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Menopause May Come Earlier to Poor Women

Poverty may play a key role, study finds

FRIDAY, Oct. 18, 2002 (HealthDayNews) -- While menopause begins at different ages for different women, researchers have found one surprising factor that may play a key role in the timing: Money.

Women who reported enduring economic hardship throughout their lives were 80 percent more likely to experience menopause symptoms early, according to a study in the November issue of Journal of Epidemiology and Community Health.

In many cases, the body changes that signal the onset of menopause came a year before they should have for the poorer women in the study. Only smoking has that much affect on the process, says lead researcher Lauren Wise, an epidemiologist with Boston University's Slone Epidemiology Center.

Although medical researchers have long associated low incomes with increased risk of heart disease, this is one of the first studies suggesting a link to the end of fertility. Still, much more research is needed to prove the connection, Wise says.

"It's really a very preliminary study. It's not very definitive," she says. "We wanted to put this information out quickly to get other researchers to look at it."

Wise and researchers from Harvard University's School of Medicine and Brown University tracked 603 women of different economic backgrounds from the Boston area, aged 36 to 45, for three years. During that period, 35 percent of the women began to notice the first signs of menopause, including cycle length variations, changes in blood flow, mid-cycle spotting, missed periods or extended time between periods.

For the average woman, the first symptoms of menopause begin at age 45, and menopause takes effect at age 50 or 51. But for the 46 women in the study who were poor throughout their lives, these first symptoms appeared as much as one year earlier than normal. The reason isn't yet clear, but it likely involves malnutrition, stress, depression and environmental toxins such as smoking or lead, Wise says.

Marie Lugano, president of the American Menopause Foundation, says this: "A woman from a lower economic class is going to have her condition exacerbated because she can't afford to go to a physician. It's pretty obvious, actually. If you don't think stress impacts men and women, think again."

Women who get regular medical care are more likely to receive low doses of estrogen during the menopause transition, leading to a more regular menstrual cycle, Lugano says. (To avoid this bias in the study, Wise didn't include data from women who had taken estrogen or were taking birth control pills.)

Lugano criticized the study because only 5 percent of the women were black or Hispanic. Those women usually begin menopause earlier, she says, a point that Wise's study supports.

Another limitation of the study is that most of the women were college-educated and financially secure, not poor.

"We need to replicate these findings in other populations," Wise says. "This needs more study."

The research was funded, in part, by the National Institute for Mental Health.

What To Do

For helpful links about menopause, visit the National Library of Medicine. For other resources, visit the North American Menopause Society.

SOURCES: Lauren Wise, epidemiologist, Boston University's Slone Epidemiology Center, Boston; Marie Lugano, president, American Menopause Foundation, New York City; November 2002 Journal of Epidemiology and Community Health
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