Epidemiology of menopause

Menopause is a common, important event in every woman’s life. The age at natural menopause (ANM) is critical for women’s health, given the physiological consequences of earlier and later timing of menopause. Although hormone replacement therapy (HRT) has a clear role in the treatment of vasomotor symptoms (VMS) that occur during menopause, debate on its risks and benefits persists. More than a decade ago, HRT use rates have plummeted, however few data exists on its current rates in Canada. The predictors of age at menopause and HRT use vary across populations, however little is known about them in Canada.Using data from the CLSA, this study will 1) determine the prevalence and characteristics of women who have used HRT 2) estimate the average ANM and examine the factors associated with it.

With this study we set out to determine the prevalence of hormone therapy use and its types; we also examined the socio-demographic, health behavior, reproductive, clinical and psychosocial factors associated with current and past hormone therapy use in the CLSA. Our other main objective was to provide estimates of the median age at natural menopause and assess the association of socio-demographic, health behavior, reproductive, clinical and psychosocial factors with age at natural menopause among Canadian women aged 45-85 years.

Overall, 9.5% of the sample reported current use of hormone therapy, whereas 21.9% reported past use. The main factors associated with a lower likelihood of current hormone therapy use were older age (>80 y), non-white ethnic background, current employment, regular smoking, obesity, and breast cancer. By contrast, alcohol consumption, and the presence of allergies or mood disorders were positively associated with current hormone therapy use. Overall, median age at natural menopause was 51 years. Having no partner, low household income and education levels, current and former smoking, and cardiovascular disease were all associated with an earlier age at natural menopause, whereas current employment, alcohol consumption, and obesity were associated with later age at natural menopause.

These findings provide a recent national picture of hormone therapy use in Canada that may be used to inform opportunities for improved physician-patient communication regarding menopause management. Results also show the importance of lifestyle factors and health conditions in determining menopausal age. These factors might help in risk assessment, prevention and early management of chronic disease risk during the menopausal transition.