Is the age of menopause determined in-utero?

doi:10.1016/S0378-3782(97)00028-5

Early Human Development

Volume 49, Issue 2, 19 September 1997, Pages 143-148

https://doi.org/10.1016/S0378-3782(97)00028-5 Get rights and content

Abstract

Objective: To determine whether age at menopause is related to size at birth. Design: A follow-up study of two groups of women whose size at birth was recorded. Setting: Hertfordshire and Sheffield, England. Population: 755 women aged 60–71 years born in Hertfordshire; 235 women aged 40–42 years born in the Jessop Hospital, Sheffield. Main outcome measures: Age at natural menopause or serum follicle stimulating hormone concentration greater than 25 IU/ml. Results: Age at menopause was unrelated to birth weight. However, it occurred at a younger age in women who had low weight at 1 year. This was independent of their body weight and smoking habits. In the population of younger women those who had had an early menopause tended to have been short at birth, with a high ponderal index (birth weight/length³). Conclusion: Growth retardation in late gestation, leading to shortness at birth and low weight gain in infancy, may be associated with a reduced number of primordial follicles in the ovary leading in turn to an earlier menopause.

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Cited by (114)

Idiopathic primary ovarian insufficiency is associated with anogenital distance, a marker for prenatal environment
2021, European Journal of Obstetrics and Gynecology and Reproductive Biology
Citation Excerpt :
Organ development during prenatal life is known to be influenced by the intrauterine environment. It has been suggested that the female reproductive tract and ovarian reserve set prenatally can be affected by intrauterine nutrition, environmental and hormonal factors [5–9]. Anogenital distance (AGD), an anthropometric measurement, is a sexually dimorphic trait and considered as a biomarker for prenatal hormonal environment [10–17].
In a significant number of women diagnosed with primary ovarian insufficiency (POI), the underlying cause cannot be found. On the other hand, the ovarian reserve set prenatally has been shown to be affected by intrauterine nutrition, environmental and hormonal factors. We aimed to evaluate the relationship between anogenital distance (AGD), which is considered as a biomarker for prenatal hormonal environment, and idiopathic POI in adolescents and young women.
This case control study was conducted between September 2018 and December 2019. The study group consisted of patients between the ages of 15–30, who developed POI following menarche without any identified genetic or iatrogenic cause. Controls were patients of the same age range who were having regular menstrual periods and were not diagnosed with polycystic ovary syndrome or endometriosis. Patients were excluded from the study if they were pregnant, had vaginal delivery or genital surgery. Distance between the anterior clitoral surface and the upper verge of the anus (AGD_AC), and between the posterior fourchette and the upper verge of the anus (AGD_AF) were measured in all subjects.
In total, 37 POI patients and 44 controls were included in the study. Two groups were similar for demographic parameters such as age and body mass index (BMI). Shorter AGD_AC and AGD_AF measurements were found to be associated with idiopathic POI.
Our results provide the first evidence of a strong association between shorter AGD measurements and the presence of idiopathic POI suggesting that prenatal environment may have role in the development of POI.
Body size at birth, early-life growth and the timing of the menopausal transition and natural menopause
2020, Reproductive Toxicology
Citation Excerpt :
The inclusion of women in the menopausal transition in the reference group along with menstruating women could explain why some previous studies were null [23,24] or observed an association of smaller magnitude between low birth weight and earlier age at menopause than we observed [26,27]. The use of recalled birth weight data, which is reported with error in adulthood [42,43], and recalled age at menopause outside of the age range when menopause usually occurs, which studies have shown is less reliable with increasing time since menopause [44–46], may have also biased the results of previous studies towards the null [21,22,25,27,29]. We observed that lower weight through 1 year of age was associated with earlier age at menopause or menopausal transition.
Whether birth weight and early-life growth are associated with age at menopause has not been resolved.
We conducted a prospective study in two U.S. birth cohorts to investigate the relation of weight at birth and weight and growth trajectory through age 4 years to menstrual status among 1001 women ages 39–49 years. We used logistic regression models with GEE.
Women who weighed more at birth and at one year were less likely to have experienced the menopausal transition or natural menopause by age 39–49 years (odds ratio(OR) = 0.50, 95% confidence interval(CI) = 0.32, 0.77 and OR = 0.82, 95%CI = 0.68, 0.99 per kilogram increase at birth and age one, respectively).
