Skip to main content
American Journal of Public Health logoLink to American Journal of Public Health
. 1993 Jul;83(7):983–988. doi: 10.2105/ajph.83.7.983

Early menopause, number of reproductive years, and bone mineral density in postmenopausal women.

D Kritz-Silverstein 1, E Barrett-Connor 1
PMCID: PMC1694784  PMID: 8328621

Abstract

OBJECTIVES. Previous studies have reported positive associations of age at menopause with bone density and inverse associations of age at menarche with bone density. This study examined the relationships of early age at menopause and number of reproductive years (defined as age at menopause minus age at menarche) with bone density in postmenopausal women. METHODS. The subjects were 555 women aged 60 to 89 years who had had either natural menopause (n = 391) or hysterectomy with bilateral oophorectomy (n = 164). Bone density was measured at the ultradistal wrist, midshaft radius, lumbar spine, and hip. RESULTS. Women who had had early menopause and those with the fewest reproductive years had significantly lower bone density at all sites. After adjustment for covariates, both age at menopause and number of reproductive years had significant positive associations with bone density at every site, and total number of reproductive years explained more of the variance in bone mineral density than did either age at menarche or age at menopause. CONCLUSIONS. Elderly women reporting early menopause or fewer reproductive years have more osteoporosis. The number of reproductive years may be more helpful than age at menopause in identifying women at increased risk of osteoporosis.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barzel U. S. Estrogens in the prevention and treatment of postmenopausal osteoporosis: a review. Am J Med. 1988 Dec;85(6):847–850. doi: 10.1016/s0002-9343(88)80033-0. [DOI] [PubMed] [Google Scholar]
  2. Cummings S. R. Epidemiologic studies of osteoporotic fractures: methodologic issues. Calcif Tissue Int. 1991;49 (Suppl):S15–S20. doi: 10.1007/BF02555081. [DOI] [PubMed] [Google Scholar]
  3. Dequeker J., Tobing L., Rutten V., Geusens P. Relative risk factors for osteoporotic fracture: a pilot study of the MEDOS questionnaire. Clin Rheumatol. 1991 Mar;10(1):49–53. doi: 10.1007/BF02208033. [DOI] [PubMed] [Google Scholar]
  4. Dhuper S., Warren M. P., Brooks-Gunn J., Fox R. Effects of hormonal status on bone density in adolescent girls. J Clin Endocrinol Metab. 1990 Nov;71(5):1083–1088. doi: 10.1210/jcem-71-5-1083. [DOI] [PubMed] [Google Scholar]
  5. Elders P. J., Netelenbos J. C., Lips P., Khoe E., van Ginkel F. C., Hulshof K. F., van der Stelt P. F. Perimenopausal bone mass and risk factors. Bone Miner. 1989 Nov;7(3):289–299. doi: 10.1016/0169-6009(89)90085-8. [DOI] [PubMed] [Google Scholar]
  6. Georgiou E., Ntalles K., Papageorgiou A., Korkotsidis A., Proukakis C. Bone mineral loss related to menstrual history. Acta Orthop Scand. 1989 Apr;60(2):192–194. doi: 10.3109/17453678909149252. [DOI] [PubMed] [Google Scholar]
  7. Gärdsell P., Johnell O., Nilsson B. E. The impact of menopausal age on future fragility fracture risk. J Bone Miner Res. 1991 May;6(5):429–433. doi: 10.1002/jbmr.5650060502. [DOI] [PubMed] [Google Scholar]
  8. Johnell O., Nilsson B. E. Life-style and bone mineral mass in perimenopausal women. Calcif Tissue Int. 1984 Jul;36(4):354–356. doi: 10.1007/BF02405345. [DOI] [PubMed] [Google Scholar]
  9. Lacey J. M., Anderson J. J., Fujita T., Yoshimoto Y., Fukase M., Tsuchie S., Koch G. G. Correlates of cortical bone mass among premenopausal and postmenopausal Japanese women. J Bone Miner Res. 1991 Jul;6(7):651–659. doi: 10.1002/jbmr.5650060702. [DOI] [PubMed] [Google Scholar]
  10. Melton L. J., 3rd, Bryant S. C., Wahner H. W., O'Fallon W. M., Malkasian G. D., Judd H. L., Riggs B. L. Influence of breastfeeding and other reproductive factors on bone mass later in life. Osteoporos Int. 1993 Mar;3(2):76–83. doi: 10.1007/BF01623377. [DOI] [PubMed] [Google Scholar]
  11. Nordin B. E., Need A. G., Chatterton B. E., Horowitz M., Morris H. A. The relative contributions of age and years since menopause to postmenopausal bone loss. J Clin Endocrinol Metab. 1990 Jan;70(1):83–88. doi: 10.1210/jcem-70-1-83. [DOI] [PubMed] [Google Scholar]
  12. Richelson L. S., Wahner H. W., Melton L. J., 3rd, Riggs B. L. Relative contributions of aging and estrogen deficiency to postmenopausal bone loss. N Engl J Med. 1984 Nov 15;311(20):1273–1275. doi: 10.1056/NEJM198411153112002. [DOI] [PubMed] [Google Scholar]
  13. Rosenthal D. I., Mayo-Smith W., Hayes C. W., Khurana J. S., Biller B. M., Neer R. M., Klibanski A. Age and bone mass in premenopausal women. J Bone Miner Res. 1989 Aug;4(4):533–538. doi: 10.1002/jbmr.5650040412. [DOI] [PubMed] [Google Scholar]
  14. Seeman E., Cooper M. E., Hopper J. L., Parkinson E., McKay J., Jerums G. Effect of early menopause on bone mass in normal women and patients with osteoporosis. Am J Med. 1988 Aug;85(2):213–216. doi: 10.1016/s0002-9343(88)80345-0. [DOI] [PubMed] [Google Scholar]
  15. Smith R. W., Jr Dietary and hormonal factors in bone loss. Fed Proc. 1967 Nov-Dec;26(6):1737–1746. [PubMed] [Google Scholar]
  16. Wasnich R., Yano K., Vogel J. Postmenopausal bone loss at multiple skeletal sites: relationship to estrogen use. J Chronic Dis. 1983;36(11):781–790. doi: 10.1016/0021-9681(83)90070-x. [DOI] [PubMed] [Google Scholar]
  17. van Hemert A. M., Vandenbroucke J. P., Birkenhäger J. C., Valkenburg H. A. Prediction of osteoporotic fractures in the general population by a fracture risk score. A 9-year follow-up among middle-aged women. Am J Epidemiol. 1990 Jul;132(1):123–135. doi: 10.1093/oxfordjournals.aje.a115624. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES