QuestionI had always heard that the earlier someone started their menses, the earlier they would begin menopause. I was recently speaking with someone who told me they had heard that the earlier someone started their menses, the later they would begin menopause. We are both nurses, though neither in this field. We would love to settle this question, and the physiology behind it. Thank you Pat
AnswerHi Pat,
Sorry it took me so long, but I had to cheat. I emailed my Dad and asked him, who else? Actually he's an endocrinologist and perfect for this question because he deals with a lot of metabolic bone disease. But I have to tell you his answer was not that exciting, nor is going to settle your bet with your friend, because you are both right. Age at onset of menarche has no predictive value to the onset of menopause. Neither can you turn it around. My father said some earlier studies with small sample sizes almost made a good case to point toward the 'early onset - early menopause group,' but as sample sizes grew, the statistical significance became less, rather than more as would be expected if there were a real difference.
It would be nice to have that info, but we're better off preventing bone loss before these ladies cross the fracrure threshold. We need to make sure our post menopausal women have recent densitometries. Did you know that 50% of women with a hip FXR who are 65+ will be dead six months later? Staggering isn't it.
Oh, I nearly forgot, and I even did a little reading on the subject myselfd. Every woman is born with all the ova she will ovulate. And that is a finite number. Medical or surgical intervention can alter this, of course. The answer to your question is that a woman will ovulate, and accordingly menstruate, for as long as she has ova to protect, and a pregnancy to prepare for. And it appears that the ova number tend to be familial, suggesting a genetic component. No surprise there.
I did read some incredible results on the dropping age of onmdet of menarche across the board. Over a century, I think it was a Swedish study, they showed a three year dropping average age. Something's going on.
So for our menopausal patients, while the pituitary-hypothalamic-gonadal axis remains efficient in preparing the endometrium for an implantation, as long as there is no ovum, there will be no hormonal surges to get tissues to grow. Sometimes I hear of menopause dragging out over six months to two years with longer and longer intervals between periods. And that makes sense that as the corpus luteum sheds the last of the ova that it would become a less efficient and intervals bewteen periods would be drawn out.
Thanks for emailing me that question. It makes me feel good that you folks value my opinion. You know any doctor is only as good as his or her nurse. I have proven it.
Have a great weekend,
Tim McNiece
