Alcohol consumption and age of maternal menopause are associated with menopause onset. Factors associated with onset of menopause in women aged 45-49. A prospective analysis of alcohol consumption and onset of perimenopause. Prospective study of factors influencing the onset of natural menopause. Associations of physical activity and diet with the onset of menopause in Japanese women Age at natural menopause in relation to all-cause and cause-specific mortality in a follow-up study of US black women. Dietary and lifestyle predictors of age at natural menopause and reproductive span in the Shanghai Women's Health Study Reproductive and dietary determinants of the age at menopause in EPIC-Heidelberg. Effects of alcohol consumption on plasma and urinary hormone concentrations in premenopausal women. Is age at menopause increasing across Europe? Results on age at menopause and determinants from two population-based studies Factors associated with age of onset and type of menopause in a cohort of UK women. Serum hormones and the alcohol-breast cancer association in postmenopausal women. Acute effect of alcohol on estradiol, estrone, progesterone, prolactin, cortisol, and luteinizing hormone in premenopausal women. Prevalence of menopause symptoms and their association with lifestyle among Finnish middle-aged women. Onset of menopause in women exposed to diethylstilbestrol in utero. Menopause and risk factors for coronary heart disease. Epidemiology of risk factors and symptoms associated with menopause in Spanish women.
OBJECTIVES To examine whether a number of nutritional and familial factors were associated with menopausal development . METHODS A prospect i ve postal survey amongst a r and om sample of 1227 women aged 47 to 51 who were premenopausal in a cross-sectional survey 2 years previously . Women were classed into three groups ; premenopause ( regular menstruation ) ; irregular menstruation ; postmenopausal ( absence of menstrual cycle for at least 6 months )  . Proportional odds regression was used to identify those factors which were independently predictive of subsequent menopausal development . RESULTS There was an 80 % ( n = 983 ) survey response rate . After exclusion of current HRT users ( n = 178 ) ; 150 ( 19 % ) women were postmenopausal , 277 ( 34 % ) had erratic menstruation and 378 ( 47 % ) were premenopause . There were significant univariate associations between menopausal status and age ( P < 0.001 ) , age of maternal menopause ( P = 0.006 ) , alcohol consumption ( P = 0.005 ) and social class ( P = 0.03 ) . Maternal age and alcohol consumption were significantly correlated with estradiol levels ( r = 0.45 , P = 0.02 , and r = 0.61 , P = 0.02 for maternal age and alcohol consumption , respectively ) . In proportional odds regression analyses , age , maternal menopausal age , alcohol consumption and smoking were independently associated with menopausal status . CONCLUSIONS These results suggest that , ( 1 ) there is a strong familial association in menopausal age , and ( 2 ) moderate consumption of alcohol is associated with delayed menopausal development This paper uses a cross-sectional sample of women aged 45 - 49 to investigate factors that might be associated with an early menopause . Using logistic regression analysis we found that age , smoking , age of maternal menopause , parity , social class , meat and alcohol consumption were all independently associated with an early natural menopause .  Meat , alcohol consumption and maternal menopausal age do not seem to have been previously noted as associated with the timing of the menopause . These associations would merit further study , preferably using prospect i ve data . However , this study in line with much previous work shows that smoking is associated with a reduction in menopausal age OBJECTIVES We prospect ively assessed the association between alcohol consumption and onset of perimenopause in women of late reproductive age using data from the Harvard Study of Moods and Cycles . Specific types of alcoholic beverages - red wine , white wine , beer , and liquor - were evaluated . METHODS Among 502 women aged 36 - 45 years residing in seven Boston communities , we assessed self-reported perimenopausal symptoms over a 5-year period . The onset of perimenopause was defined using changes in menstrual characteristics . We administered a semiquantitative food frequency question naire at enrollment to measure regular alcohol consumption during the past year . Hazard ratios ( HRs ) and 95 % confidence intervals were derived from Cox regression models . RESULTS No association was found between total alcohol consumption and time to perimenopause . Compared with women consuming < 1 alcoholic drink per month , HRs for those drinking red wine in quantities of 1 - 3 glasses per month , 1 glass per week , or > or=2 glasses per week were all below 1.0 , after accounting for other sources of alcohol . Among never smokers , the inverse association with red wine was stronger and a positive association was observed with liquor consumption although numbers were small . No associations were observed with white wine