Factors associated with onset of menopause in women aged 45-49. Alcohol consumption and age of maternal menopause are associated with menopause onset. Dietary and lifestyle predictors of age at natural menopause and reproductive span in the Shanghai Women's Health Study Associations of physical activity and diet with the onset of menopause in Japanese women Vitamin D and calcium intake and risk of early menopause. Reproductive and dietary determinants of the age at menopause in EPIC-Heidelberg. Potential risk factors for development of postmenopausal osteoporosis — Examined over a 12-year period Age at natural menopause in relation to all-cause and cause-specific mortality in a follow-up study of US black women. Processed and unprocessed red meat consumption and hypertension in women. Onset of menopause in women exposed to diethylstilbestrol in utero. Prospective study of factors influencing the onset of natural menopause. Physical activity and the menopause experience: a cross-sectional study. Alcohol, tobacco, and mammographic density: a population-based study Population based study of coffee, alcohol and tobacco use and risk of ovarian cancer Evidence-based review of therapies at the menopause. Factors associated with age of onset and type of menopause in a cohort of UK women. A longitudinal analysis of the association between menopause and depression. Results from the Massachusetts Women's Health Study. Acute effect of alcohol on estradiol, estrone, progesterone, prolactin, cortisol, and luteinizing hormone in premenopausal women. Daily apple versus dried plum: impact on cardiovascular disease risk factors in postmenopausal women. Reproductive hormone exposure timing and ischemic heart disease: Complicated answers to a simple question. Fish consumption and the incidence of cerebrovascular disease. Is age at menopause increasing across Europe? Results on age at menopause and determinants from two population-based studies Women and Menopause: Beliefs, Attitudes, and Behaviors. The North American Menopause Society 1997 Menopause Survey
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 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 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 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 Background : Early menopause , defined as the cessation of ovarian function before the age of 45 y , affects ∼10 % of women and is associated with higher risk of cardiovascular disease , osteoporosis , and other conditions . Few modifiable risk factors for early menopause have been identified , but emerging data suggest that high vitamin D intake may reduce risk . Objective : We evaluated how intakes of vitamin D and calcium are associated with the incidence of early menopause  in the prospect i ve Nurses ' Health Study II ( NHS2 ) . Design : Intakes of vitamin D and calcium from foods and supplements were measured every 4 y with the use of a food-frequency question naire . Cases of incident early menopause were identified from all participants who were premenopausal at baseline in 1991 ; over 1.13 million person-years , 2041 women reported having natural menopause before the age of 45 y. We used Cox proportional hazards regression to evaluate relations between intakes of vitamin D and calcium  and incident early menopause while accounting for potential confounding factors . Results : After adjustment for age , smoking , and other factors , women with the highest intake of dietary vitamin D ( quintile median : 528 IU/d ) had a significant 17 % lower risk of early menopause than women with the lowest intake [ quintile median : 148 IU/d ; HR : 0.83 ( 95 % CI : 0.72 , 0.95 ) ; P-trend = 0.03 ] . Dietary calcium intake in the highest quintile ( median : 1246 mg/d ) compared with the lowest ( median : 556 mg/d ) was associated with a borderline significantly lower risk of early menopause ( HR : 0.87 ; 95 % CI : 0.76 , 1.00 ; P-trend = 0.03 ) . Associations were stronger for vitamin D and calcium from dairy sources than from nondairy dietary sources , whereas high supplement use was not associated with lower risk . Conclusions : Findings suggest that high intakes of dietary vitamin D and calcium may be modestly associated with a lower risk of early menopause . Further studies evaluating 25-hydroxyvitamin D concentrations , other dairy constituents , and early menopause are warranted 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 In a longitudinal study , we investigated the influence of risk factors on bone mass at menopause  and  postmenopausal bone loss  in 121 healthy postmenopausal women . These women had completed a 2-year prospect i ve study in 1979 and a follow-up examination in 1989 . Measurements of the bone mineral content in the distal forearm ( single photon absorptiometry ) were performed 9 times during the initial study and once at the follow-up examination . Bone mass at menopause ( initial measurement ) , rate of early postmenopausal bone loss , and the subsequent rate of bone loss over 10 years were thus determined . In addition , the bone mineral