The prevalence and the age at the onset of menopause in Turkish women in rural area

OBJECTIVE: To find out the prevalence of natural menopause among Turkish women according to age and certain demographic variables in a specific rural area.

METHODS: This cross sectional study was carried out in Silivri district of Istanbul, Turkey between January and May 2000. Included in the study were 845 women between the ages of 30-60 years, not undergoing any hormonal replacement, living in the villages of Silivri district, Istanbul, Turkey. The participants were asked for their ages, level of education, number of pregnancies, age at menarche, presence of menstruation, age at the onset of menopause, physical activity outside home and the use of oral contraceptives. Females declaring at least one year of amenorrhea were accepted as being in menopause.

RESULTS: The median age for menopause was 47 years. Of the total 845 participants, 326 women were found to be in natural menopause. The prevalence of menopause was estimated as 8.6% for females younger than 40 years, 31.8% for females between the ages 40-45 years and 80.9% among females older than 45 years. Any of the variables questioned in our study have an effect on premature onset of menopause, but we found that never been pregnant (p=0.037, odd ratio (OR)=2.221, 95% confidence interval (CI)=1.048, 4.707) reduces the reproductive period, and the age at menarche younger than 13 prevents early menopause (p=0.000, OR=0.336, 95% CI=0.195, 0.579). Furthermore, both lead to early onset of menopause. Hazard ratios of the variables that have an effect on the onset of early menopause are calculated as 2:10 (95% CI=1.01, 4.39) for those who were never been pregnant and 1:10 for those with the menarche ages over 13 years (95% CI=0.68, 1.78).

CONCLUSION: There was a noticeably high percentage of females (8.6%) younger than 40 years who were entering menopause. On the other hand, an early onset of natural menopause among Turkish women living in this rural area was found to be associated with never been pregnant and their age of menarche.