or beer . CONCLUSION While there was no association between total alcohol consumption and onset of perimenopause , there was some suggestion of an inverse association between red wine and risk of perimenopause , particularly among never smokers Late or early menopause has been implicated in risk of several chronic diseases in women . To study factors influencing the onset of natural menopause , the authors analyzed the follow-up data of 4694 premenopausal women who enrolled in the New York University Women Study at ages 34 - 61 . In an average of 5.4 years of observation , there were 2035 incidences of menopause , with the median age of 51.3 years . Current smokers experienced menopause 0.75 years earlier than never-smokers . Those who smoked more than 10 cigarettes per day had a 40 % increase in risk of earlier menopause . In contrast , women who had three or more children experienced menopause 0.86 years later than nulliparous women , and Jewish women , 0.66 years later than Catholic women . There was also a modest increase in the age at menopause with increasing body mass index . This prospect i ve study provides solid epidemiologic evidence that several factors other than cigarette smoking have impact on the onset of natural menopause Objective Prospect i ve studies on physical activity and diet and the onset of natural menopause are scarce . The aim of this study was to examine the association of physical activity and dietary factors potentially related to endogenous estrogen levels such as fats , dietary fiber , soy isoflavones , and alcohol with the onset of  menopause in a cohort of premenopausal women . Methods Study participants were 3,115 premenopausal Japanese women aged 35 to 56 years derived from the participants in the Takayama Study .  Physical activity  was assessed by a vali date d question naire at baseline , and the metabolic equivalent score was calculated . The  dietary intakes  were estimated by a vali date d food frequency question naire at baseline and adjusted for total energy .  Menopause status was defined as the absence of menstruation for 12 months or more . The Cox proportional hazard model was used to estimate the hazard ratio of the occurrence of menopause after controlling for age , parity , body mass index , smoking status , years of education , and lifelong irregular menstrual cycle . Results During the 10-year follow-up , 1,790 women experienced natural menopause . A high physical activity level and a high intake of polyunsaturated fat were moderately but significantly associated with the earlier onset of menopause ; the hazard ratios for the highest versus lowest quartile were 1.17 ( 95 % CI , 1.02 - 1.34 ) for physical activity and 1.15 ( 95 % CI , 1.01 - 1.31 ) for polyunsaturated fat intake . Total fat , other types of fat , dietary fiber , soy isoflavones , and alcohol were not associated with the onset of menopause . Conclusions These data suggest that high levels of physical activity and polyunsaturated fat intake are associated with earlier onset of menopause OBJECTIVES Early age at natural menopause has been associated with increased all-cause mortality in several studies , although the literature is not consistent . This relation has not been examined among African American women . STUDY DESIGN Data were from the Black Women 's Health Study , a follow-up study of African-American women enrolled in 1995 . Among 11,212 women who were naturally menopausal at entry to the study or during follow-up through 2008 , we assessed the relation of age at natural menopause to all-cause and cause-specific mortality . At baseline and biennially , participants reported on reproductive and medical history , including gynecologic surgeries and exogenous hormone use .  Mortality data were obtained from the National Death Index . Multivariable Cox proportional hazard models were used to estimate mortality rate ratios ( MRR ) and 95 % confidence intervals ( CI ) for categories of age at menopause . RESULTS Of 692 deaths identified during 91,829 person years of follow-up , 261 were due to cancer , 199 to cardiovascular diseases and 232 to other causes . Natural menopause before age 40 was associated with increased all-cause mortality ( MRR=1.34 , 95 % CI 0.96 - 1.84 , relative to menopause at 50 - 54 years ; P-trend=0.04 ) and with the subcategories of death considered - cancer , cardiovascular disease , and all other causes . The associations were present among never and ever users of postmenopausal female hormones and among never and ever smokers . CONCLUSIONS In this large prospect i ve cohort of African-American women , natural menopause before age 40 was associated with a higher rate of all-cause and cause-specific mortality . These findings provide support for the theory that natural menopause before age 40 may be a marker of accelerated somatic aging Objective : Modifiable factors predicting the onset of menopause , a transition with important implication s for women 's health , have not been fully characterized . We evaluated the impact of dietary , lifestyle and reproductive factors on age at natural menopause and reproductive span in Chinese women . Design : Study participants were Chinese women aged 40 to 70 who experienced natural menopause and participated in a population -based , prospect i ve study , the Shanghai Women 's Health Study ( N = 33,054 ) .  