Age at menopause is significantly and positively associated with polycystic ovary syndrome (PCOS), according to data from a recent regression model analysis.1
Takeaways
- Women with polycystic ovary syndrome (PCOS) experience approximately a 5% longer time to menopause compared to those without the condition, according to a recent study's findings.
- The association between PCOS and age at menopause remains statistically significant even after adjusting for various demographic, clinical, and behavioral factors, indicating a robust link between them.
- While the study provides valuable insights, further longitudinal analysis involving a more diverse population is necessary to confirm and understand the underlying mechanisms driving the association between PCOS and menopause.
- The observed link between PCOS and extended time to menopause highlights potential implications for fertility and reproductive health among women with PCOS, warranting attention in clinical practice.
- The study utilized data from the Tehran Lipid and Glucose Study, a population-based initiative, and employed rigorous statistical methods, including accelerated failure time survival regression models, to analyze the association between PCOS and age at menopause.
Findings from a new study by an international team of investigators indicated that women with PCOS experienced an approximate 5% extended time to menopause compared with women without PCOS, an association that remained significant even when controlling for patient demographics, disease history, and behaviors such as contraceptive use. The investigators believe the findings warrant both longitudinal analysis, including a more diverse population of women to affirm the association, as well as research into the pathophysiology of PCOS, which accelerates menopause onset.
Led by Mina Amiri, PhD, assistant professor at the Research Institute for Endocrine Sciences at Shahid Beheshti University of Medical Sciences in Tehran, Iran, the investigators sought to determine whether PCOS was associated with age at menopause in women vs a control group of women without the ovary syndrome, with adjustments for clinical and demographic confounders. Prior research has elucidated a potential influence of PCOS on variable age of menopause among aging women; an international analysis published in August 2023 showed that women with PCOS report higher anti-Müllerian hormone levels than those without; such levels are highly correlative of follicle counts, which themselves are understood to be associated with differences in menopause age.2
Investigators conducted their population-based prospective study using data from the Tehran Lipid and Glucose Study, an initiative designed to assess the epidemiology of noncommunicable disease risk factors and outcomes among the population of Tehran, Iran, implemented in 1999.1,3 Amiri et al included 1696 participants of reproductive age from the original study who averaged a follow-up of approximately 20 years.
Among the participants, 348 women with PCOS (20.5%) were followed to interpret the age at which they reached menopause vs the control arm of 1348 women without PCOS (79.5%). The investigators determined the association between PCOS and age at menopause via an accelerated failure time survival regression model.
Their analyses were conducted with and without adjustment for potential confounders such as baseline age, menarche age, body mass index (BMI), physical activity, smoking status, oral contraceptive use, and history of hypertension and type 2 diabetes mellitus (T2DM). The correlative risk of later-life BMI increase—and therefore, cardiovascular disease and T2DM risks—among women with PCOS is well established.4
The investigators observed a significant, positive association between PCOS and age of natural menopause among affected women. In the unadjusted accelerated failure time survival model, women experienced time to menopause by a factor of 1.05 compared with the control arm (95% CI, 1.02-1.06; P < .001).1
When adjusting for the confounders of age and clinical, demographic, and comorbid factors, investigators found the correlation between PCOS and age of natural menopause remained statistically significant (time ratio, 1.03; 95% CI, 1.01-1.06; P = .002). The team concluded that their prospective analysis suggests a significant link between age to natural menopause and PCOS in women—an outcome that may complicate the understood fertility and reproductive health of women with PCOS. “However, further large longitudinal studies on diverse populations accounting for other relevant confounders are still needed to provide data on the actual difference in age at menopause and to elucidate the underlying mechanisms of this association,” they concluded.
References
- Amiri M, Rahmati M, Firouzi F, Azizi F, Ramezani Tehran F. A prospective study on the relationship between polycystic ovary syndrome and age at natural menopause. Menopause. 2024;31(2):130-137. doi:10.1097/GME.0000000000002261
- Mohammad H, S JC, Haripriya G, Maskeri D, K P, Priya P. Model of anti-Mullerian hormone over age to predict menopause in polycystic ovary syndrome and eumenorrheic women: a study on Southern Indian population. Cureus. 2023;15(8):e43419. doi:10.7759/cureus.43419
- Azizi F, Zadeh-Vakili A, Takyar M. Review of rationale, design, and initial findings: Tehran Lipid and Glucose Study. Int J Endocrinol Metab. 2018;16(suppl 4):e84777. doi:10.5812/ijem.84777
- Sharma S, Mahajan N. Polycystic ovarian syndrome and menopause in forty plus women. J Midlife Health. 2021;12(1):3-7. doi:10.4103/jmh.jmh_8_21
