Age at menopause and multimorbidity in postmenopausal women

Introduction:
We examined the association between age at menopause and multimorbidity in postmenopausal women in the United States.

Material and methods:
The data were obtained from the National Health and Nutrition Examination Survey (2007–2010, 2013–2014, and 2017–2018), which included 3168 postmenopausal women over 40 years old. The exposure variable was age at menopause, while the outcome variable was multimorbidity, defined as having 2 or more health conditions. Health conditions included hypertension, diabetes, cardiovascular disease (CVD), cancer, arthritis, obesity, osteoporosis, thyroid disease, chronic bronchitis, emphysema, and liver conditions. Logistic regression models were employed to estimate unadjusted and adjusted odds ratios (OR) and 95% confidence intervals. We also used logistic regression models with restricted cubic splines to illustrate the association between continuous menopausal age and multimorbidity.

Results:
The adjusted OR for multimorbidity in women with age at menopause of < 40, 40–44, and 55+ years were 4.25 (3.07–5.89), 1.46 (1.08–1.99), and 0.61 (0.43–0.85), respectively, compared to age at menopause of 45–54 years. Premature menopause was associated with every health condition and multimorbidity except for liver conditions. Early menopause was related to hypertension and CVD. Continuous menopausal age, regardless of menopausal type, presented inverse and linear associations with multimorbidity. The study found no significant interaction effects between age at menopause and hormone therapy on the association between age at menopause and multimorbidity.

Conclusions:
Premature or early menopause was associated with increased risks of developing multiple health conditions. Implementing early surveillance and intervention strategies is imperative to mitigate the burden of multimorbidity among women undergoing premature or early menopause.