Women who had a lighter weight at birth and women who were lighter than their peers through infancy experienced the menopausal transition or natural menopause at an earlier age.
EMAS position statement: Predictors of premature and early natural menopause
2019, Maturitas
While the associations of genetic, reproductive and environmental factors with the timing of natural menopause have been extensively investigated, few epidemiological studies have specifically examined their association with premature (<40 years) or early natural menopause (40–45 years).
The aim of this position statement is to provide evidence on the predictors of premature and early natural menopause, as well as recommendations for the management of premature and early menopause and future research.
Literature review and consensus of expert opinion.
Strong genetic predictors of premature and early menopause include a family history of premature or early menopause, being a child of a multiple pregnancy and some specific genetic variants. Women with early menarche and nulliparity or low parity are also at a higher risk of experiencing premature or early menopause. Cigarette smoking (with a strong dose–response effect) and being underweight have been consistently associated with premature and early menopause. Current guidelines for the management of premature and early menopause mainly focus on early initiation of hormone therapy (HT) and continued treatment until the woman reaches the average age at menopause (50–52 years). We suggest that clinicians and health professionals consider the age at menopause of the relevant region or ethnic group as part of the assessment for the timing of HT cessation. In addition, there should be early monitoring of women with a family history of early menopause, who are a child of a multiple pregnancy, or who have had early menarche (especially those who have had no children). As part of preventive health strategies, women should be encouraged to quit smoking (preferably before the age of 30 years) and maintain optimal weight in order to reduce their risk of premature or early menopause.
Premature ovarian insufficiency and perinatal parameters: A retrospective case-control study
2017, Maturitas
The peak number of oocytes is reached during intrauterine development, after which numbers decline until reserves are depleted and a woman enters menopause. In premature ovarian insufficiency (POI), the process of follicle depletion occurs at a young age (generally taken as 40 years); the condition affects about 1% of women. In this study, we investigate whether women with POI had experienced a different perinatal milieu, as reflected in their birth weight or prematurity.
In this retrospective case-control study, we evaluated whether women diagnosed with POI had a different birth weight or prematurity rate (<37 weeks) compared with women aged over 40 at natural menopause (the controls). Binary logistic regression models were used to analyze the data and correct for smoking. 59 women with POI and 92 controls were recruited.
13.6% of women diagnosed with POI were born prematurely, compared with 6.6% of controls (p = 0.018). Corrected for gestational age, women with POI did not have a different birth weight compared with controls. As a consequence of the design of our study, mean age at time of interview differed significantly between groups, at 37.5 and 46 years respectively for women diagnosed with POI and controls. Years of oral contraception use, smoking, age at menarche, BMI and education levels were similar in the two groups.
Our findings indicate that prematurity is a risk factor for POI. Prenatal factors contributing to prematurity, or postnatal factors that are the result of prematurity, may lead to early follicle depletion.
Developmental Origins of Adult Health and Disease
2016, Obstetrics: Normal and Problem Pregnancies
Human Reproductive Ecology
2015, Basics in Human Evolution
Human reproductive ecology (HRE) studies human reproduction in the context of local ecological variables. The perspective of HRE is evolutionary, and its central goal is to provide models for explaining variation in reproductive patterns as adaptations to the environment. Reproductive function shows significant variation between and within individuals and populations. Human reproductive function has been shown to vary in response to ecological variables such as nutrition, physical activity, acute immunological challenges, psychological stress, and social context. HRE allows us to explore what the consequences of that variation are in terms of health, fertility, and ultimately, reproductive fitness.

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Is the age of menopause determined in-utero?

Abstract

Bailliere's Clin. Endocrinol. Metab.

An investigation of the age at menopause

J. Biosoc. Sci.

What determines the age at menopause?

Br. Med. J.

Follicular depletion during the menopause transition: evidence for accelerated loss and ultimate exhaustion

J. Clin. Endocrinol. Metab.

A quantitative morphological investigation of the follicular system in newborn female infants

Acta Anatomica

Early growth and death from cardiovascular disease in women

Br. Med. J.