density of the lumbar spine and proximal femur was measured by dual-energy X-ray absorptiometry ( DXA ) in 1989 . Information about risk factors was assessed by st and ardized question naires and included reproductive history and lifestyle factors ( intake of calcium and vitamin D supplements , consumption of alcohol and caffeine , smoking habits , and physical activity ) . Lactation , oral contraceptive use , and dietary calcium intake above 1500 mg per day was associated with significantly increased bone mass at menopause . The number of pregnancies reduced the rate of early postmenopausal bone loss , whereas moderate alcohol consumption reduced the subsequent rate of bone loss . Smoking significantly reduced femoral bone mineral density . In conclusion , the present prospect i ve study showed that some of the examined putative risk factors positively influenced bone mass at menopause , especially calcium intake , whereas the postmenopausal bone loss was virtually unaffected . Assessment of risk factors in postmenopausal women thus seems to have limited value for reducing future risk of osteoporosis 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 BACKGROUND High processed red meat consumption is associated with increased risk of cardiovascular disease . The high sodium content of processed red meat could increase blood pressure and explain the association with cardiovascular disease . OBJECTIVE We evaluated the relation between the consumption of unprocessed and processed red meat and incident hypertension . DESIGN In a prospect i ve cohort of 44,616 disease-free French women who responded to a vali date d dietary question naire , we observed 10,256 incident cases of hypertension between 1993 and 2008 . Cases were identified through self-reports of diagnosed or treated hypertension . Multivariate Cox regression models were adjusted for age , education , smoking , physical activity , body mass index , menopause , menopausal hormone therapy , and alcohol , bread , coffee , and fruit and vegetable consumption . RESULTS Women who consumed ≥5 servings of processed red meat/wk ( 50 g = 1 serving ) had a 17 % higher rate of hypertension than that of women who consumed < 1 serving/wk ( HR : 1.17 ; 95 % CI : 1.09 , 1.26 ; P-trend = 0.0002 ) . No association was observed between unprocessed red meat consumption and hypertension . When women who consumed ≥5 servings of unprocessed red meat/wk ( 100 g = 1 serving ) were compared with women who consumed < 1 serving unprocessed red meat/wk , the multivariate HR was 0.99 ( 95 % CI : 0.91 , 1.08 ; P-trend = 0.63 ) . CONCLUSIONS In this large prospect i ve cohort of French women , we observed an association between the consumption of processed red meat and hypertension . We observed no association for unprocessed red meat consumption and hypertension 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 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 A r and omly selected community cohort of 2000 Australian born women aged 45 to 55 were interviewed on the telephone and information obtained on their health and well-being . These women were divided into pre- , peri- , natural and surgical menopausal groups on their menstrual history . A physical activity question naire was sent to 1181 women in the first three of these groups . These question naires were completed and returned by 61.6 % of the women . The response rate in all groups was significantly associated with the years of education , employment status , body mass index ( BMI ) and self-rated health of the participants . The aim of the study was to test the hypothesis that physical activity is a major contributor to health and well-being by establishing the relationships between physical activity and certain health outcomes , such as menopausal symptoms , psychological well-being , self-rated health and BMI in this cohort of mid-life women . The inter-relationship between physical activity and other variables , including menopausal status , interpersonal stress , health related and preventive health behaviours was examined . Levels of  physical activity  were significantly associated with better self-rated health , lower BMI measurements , moderate alcohol intake and self-breast examination . There was no significant association between levels of physical activity , psychological well-being and women 's experience of symptoms during the natural menopause transition Mammographic density ( MD ) , or the proportion of the breast with respect to its overall area that is composed of dense tissue , is a strong risk factor for breast cancer . Studies support a positive association of mammographic density  and alcohol drinking . This was a cross-sectional multicenter study based on 3584 women , aged 45–68 years , recruited from seven screening centers within the Spanish breast cancer screening program network . The association between MD , alcohol consumption and tobacco use was evaluated by using ordinal logistic models with r and om center-specific intercepts . We found a weak positive association between current alcohol