Highlights
- •In the study's random sample of women aged 18 to 50 years who resided in Olmsted County between 1988 and 2007, median age was 51 years for spontaneous and 46 years for induced menopause.
- •The frequency of premature spontaneous or induced menopause was 3.1 %.
- •Bilateral oophorectomy was the most common cause of premature menopause.
- •Hysterectomy with at least one ovary conserved concealed the onset of menopause.
- •Gynecologic surgeries for benign conditions should be reduced.
Abstract
Objective
There is limited information on the prevalence of premature and early menopause. Therefore,
we studied the frequency and type of premature (age < 40 years) or early (age 40–44 years)
menopause in a geographically-defined American population.
Methods
We studied a random sample of women aged 18 to 50 years who resided in Olmsted County,
MN between 1988 and 2007. Women were followed through December 2021, and age at cessation
of menses was assessed via review of the medical records included in a medical records-linkage
system. Menopause was defined as cessation of menses due to spontaneous or induced
ovarian insufficiency.
Results
1015 women (71.3 %) underwent spontaneous menopause, 138 (9.7 %) underwent bilateral
oophorectomy, 17 (1.2 %) had antecedent chemotherapy or radiation therapy, and 254
(17.8 %) underwent hysterectomy or endometrial ablation. The median age at cessation
of menses was 51.0 years (IQR, 49.0–52.0) for spontaneous menopause, 46.0 years (IQR,
41.0–49.0) for menopause induced by oophorectomy, chemotherapy, or radiation therapy,
and 38.0 years (IQR, 33.0–44.0) for hysterectomy. Considering both spontaneous and
induced menopause, the frequency was 3.1 % (95 % CI, 2.2–4.2) for premature and 6.2 %
(95 % CI, 5.0–7.8) for early menopause. Considering only spontaneous menopause, the
frequency reduced to 0.4 % (95 % CI, 0.2–1.0) for premature and 5.2 % (95 % CI, 4.0–6.8)
for early menopause. However, considering all types of cessations of menses, the frequency
was 12.2 % (95 % CI, 10.6–14.0) for premature and 9.7 % (95 % CI, 8.3–11.3) for early
cessation of menses.
Discussion
Approximately 3 % of women in the general population experienced either spontaneous
or induced premature menopause. The most common cause of premature menopause was bilateral
oophorectomy.
Keywords
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Article info
Publication history
Published online: February 06, 2023
Accepted:
January 16,
2023
Received in revised form:
January 11,
2023
Received:
August 29,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
