Higher multimorbidity risk reported from reduced reproductive lifespan

Higher multimorbidity risk reported from reduced reproductive lifespan | Image Credit: © Tinashe Njaku/peopleimages.com - © Tinashe Njaku/peopleimages.com - stock.adobe.com.

The risk of multimorbidity is increased among women with a reduced reproductive lifespan, according to a recent study published in Menopause, the journal of The Menopause Society.¹

Menopause occurs when a women’s fertility declines because of the aging of the ovaries. This has been associated with a significantly increased risk of cardiovascular disease, osteoporosis, and other diseases.

Recently, interest has arisen about the association between reproductive-related factors and women’s health. The ovaries have been identified as one of the most rapidly aging organs in women, leading to women entering menopause when aged approximately 50 years.

Research has evaluated potential associations between age at menarche and menopause and health outcomes in women. This includes the potential risk of cardiovascular disease.

In a study including over 120,000 postmenopausal women, an association was reported between the duration of an individual’s reproductive lifespan and their risk of stroke. This is because of the length of exposure to endogenous estrogens is linked to the duration between menarche and menopause.

A longer duration of endogenous estrogens exposure usually leads to a reduced risk of disease, increasing women’s lifespans. In a new study with more than 1300 postmenopausal Chinese women, the impact of reproductive factors on multimorbidity was evaluated.

The study was cross-sectional and was conducted because of a lack of data about the association between reproductive lifespan and multimorbidity, despite menopause being considered a risk factor for multimorbidity.² Reproductive lifespan was defined as the period between menarche and menopause, and associations were identified using a logistic regression model.

Participants had an average reproductive lifespan of 34 years, and multimorbidity was defined as presenting with at least 2 chronic diseases.¹ Patients were divided into quartiles based on the length of their reproductive lifespan, with categories including Q1 at 32 years or under, Q2 at 33 to 34 years, Q3 at 35 to 37 years, and Q4 at 38 years or longer.

Women in the Q3 and Q4 groups had significantly reduced odds of multimorbidity vs those in the Q1 group, indicating a direct link between a longer reproductive lifespan and reduced risk of multimorbidity. This association was identified as a linear trend, meaning the longer the reproductive lifespan, the lower the risk of multimorbidity.

Multimorbidity was present in 22.2% of patients overall.² When comparing trends among quartiles, the odds ratios (ORs) for multimorbidity in Q3 and Q4 when compared to Q1 were 0.529 and 0.510, respectively. The risk was not significantly reduced in Q2 patients vs Q1 patients, with on OR of 0.7.

Investigators recommended health care professionals screen and assess reproductive factors to determine which individuals are at high risk.¹ Study results can be found in the article “Association between reproductive lifespan and multimorbidity among Chinese postmenopausal women.”

“What remains unclear and needs to be studied further is the direction of the association,” said Stephanie Faubion, MD, MBA, medical director for The Menopause Society. “In other words, does the presence of multiple chronic diseases cause the ovary to stop functioning earlier, or are the chronic diseases the result of the ovary ‘timing out’ earlier?”

References

1. Does it matter that the ovaries are the most rapidly aging organs in the female body? The Menopause Society. August 1, 2024. Accessed August 12, 2024. https://www.menopause.org/docs/default-source/press-release/reproductive-lifespan-and-multimorbidity.pdf
2. Jiao J, Xuehua F, Ailing G, Yi Y. Association between reproductive lifespan and multimorbidity among Chinese postmenopausal women. Menopause. 2024. doi:10.1097/GME.0000000000002419