Health Answers: What factors influence the timing of menopause?

Q. What factors influence the timing of menopause?

A. Menopause typically occurs in women between the ages of 45 and 55, but the age of onset varies; the average age in the United States is about 51.

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Ellen Gold, an epidemiologist at the University of California, Davis, says that “the age of menopause is a marker for what happens later in terms of chronic disease risk and mortality.” Women who have a later onset of menopause have, on average, a longer life expectancy and lower risk of heart disease, stroke, and osteoporosis. On the flip side, they have a higher risk of breast, endometrial, and ovarian cancers. But the risk of these cancers is far lower than the other diseases, Gold says, and late menopause is generally considered a marker of good health status.

Family history and genetics play a role in when a woman’s menopause starts. Gold says that studies have also linked the timing of menopause to a variety of lifestyle and health factors. “The one very consistent thing almost every study shows is that women who smoke have an earlier onset of menopause,” Gold says. Women of lower socioeconomic status also tend to have menopause earlier.

Two reproductive factors are often linked to later menopause in studies: having more pregnancies and taking oral contraceptives. Both factors reduce how often a woman ovulates over a lifetime, Gold says, which may prolong their ovulation. The age at which women start their periods, however, does not seem to predict the age of menopause.