A recent 21-year follow-up prospective study was designed to analyze the association between smoking and the onset of menopause at an earlier age in a large cohort of middle-aged women after adjustment for a number of potential confounders . The main outcomes were age of menopause measured at the 21-year follow-up, smoking and menopausal status. This study was based on 3545 women who provided data on their menopausal status at the 21-year follow-up of the study and prospective as well as concurrent data on smoking. In univariate analysis, tobacco smoking during the reproductive life course, socioeconomic status and gravidity were significantly associated with earlier age of menopause. In multivariate analyses, women who smoked cigarettes were more prone to develop earlier menopause than non-smokers. Compared to current smokers, risk of early menopause was significantly lower in those women who were former smokers. In summary, data from this study suggest that the impact of smoking is independent of other covariates associated with both smoking and age of menopause. These findings raise the possibility that effective programs for smoking cessation may lead to a later age of menopause and reduce the risk of adverse health consequences of early menopause.
Ob Gyn Senior Consultant, Hospital Clínic Barcelona, and Full Professor, University of Barcelona, Spain
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