Dietary intake  at the baseline survey was assessed by food-frequency question naire . Regression ( & bgr ; ) coefficients , calculated by multivariable linear regression , were used to estimate the effects of dietary , lifestyle , and reproductive patterns on age at menopause and the number of reproductive years , adjusting for potential confounding factors . Results : Early menarche , younger age at first live birth , older age at last live birth , longer duration of breast-feeding , and higher parity were associated with longer reproductive years ( Ptrend < 0.01 for all ) . Higher body mass index at age 20 , mid-life weight gain , and leisure-time physical activity during adolescence and adulthood predicted later menopause and longer reproductive span ( Ptrend < 0.01 for all ) . Total intake of calories , fruits , and protein  was positively associated with later menopause ( Ptrend < 0.05 for all ) and longer reproductive span ( Ptrend < 0.05 ) , except for carbohydrates ( Ptrend = 0.06 ) , and long-term tea consumption predicted longer reproductive span ( Ptrend = 0.03 ) . Vegetable , fat , soy , and fiber intakes did not significantly affect reproductive span or age at menopause . Smoking was inversely associated with both early age at menopause and shorter reproductive span ( Ptrend < 0.01 ) . Conclusions : In addition to reproductive factors , intake of fruits and protein , smoking , tea consumption , lifetime patterns of physical activity , and weight gain influenced the onset of menopause and /or reproductive span in Chinese women OBJECTIVES The aim of the study was to explore the influence of reproductive and dietary factors on the age at menopause . METHODS During follow-up of the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) cohort in Heidelberg ( median duration 5.8 years ) , 1009 women experienced natural menopause . They were compared to 3798 women who did not experience menopause .  Baseline dietary intake  was obtained by means of vali date d food frequency question naires . Data on reproductive history and medication was collected by means of question naires . Cox ' proportional hazard models were applied in order to identify determinants of the age at natural menopause . RESULTS Increasing age at first full term pregnancy and a longer time interval until occurrences of regular menses are associated with later onset of natural menopause . Compared to never smokers , current smokers have the risk of younger age at menopause . High carbohydrate consumption and high intake of vegetable , fibre and cereal products are inversely related to the age at natural menopause . Women with higher intake of total fat , protein and meat experienced a delayed onset of natural menopause . CONCLUSION Age at natural menopause is influenced by lifestyle and dietary factors . Further studies including biological markers are needed to clarify these associations BACKGROUND Most epidemiologic studies of the relationship between alcohol consumption and breast cancer risk  over the past decade have shown that persons who consume a moderate amount of alcohol are at 40%-100 % greater risk of breast cancer than those who do not consume alcohol . Dose-response effects have been observed , but no causal relationship has been established . PURPOSE This study examines the hypothesis that alcohol consumption affects levels of reproductive hormones . METHODS A controlled-diet study lasting for six consecutive menstrual cycles was conducted . Participants were r and omly assigned to two groups , and a crossover design was used . During the last three menstrual cycles , alcohol consumption of the two groups was reversed . Thirty-four premenopausal women , aged 21 - 40 years , with a history of regular menstrual cycles , consumed 30 g of ethanol ( equivalent to approximately two average drinks ) per day for three menstrual cycles and no alcohol for the other three . All food and alcohol consumed were provided by the study . Caloric intake was monitored to ensure that each woman would maintain body weight at approximately the baseline level . Hormone assays were performed on pooled plasma or 24-hour urine specimens collected during the follicular ( days 5 - 7 ) , peri-ovulatory ( days 12 - 15 ) , and mid-luteal ( days 21 - 23 ) phases of the third menstrual cycle for subjects on each diet . RESULTS Alcohol consumption was associated with statistically significant increases in levels of several hormones . Plasma dehydroepi and rosterone sulfate levels were 7.0 % higher in the follicular phase ( P = .05 ) . In the peri-ovulatory phase , there were increases of 21.2 % ( P = .01 ) in plasma estrone levels , 27.5 % ( P = .01 ) in plasma estradiol levels , and 31.9 % ( P = .009 ) in urinary estradiol levels . In the luteal phase , urinary estrone levels rose 15.2 % ( P = .05 ) , estradiol levels increased 21.6 % ( P = .02 ) , and estriol levels rose 29.1 % ( P = .03 ) . No changes were found in the percent of bioavailable estradiol , defined by the sum of percent free estradiol and percent albumin-bound estradiol . However , increased total estradiol levels in the peri-ovulatory phase suggest elevated absolute amounts of bioavailable estradiol . CONCLUSION This study has shown increases in total estrogen levels and amount of bioavailable estrogens in association with alcohol consumption in premenopausal women . IMPLICATION This possible explanatory mechanism for a positive association between alcohol consumption and breast cancer risk merits further investigation Objective : To investigate the variability and determinants of menopause age in two European cohort studies , the European Respiratory Health Survey and the Swiss Air Pollution and Lung Disease in Adults Cohort . Methods : Age at menopause was estimated in 5,288 women , aged 30 to 60 years , r and omly selected in nine European countries between 1998 and 2002 . Determinants of natural and surgically induced menopause were investigated by Cox regression and heterogeneity by meta- analysis .  Follicle-stimulating hormone and luteinizing hormone levels were assessed in a sub sample . Results : A quarter of the women were postmenopausal by age 50.8 years . Median age of natural menopause was 54 years . Hormone levels were within expected ranges for premenopausal and postmenopausal women . Surgically induced menopause was highly prevalent ( 22%-47 % ) , associated with earlier timing of menopause . Determinants of earlier menopause were current smoking ( hazard ratio [ HR ] , 1.59 ; 95 % CI , 1.27 - 1.98 ) , body mass index greater than 30 kg/m2 ( HR , 1.32 ; 95 % , CI , 1.02 - 1.70 ) , and low physical activity ( HR , 1.37 ; 95 % , CI , 1.12 - 1.67 ) . The determinant for later menopause was multiparity ( HR , 0.74 ; 95 % CI , 0.62 - 0.89 ) . Predictors were similar for naturally and surgically induced menopause . Oral contraceptive use yielded heterogeneous effects on timing of menopause . Later birth was associated with later menopause ( HR , 0.934 ; 95 % CI , 0.91 - 0.96 ) . This evidence of a secular trend is heterogeneous across countries . Conclusions : Age at menopause varies across Europe , shifting toward higher ages . This secular trend seems paradoxical because several adult determinants , that is , overweight , smoking , sedentarity , and nulliparity , associated with early menopause are on the rise in Europe . The heterogeneity of the secular trend suggests additional country-specific factors not included in the study , such as improved childhood nutrition and health , that have an influence on reproductive aging OBJECTIVE We sought to describe the pattern of  age at menopause  and factors associated with type of menopause . STUDY DESIGN This was a prospect i ve cohort study of 5113 postmenopausal health survey respondents in the Royal College of General Practitioners ' Oral Contraception Study .  Logistic regression was used to evaluate associations between sociodemographics , lifestyle , and medical history and menopause type . RESULTS Median age at natural menopause ( n = 3650 ) was 49.0 years ( interquartile range , 45.0 - 51.0 ) , and at surgical menopause ( n = 1463 ) was 42.4 years ( 38.0 - 46.4 ) . Early natural menopause was associated with smoking , ever-use of oral contraception , sterilization , and history of endometriosis ( all increased odds ratios ) and ever-use of hormone replacement therapy ( decreased ) . Surgical menopause was associated with manual social class , sterilization , and having a history of endometriosis , menorrhagia , or painful menstruation ( all increased ) , and ever-use of hormone replacement therapy ( decreased ) . CONCLUSION Age at natural menopause was younger in this cohort than in other studies . More associations were found for surgical menopause than early natural menopause BACKGROUND Alcohol ingestion is associated with an increased risk of breast cancer  in most epidemiologic studies . Results , however , are heterogeneous at lower levels of alcohol intake , and a biologic mechanism for the association has not been clearly identified . To determine whether alcohol consumption by postmenopausal women elevates serum levels of hormones associated with an increased risk of breast cancer , we performed a controlled feeding study . METHODS Participants were 51 healthy postmenopausal women not using hormone replacement therapy . Each participant rotated through three 8-week dietary periods in which she consumed 15 or 30 g of alcohol per day or an alcohol-free placebo beverage . The order of assignment to the three alcohol levels was r and om . During the dietary periods , all food and beverages were supplied by the study , and energy intake was adjusted to keep body weight constant . Levels of estradiol , estrone , estrone sulfate , testosterone , and rostenedione , progesterone , dehydroepi and rosterone ( DHEA ) , DHEA sulfate ( DHEAS ) , and and rostenediol were measured by radioimmunoassays in serum collected at the end of each dietary period . All statistical tests are two-sided . RESULTS When women consumed 15 or 30 g