Work

Age at natural menopause and stroke: A U-shaped association in the health and retirement study

Year: 2025

Type: article

Abstract: BACKGROUND: The association between age at natural menopause and cerebrovascular risk is unclear. This study investigates non-linear relationships, effect modification, mediation, and long-term stroke-free survival in postmenopausal women. METHODS: We analyzed 9,159 postmenopausal women from the Health and Retirement Study. Menopause age was categorized (<40, 40-44, 45-49, 50-55, >55) and modeled continuously. Stroke outcomes were derived from self-reports and linked Medicare claims. We used multivariable logistic regression with restricted cubic splines, interaction terms among hypertension, diabetes, and hypercholesterolemia, structural equation modeling for mediation, and Kaplan-Meier/Cox models for survival analysis. RESULTS: Each additional year of later menopause was linked to lower stroke odds (OR 0.935, 95 % CI 0.922-0.948). Compared to the 50-55 age group, those with menopause <45 years (OR 2.76, 95 % CI 2.09-3.47) and 45-49 years (OR 2.08, 95 % CI 1.72-2.62) had higher risks. Spline analysis indicated a U-shaped curve, with the lowest risk at ages 50-52. Stroke-free survival differed significantly across groups (log-rank p = 0.0017), particularly worse with premature menopause. CONCLUSIONS: Age at natural menopause exhibits a U-shaped association with stroke risk, emphasizing the importance of timing in individualized prevention strategies.

Source: Journal of Stroke and Cerebrovascular Diseases

DOI: 10.1016/j.jstrokecerebrovasdis.2025.108497

Authors: QinFeng Zeng, Wenjia Zhang, Yingzhi Liu, Weijun Yang, XiaoLing Wu, Jieding Li

Language: English

Topic: Menopause: Health Impacts and Treatments

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,170

Funder: National Institute on Aging