intake and higher MD , with current alcohol consumption increasing the odds of high MD by 13 % ( OR = 1.13 ; 95 % CI 0.99–1.28 ) and high daily grams of alcohol being positively associated with increased MD ( P for trend = 0.045 ) . There were no statistically significant differences in MD between smokers and non-smokers . Nevertheless , increased number of daily cigarettes and increased number of accumulated lifetime cigarettes were negatively associated with high MD ( P for trend 0.017 and 0.021 ) . The effect of alcohol on MD was modified by menopausal status and tobacco smoking : whereas , alcohol consumption and daily grams of alcohol were positively associated with higher MD in postmenopausal women and in women who were not currently smoking , alcohol consumption had no effect on MD in premenopausal women and current smokers . Our results support an association between recent alcohol consumption and high MD , characterized by a modest increase in risk at low levels of current consumption and a decrease in risk among heavier drinkers . Our study also shows how the effects of alcohol in the breast can be modified by other factors , such as smoking Coffee , alcohol and tobacco use have been examined in many epidemiologic studies of ovarian cancer but findings have generally been inconclusive . To explain prior inconsistent findings , we sought to determine whether associations with these exposures might vary by histologic subtype of ovarian cancer or menopausal status at diagnosis . We conducted a population ‐based case‐control study in eastern Massachusetts and New Hampshire involving 549 women with newly‐diagnosed epithelial ovarian cancer and 516 control women selected either by r and om digit dialing or through lists of residents .  Coffee and alcohol consumption  was assessed through a semi‐quantitative food‐frequency question naire , and information on tobacco smoking was collected through personal interview . Consumption of coffee and caffeine was associated with increased risk for ovarian cancer but only among premenopausal women . There was no increase in risk for ovarian cancer overall associated with tobacco or alcohol use in either pre‐ or post‐menopausal women . Association of borderline significance for tobacco and invasive serous cancers and alcohol and mucinous cancers were observed but reduced after adjustment for coffee consumption . We conclude that coffee and caffeine consumption may increase risk for ovarian cancer among premenopausal women and are findings that have some epidemiologic and biologic support . Int . J. Cancer 88:313–318 , 2000 . © 2000 Wiley‐Liss , Background and Objective The highest level of scientific evidence available for each therapy for menopausal symptoms was sought , for example , systematic review s of r and omised controlled trials ( RCTs ) . Results There is reasonable evidence that some symptoms are modified by lifestyle , for example , cessation of smoking , exercise , reduction of alcohol , diet and alleviation of psychosocial stress . No complementary medicine , for example , phytoestrogens , black cohosh , herbal or homeopathic medicines or complementary therapies , for example , acupuncture , yoga , chiropractic manipulation , reflexology or magnetic devices have a greater effect than the usual placebo effect seen in quality blinded RCTs . Some have potential side-effects . So-called ' bioidentical hormones ' have no evidence -base and potential for harm . None of the above therapies have evidence of efficacy and long-term safety . Selective serotonin and noradrenaline re-uptake inhibitors ameliorate vasomotor symptoms and sometimes menopausal depression better than placebo . The most effective therapy for menopausal ( oestrogen ) deficiency symptoms is oestrogen which is the main component of hormone replacement therapies ( HRT ) . Compared with placebo HRT is highly effective in relieving hot flushes , night sweats , dry vagina and dyspareunia . It also improved joint pains , sexuality and sleeplessness and reduced subsequent fractures in RCTs . The increased risk of oral HRT for thromboembolism is small around menopause , for those without thrombotic risk factors , and is not elevated with non-oral routes . Cardiovascular disease may be reduced when HRT is initiated near menopause . Breast cancer risk increases after several years with the use of oral HRT containing progestogens at an annual rate of 8/10 000 ( < 0.1 % ) . No increase in breast cancer risk was seen with oestrogen-only HRT 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 The present article prospect ively examines the effect of change in menopause status on depression , while controlling for prior depression . This is a longitudinal follow-up of previous cross-sectional analyses reported by McKinlay , McKinlay , and Brambilla who examined the relative contribution of menopause to depression . The data derive from the Massachusetts Women 's Health Study , a 5-year longitudinal study of a cohort of 2565 women aged 45 to 55 years at baseline ( 1981 to 1982 ) . Results show that prior