A Life Course Approach to Reproductive Aging

We describe how a woman’s age at menopause and whether she experiences natural or surgical menopause depends on her social and biological experiences from prenatal through adult life. We contrast evidence from Western industrialized nations and developing countries. Menopause occurs because of the depletion of the follicular reserve or as a result of surgery. Among the most robust risk factors for age at natural menopause are those that influence follicular pool development and decline, including birth outcomes, early life development and socioeconomic status, smoking, and parity. Relationships with indicators of reproductive health from earlier in life, adult weight, and adult socioeconomic status have less robust relationships with age at and type of menopause. Hysterectomy is related to socioeconomic status across the life course, parity, and weight in mid to later adulthood. While studies from Western industrialized countries are more numerous, studies from developing countries suggest differences in socioeconomic status and early life development for both age at menopause and type of menopause. We close by providing suggestions for how future research may further the understanding of the interaction of social and biological contributors to age at and type of menopause

Keywords: Natural menopause, hysterectomy, life course, weight, socioeconomic status, birth outcomes, reproductive characteristics, age at menarche, reproductive aging, genetics, developing countries.