Type and Timing of Menopause and Later Life Mortality among Women in the Iowa Established Populations for the Epidemiological Study of the Elderly (EPESE) Cohort

Mary Ann Liebert Inc., Publishers

Journal of Women’s Health

Sarah E. Tom, Rachel Cooper, Robert B. Wallace, and Jack M. Guralnik. Journal of Women’s Health. January 2012, 21(1): 10-16. doi:10.1089/jwh.2011.2745. Published in Volume: 21 Issue 1: January 12, 2012
Online Ahead of Print: October 4, 2011


Background: The relationship between menopausal characteristics and later life mortality is unclear. We tested the hypotheses that women with surgical menopause would have increased all-cause and cardiovascular mortality compared with women with natural menopause, and that women with earlier ages at natural or surgical menopause would have greater all-cause and cardiovascular mortality than women with later ages at menopause.

Methods: Women who participated in the Iowa cohort of the Established Populations for the Epidemiologic Study of the Elderly (n=1684) reported menopausal characteristics and potential confounding variables at baseline and were followed up for up to 24 years. Participants were aged 65 years or older at baseline and lived in rural areas. We used survival analysis to examine the relationships between menopausal characteristics and all-cause and cardiovascular mortality.

Results: A total of 1477 women (87.7% of respondents) died during the study interval. Women with an age at natural menopause ‚Č•55 years had increased all-cause and cardiovascular disease mortality compared with women who had natural menopause at younger ages. Type of menopause and age at surgical menopause were not related to mortality. These patterns persisted after adjustment for potential confounding variables.

Conclusions: Among an older group of women from a rural area of the United States, later age at natural menopause was related to increased all-cause and cardiovascular mortality. Monitoring the cardiovascular health of this group of older women may contribute to improved survival times.

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Author: Leslie Carol Botha

Author, publisher, radio talk show host and internationally recognized expert on women's hormone cycles. Social/political activist on Gardasil the HPV vaccine for adolescent girls. Co-author of "Understanding Your Mood, Mind and Hormone Cycle." Honorary advisory board member for the Foundation for the Study of Cycles and member of the Society for Menstrual Cycle Research.