depression is the variable most predictive of subsequent depression , as measured by the Center for Epidemiologic Studies -Depression ( CES-D ) scale . Onset of natural menopause was not associated with increased risk of depression . Experiencing a long perimenopausal period ( at least 27 months ) , however , was associated with increased risk of depression . The association between a long perimenopause and depression appeared to be explained by increased menopausal symptoms rather than by the menopause status itself . The observed increase in depression during a lengthy perimenopause appears to be transitory 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 Evidence suggests that consumption of apple or its bioactive components modulate lipid metabolism and reduce the production of proinflammatory molecules . However , there is a paucity of such research in human beings . OBJECTIVE Women experience a lower rate of cardiovascular disease before menopause compared with men . However , after the onset of menopause , the risk of cardiovascular disease increases drastically due to ovarian hormone deficiency . Hence , we conducted a 1-year clinical trial to evaluate the effect of dried apple vs dried plum consumption in reducing cardiovascular disease risk factors in postmenopausal women . DESIGN One-hundred sixty qualified postmenopausal women were recruited from the greater Tallahassee , FL , area during 2007 - 2009 and were r and omly assigned to one of two groups : dried apple ( 75 g/day ) or dried plum ( comparative control ) . Fasting blood sample s were collected at baseline , 3 , 6 , and 12 months to measure various parameters . Physical activity recall and 7-day dietary recall were also obtained . RESULTS Neither of the dried fruit regimens significantly affected the participants ' reported total energy intake throughout the study period . On the contrary , women who consumed dried apple lost 1.5 kg body weight by the end of the study , albeit not significantly different from the dried plum group . In terms of cholesterol , serum total cholesterol levels were significantly lower in the dried apple group compared with the dried plum group only at 6 months . Although dried plum consumption did not significantly reduce serum total cholesterol and low-density lipoprotein cholesterol levels , it lowered their levels numerically by 3.5 % and 8 % , respectively , at 12 months compared with baseline . This may explain the lack of significance observed between the groups . However , within the group , women who consumed dried apple had significantly lower serum levels of total cholesterol and low-density lipoprotein cholesterol by 9 % and 16 % , respectively , at 3 months compared with baseline . These serum values were further decreased to 13 % and 24 % , respectively , after 6 months but stayed constant thereafter . The within-group analysis also reported that daily apple consumption profoundly improved atherogenic risk ratios , whereas there were no significant changes in lipid profile or atherogenic risk ratios as a result of dried plum consumption . Both dried fruits were able to lower serum levels of lipid hydroperoxide and C-reactive protein . However , serum C-reactive protein levels were significantly lower in the dried plum group compared with the dried apple group at 3 months . CONCLUSIONS There were no significant differences between the dried apple and dried plum groups in altering serum levels of atherogenic cholesterols except total cholesterol at 6 months . However , when within treatment group comparisons are made , consumption of 75 g dried apple ( about two medium-sized apples ) can significantly lower atherogenic cholesterol levels as early as 3 months . Furthermore , consumption of dried apple and dried plum are beneficial to human health in terms of anti-inflammatory and antioxidative properties Premenopausal women have a relatively lower risk of ischemic heart disease ( IHD )  compared to age matched men and this gender gap narrows after menopause . The observation that the onset of IHD occurs 10 years later in women than it does in men is said to suggest that endogenous reproductive hormones play a protective role . Indeed , animal models and human epidemiological studies suggest that oophorectomy is a risk factor for accelerated IHD . In animal models , hormone therapy ( HT ) has anti-atherosclerotic effects after oophorectomy , HT in the form of oral contraceptives ( OCs ) prevents atherosclerosis in anovulatory cycling women , and large numbers of premenopausal women taking OCs have relative safety from an IHD st and point ( 1 ) . Further , observational epidemiological studies in humans have consistently demonstrated protective effects for IHD among HT users . Such studies are typically performed on relatively younger women where  HT  is prescribed for  vasomotor symptoms during menopausal transition or shortly following menopause . In contrast , clinical trials in older , postmenopausal and often asymptomatic women have demonstrated no overall benefit and early adverse effects when