of alcohol per day , respectively , estrone sulfate concentrations increased by 7.5 % ( 95 % confidence interval [ CI ] = -0.3 % to 15.9 % ; P = .06 ) and 10.7 % ( 95 % CI = 2.7 % to 19.3 % ; P = .009 ) and DHEAS concentrations increased by 5.1 % ( 95 % CI = 1.4 % to 9.0 % ; P = .008 ) and 7.5 % ( 95 % CI = 3.7 % to 11.5 % ; P<.001 ) relative to levels when women consumed placebo . None of the other hormones measured changed statistically significantly when women consumed alcohol . CONCLUSIONS Results suggest a possible mechanism by which consumption of one or two alcoholic drinks per day by postmenopausal women could increase their risk of breast cancer BACKGROUND Heavy alcohol consumption is associated with menstrual irregularities , including anovulation , luteal-phase dysfunction , recurrent amenorrhea , and early menopause . In addition , moderate to heavy alcohol intake has been found to increase the risk of spontaneous abortions and breast cancer . These adverse effects could at least in part originate from alcohol-mediated changes in hormone levels . METHODS The acute effect of alcohol on the hormone balance in women using oral contraceptives ( OC+ ) and also in nonusers ( OC- )  , was evaluated in 30 OC- and 31 OC+ subjects , representing the whole period of the menstrual cycle . It was also evaluated in 40 OC- and 47 OC+ subjects during the midcycle phase and in 10 OC+ subjects with unknown cycle phase . RESULTS We found that among subjects who used oral contraceptives  , estradiol levels increased and progesterone levels decreased after intake of alcohol ( 0.5 g/kg ) . No dose effect ( 0.34 - 1.02 g/kg ) on progesterone was observed in a sub study on 10 OC+ subjects . With regard to estrone levels , no effect was observed , although a significant increase was found in the estradiol-to-estrone ratio . Among subjects not using oral contraceptives , progesterone levels decreased after intake of alcohol ( 0.5 g/kg ) . No effect was found in estradiol , estrone , or the estradiol-to-estrone ratio during midcycle in this study group . A transient elevating effect of alcohol ( 0.5 g/kg ) on prolactin levels was observed in both study groups . We found that alcohol ( 0.5 g/kg ) had no significant effect on luteinizing hormone ( LH ) levels among subjects not using oral contraceptives , and observed a decline among subjects using oral contraceptives at midcycle . CONCLUSIONS We suggest that the estradiol and progesterone effects are related to decreased steroid catabolism , result ing from the alcohol-mediated increase in the hepatic NADH-to-NAD ratio . The transient effect on prolactin levels may reflect acute changes in opioid and dopamine levels in the hypothalamus . The present findings regarding female sex steroids may be of relevance in the association between moderate to heavy alcohol consumption and the development of breast cancer BACKGROUND AND AIM OF THE STUDY The aim of this study is to report the prevalence of menopausal symptoms by severity among the Finnish female population and the association of their symptoms with lifestyle ( smoking , use of alcohol , physical activity ) and body mass index ( BMI ) . MATERIAL AND METHODS Health 2000 is a nationally representative population -based study of Finnish adults . Data were collected by home interview , three self-administered question naires and a clinical examination by a physician . This study included women aged 45 - 64 years ( n=1427 ) . All symptoms included menopause-specific symptoms . Both univariate analysis and a factor analysis based on symptom factors were performed by menopausal group . Multiple regression analysis included each symptom factor as a dependent variable and confounding and lifestyle factors ( age , education , smoking , alcohol use , physical activity , BMI , use of hormonal replacement therapy ( HRT ) and chronic disease status ) . RESULTS Over one-third ( 38 % ) of the premenopausal , half of the perimenopausal , and 54 % of both postmenopausal and hysterectomized women reported bothersome symptoms . The difference between pre- and perimenopausal women was largest and statistically most significant in the case of back pain and hot flushes . Physically active women reported fewer somatic symptoms than did women with a sedentary lifestyle . Smoking was not related to vasomotor symptoms . CONCLUSION Bothersome symptoms are common in midlife , regardless of menopausal status . Inverse association between physical activity and menopausal symptoms needs to be confirmed in r and omized trials OBJECTIVES As part of a larger health survey , we sought to determine whether prenatal exposure to diethylstilbestrol is associated with onset of early menopause or menopausal symptoms . STUDY DESIGN Diagnosis of premature ovarian failure and symptoms of menopause were determined in a telephone interview with 542 women whose mothers participated in a r and omized clinical trial of the use of diethylstilbestrol in pregnancy in the early 1950s . These women were aged 37 to 39 at the time of the interview . Medical records were obtained to confirm diagnosis of premature ovarian failure . RESULTS The