Premature ovarian failure: frequency and risk factors among women attending a network of menopause clinics in Italy
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Abstract
OBJECTIVE: To determine the frequency and causes of preterm ovarian failure (menopause before 40 years of age) and early menopause (menopause between 40 and 45 years). DESIGN: Cross sectional study. SETTING: Menopause clinics in Italy. POPULATION: Women attending menopause clinics in Italy. METHODS: Between 1997 and 1999 we conducted a large cross sectional study on the characteristics of women around menopause attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. Eligible for the study were all women aged 45-75 years consecutively observed for the first time at the participating centres on randomly selected days during the study period. MAIN OUTCOME MEASURE: Factors associated with preterm ovarian failure. RESULTS: Out of 15,253 women aged 55 years or more with spontaneous menopause who entered the study, 269 (1.8%) reported preterm ovarian failure, and 1085 (7.1%) reported spontaneous menopause at age 40-45 years. The risk of preterm ovarian failure and of early menopause was higher in women reporting lifelong irregular menstrual cycles: in comparison with women reporting menopause at age > or =45 years, the OR (irregular vs regular menstrual cycles) of preterm ovarian failure was 1.3 (95% CI 1.0-1.7) and of early menopause of 1.2 (95% CI 1.0-1.5). Parous women reported less frequently preterm ovarian failure (chi(2) trend P < 0.05) and early menopause (OR 0.8, 95% CI 0.7-1.0). No significant association emerged between risk of preterm ovarian failure or menopause at age 40 to <45 and education, age at menarche, oral contraceptive use and smoking habits. CONCLUSION: Nulliparity and lifelong irregular menstrual cycles are associated with an increased risk of preterm ovarian failure.
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