r and omized to a variety of forms of HT ( 1 ) . These data discrepancies have called into question the validity of the reproductive hormone estrogen protection hypothesis , and raise the alternative possibility that  HT efficacy may differ according to the timing of exposure . Stated as a simple question , is the effect of HT on the risk of IHD in relatively young pre- or early menopausal women with vasomotor symptoms , different than it is in older , fully menopausal women ? Data from the Women ’s Ischemia Syndrome Evaluation ( WISE ) , a prospect i ve multi-center NHLBI-sponsored study design ed to explore female-specific pathophysiology in a large sample of women undergoing coronary angiography for suspected IHD ( 2 ) , may shed light on this controversy . These new data , prospect ively obtained using novel methods , including detailed reproductive health question naires , menopausal adjudication algorithms , and quantitative coronary angiography as a measure of atherosclerosis , allow a more precise inspection of this question . However , to answer this simple question we need to first answer others . Specifically , how can we integrate and underst and the findings from the available observational , animal and clinical trial data ? And to interpret these data other questions become relevant : 1 ) How accurately was menopause assessed in prior observational HT studies ? 2 ) Does HT in premenopausal women in the form of OC therapy confirm atherosclerosis benefit ? and 3 ) Does HT in early menopausal women confer reduced atherosclerosis and benefit on the risk of IHD Studies of the beneficial role of fish consumption in the prevention of CVD are not consistent in their findings , particularly those studies that focus on the risk of stroke . The aim of the present study is to investigate the relationship between the consumption of different types of fish and the subsequent incidence of cerebrovascular disease ( CVA ) . We prospect ively evaluated the association between consumption of different types of fish and CVA in 3958 men and women aged 40 - 79 years who were free of heart disease and had participated in a health examination survey from 1967 to 1972 . A total of 659 incident cases of CVA occurred during a follow-up until the end of 1994 . A dietary history interview method provided data on habitual consumption of fish and other foods over the preceding year at baseline . Total fish intake did not predict CVA , but consumption of salted fish suggested an increased risk of intracerebral haemorrhage . The relative risk of intracerebral haemorrhage between the highest tertile of salted fish consumption and non-consumers was 1.98 ( 95 % CI 1.02 , 3.84 ; P for trend = 0.06 ) after adjustment for age , sex , energy intake , smoking , BMI , physical activity , geographic area , occupation , diabetes , use of post-menopausal hormones , serum cholesterol , hypertension , and consumptions of butter , vegetables , fruits and berries . The relationship between fish consumption and stroke risk is not straightforward . How the fish is prepared for consumption may play an important role , affecting the association 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 The main purpose in organizing this survey was to collect information relevant to The North American Menopause Society 's ( NAMS ) educational mission and to document women 's knowledge of , and attitudes toward , menopause . DESIGN During June-July 1997 , The Gallup Organization conducted 750 telephone interviews with a r and omly selected sample of women 45 - 60 years of age from across the United States . Women were asked about their sources of information on menopause , what changes in health they anticipated as a result of menopause , why they used hormone therapy , and their attitudes toward menopause as a natural or a medical event . RESULTS Women are more likely to believe that depression and irritability are associated with menopause than heart disease , but only a few associate menopause with an increasing vulnerability to either memory loss or Alzheimer 's disease . Relief of physical symptoms of menopause was mentioned as the reason for starting hormone therapy more often than to protect against osteoporosis ( 25 % relative to 15 % ) , or to prevent stroke or a heart attack ( 10 % ) , or to reduce the risk of developing Alzheimer 's disease ( 2 % ) . The single main source of women 's information on menopause was a health professional ( 49 % ) . The majority of women who were already menopausal or experiencing menstrual changes expressed an attitude toward menopause that was either neutral ( 42 % ) or positive ( 36 % ) . CONCLUSIONS Women are divided in their views of menopause , some seeing it as a medical condition requiring medical treatment , whereas others see it as a natural transition to be managed by " natural " means . Providing women with accurate , up-to- date information and enhancing communication between healthcare providers and menopausal women remain the challenges for NAMS
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 .