prevalence of menopausal symptoms ( specifically hot flashes and night sweats ) did not differ for exposed and unexposed women . One exposed woman and no unexposed women had a medically confirmed diagnosis of premature ovarian failure . CONCLUSIONS Prenatal diethylstilbestrol exposure was not related to diagnosis or symptoms of menopause in this study . Further follow-up will be necessary to determine if a difference in age at menopause emerges as these women become older Postmenopausal women are believed to have a higher risk of coronary artery disease than premenopausal women . In this study , we prospect ively determined changes in coronary risk factors that were attributable to natural menopause in 541 healthy , initially premenopausal women 42 to 50 years of age . After approximately 2 1/2 years , 69 women had spontaneously stopped menstruating for at least 12 months , and 32 women had stopped natural menstruation and received hormone-replacement therapy for a period of at least 12 months . An equal number of age-matched premenopausal women in the study group served as controls . In women who had a natural menopause and did not receive hormone-replacement therapy , serum levels of high-density lipoprotein ( HDL ) cholesterol declined as compared with those of premenopausal controls ( -0.09 vs. 0.00 mmol per liter ; P = 0.01 ) , and levels of low-density lipoprotein ( LDL ) cholesterol increased ( + 0.31 vs. + 0.14 mmol per liter ; P = 0.04 ) . In menopausal women who received hormone-replacement therapy , HDL and LDL cholesterol levels did not change , but the levels of triglycerides ( + 0.42 vs. -0.04 mmol per liter ; P less than 0.001 ) , apolipoprotein A-I ( + 0.18 vs. + 0.03 g per liter ; P less than 0.01 ) , and apolipoprotein A-II ( + 0.05 vs. -0.03 g per liter ; P less than 0.05 ) increased as compared with premenopausal controls . Natural menopause did not affect blood pressure , plasma glucose or insulin levels , body weight , the total number of kilojoules consumed in the diet , or the total number of kilojoules expended in physical activity . These results suggest that a natural menopause has an unfavorable effect on lipid metabolism , which may contribute to an increase in the risk of coronary disease .  Hormone-replacement therapy may prevent some of these changes OBJECTIVES ( 1 ) To assess the prevalence of risk factors for osteoporosis and cardiovascular disease and the prevalence and severity of the appearance of menopausal symptoms among Spanish menopausal women . ( 2 ) To identify the main factors responsible for this severity . ( 3 ) To detect symptom differences between perimenopausal and postmenopausal women . METHODS Cross-sectional descriptive study encompassing women aged 45 - 65 years in the whole Spanish territory . The study population sample was collected through r and om sampling . A total of 10,514 women were included . The sociodemographic , medical history and lifestyle data were assessed by means of a survey . The Kupperman scale was used to assess the severity of menopausal symptoms . RESULTS The prevalence of risk factors for osteoporosis and cardiovascular disease were 67.6 % and 74.8 % , respectively . The most common risk factors were physical inactivity ( 53.6 % ) , obesity ( 44.3 % ) , arterial hypertension ( 36.6 % ) , hypercholesterolemia ( 31.4 % ) , low calcium intake ( 30.1 % ) and smoking ( 28.7 % ) . The predominant symptoms experienced by menopausal women were hot flushes ( 51.4 % ) , insomnia ( 45.7 % ) and irritability ( 42.2 % ) . These were severe in 3.3 % of the sample , moderate in 27.3 % , mild in 24.6 % while 44.8 % had no symptoms . The prevalence of joint pain ( 40.1 % ) and depressive mood ( 40 % ) was higher in perimenopausal than in postmenopausal women . Logistic regression analysis showed that there were differences for age , BMI , smoking , social class and poor consumption of dairy products in the severity of menopausal symptoms . CONCLUSIONS A high prevalence of risk factors for osteoporosis and cardiovascular disease was observed in our study . The main factors contributing to more severe menopausal symptoms were age , BMI , smoking social class and poor consumption of dairy products . In general , postmenopausal women presented significantly higher rates of menopausal symptoms when compared to perimenopausal women
WIDER IMPLICATION S The findings of this review indicate that alcohol consumption , particularly low and moderate alcohol intake , might be associated with later onset of menopause although the magnitude of the association is low .
BACKGROUND Early onset of menopause is associated with long-term health risks , including cardiovascular disease and premature death .
Although alcohol intake has been suggested to affect the age at which natural menopause occurs , results from observational studies are not consistent .
OBJECTIVE AND RATIONALE In the view of the differing risks to the health of early menopause and the increasing trends in alcohol consumption in women , in this systematic review , we aim ed to quantify the association between all levels of alcohol consumption and menopause onset .