped, censored, and truncated data.J R Stat Soc Ser B. 1976; 38: 290-295
Article info
Publication history
Accepted:
October 4,
2005
Received in revised form:
September 26,
2005
Received:
August 8,
2005
Identification
Copyright
© 2005 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
