Onset of natural menopause in African American women Original paper
-
Women’s Health
Women’s Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
-
Menopause
Menopause
OverviewMenopause is a natural biological event marking the permanent cessation of menstruation, which occurs after 12 consecutive months without a period, usually between the ages of 45 and 56. This transition results from the loss of ovarian follicles, leading to a decrease in the production of key hormones, particularly estrogen and progesterone. Estrogen’s decline impacts […]
-
Divine Aleru
I am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
I am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
What was studied?
This large prospective cohort study investigated predictors of the onset of natural menopause among African American women, with particular attention to the potential role of perceived experiences of racism. The researchers aimed to clarify how demographic, reproductive, lifestyle, and psychosocial factors, including experiences of racism, affect the timing of natural menopause. Data were drawn from the Black Women’s Health Study, with baseline and follow-up information (including exposures and outcomes) collected by mailed questionnaires between 1995 and 1999. Using Cox proportional hazards regression, the study evaluated associations between various risk factors (smoking, body mass index [BMI], oral contraceptive use, parity, education, physical activity, age at menarche, unilateral oophorectomy, and perceived racism) and the incidence of natural menopause over a four-year period.
Who was studied?
The analytic sample included 17,070 African American women in the United States who were aged 35 to 55 years and premenopausal at baseline in 1995. Participants were drawn from the broader Black Women’s Health Study, which initially enrolled 64,500 women via mailed questionnaires. Inclusion criteria for this analysis required premenopausal status at baseline and completion of at least one follow-up questionnaire in 1997 or 1999. The cohort was well-educated, with the majority having completed high school or higher education, making the results particularly applicable to similarly educated African American women in the U.S. Generalizability to women with less education or lower socioeconomic status may be limited.
Most important findings
The study found that current smoking was the strongest predictor of earlier natural menopause, with a hazard ratio of 1.43 for current smokers and 1.21 for ex-smokers compared to never smokers. There was a clear dose-response relationship between smoking intensity (pack years) and risk of earlier menopause. Higher BMI was inversely associated with risk: women with a BMI ≥30 had a 22% lower risk compared to those with a BMI of 20–24. Use of oral contraceptives for at least one year also delayed menopause. Other reproductive factors and education were not significantly associated with menopause onset. Unilateral oophorectomy was associated with earlier menopause only among younger women. For perceived racism, most hazard ratios were elevated, but few reached statistical significance. The most notable was a 32% increased risk for women who experienced being treated as “not intelligent” monthly and a 23% increased risk for those thinking about their race daily.
Key implications
This study underscores that similar to White women, smoking is the most consistent and modifiable risk factor for earlier menopause among African American women, with implications for counseling and preventive health. Higher BMI and oral contraceptive use appear protective against early menopause. The findings regarding racism are suggestive but not definitive; while some associations were present, they were generally modest and inconsistent, indicating a need for further research on psychosocial stressors and reproductive aging in this population. Clinicians should be aware of these factors when discussing reproductive health and menopause timing with African American women but should recognize that current evidence does not support strong, actionable links between perceived racism and menopause onset.