Age at natural menopause in women with a history of chronic diseases-A population-based cohort study

Objective: This study was carried out to determine whether chronic diseases can influence age at natural menopause (ANM).Study design and main outcome measures: This population-based prospective study recruited all eligible women from participants in the Tehran Lipid and Glucose Study (TLGS). The Cox proportional-hazards model (unad-justed and adjusted) was used to assess associations of ANM with chronic diseases, including diabetes mellitus (DM), hypertension (HTN), dyslipidemia, metabolic syndrome (MetS), cardiovascular disease (CVD), chronic kidney disease (CKD), and thyroid disorders, which were not included simultaneously in the model because there were correlations between chronic diseases.Results: A total of 4662 women, aged 15-50 years, who had not reached menopause at initiation of the TLGS were included. Of these women, 1220 (26.2%) experienced menopause during the study follow-up. In the multivar-iable Cox regression model adjusted for potential confounders, women with DM [HR:1.75; 95%CI: (1.32, 2.32)], HTN [HR: 2.11; 95%CI: (1.64, 2.72)], MetS [HR: 2.01; 95%CI: (1.57, 2.58)], CVD [HR: 3.02; 95%CI: (1.93, 4.73)], CKD [HR: 2.64; 95%CI: (2.16, 3.22)], and thyroid disorders [HR: 1.41; 95%CI: (1.06, 1.88)] reached menopause earlier, while dyslipidemia was not associated with ANM. Conclusion: This study demonstrates that women with a history of chronic diseases, such as metabolic disorders, cardiovascular events, and CKD, experience menopause earlier than their counterparts without such a history.