Socioeconomic Class linked to Early Menopause

A recent study has found that a woman’s chance of suffering from premature menopause, or premature ovarian failure (POF), is connected to her socioeconomic class as well as whether or not she smokes.

Female participants in a recent study who were from the lowest social class were found to be almost three times as likely to suffer from POF as women from the highest social class.

POF is defined as the onset of menopause before the age of forty years old. It is characterized by amenorrhea and sterility, and is commonly associated with infertility, but it also is connected to significantly increased mortality rates and a general decreased quality of life, said Islam.

According to Dr. Rumana Islam of Imperial College, London, UK, who conducted the research, prior studies have found that very few women suffering from POF actually seek hospital care, and as such, there is a lack of information concerning the disorder.

With her colleague Dr. Rufus Cartwright, Islam studied the records of 4,968 women who formed part of the 1958 Birth Cohort. "This included all the women born in Britain in a single week," said Islam. "They have been followed up eight times, most recently at age fifty, when they were asked about the date and cause of their menopause and also their quality of life."

Out of the 4,968 study participants, 370 (7.4%) underwent either spontaneous or medically induced POF.

Nearly 20% of the women in the study who underwent POF suffered from it as a result of removal of the ovaries and/or hysterectomy, or as a consequence of chemotherapy. "While hysterectomy has become less common over the last decade, our findings reinforce the recommendation that it should be a last resort for menstrual disorders, and that oophorectomy should be avoided in younger women," said Dr. Islam.

Social class was found to be a large influence concerning which women underwent POF; smoking was also a strong factor. "Socioeconomic influences on health are pervasive, but often hard to disentangle," said Islam. "Based on these data we can only speculate as to what they are, but the effect might be due to an unaccounted for environmental effect. Despite the availability of universal health care throughout these women's lives, there might also be differences in access to health care or differences in health behaviors.”

The SF-36 health survey was used to measure the women’s quality of life, and researchers found that women with POF were more than twice as likely to report poor quality of life. Further, quality of life was not be bettered by taking confounding factors such as smoking, obesity, and physical exercise into account.

"There was also a profound impact on quality of life ten years after POF, affecting vitality, physical function, mental health, and general health perceptions. However, social function was unaffected," said Dr. Islam.

According to Islam, this research provides evidence for the first time the largely unrecognized physical and psychological burden of women suffering from POF in the general population. Islam stated that this data "suggests an immediate need for primary care practitioners to screen for POF in women who present with amenorrhea before the age of forty. Our data provide a clear rationale for the management of POF symptoms by healthcare providers. We believe that women with POF can benefit from multidisciplinary specialist care, including support for their significant psychological and physical symptoms. Their long-term health needs should also be considered.”

“Our study has shown POF has a major impact on the quality of life of a significant section of the population, and it needs addressing urgently," concluded Islam.

These results were announced the annual conference of the European Society of Human Reproduction and Embryology.