OBJECTIVE: We attempted to determine whether gynecologic histories differ in women who have and have not experienced an early menopause. STUDY DESIGN: A group f 344 "case" women whose average age at menopause was 42.2 years and an age-matched group of 344 "control" women still menstruating or menopausal after age 46 were selected from a survey of 10,606 women aged 45 to 54 years for interviews about their reproductive history. RESULTS: Case women were more likely to have had menarche at or before age 11, had shorter cycle lengths, had fewer pregnancies with live births, and had more frequent pelvic operations including unilateral oophorectomy and multiple cesarean sections. Case women had a greater number of presumed ovulatory cycles, as estimated from age at menarche, average cycle length, and years of anovulation associated with pregnancies or oral contraceptive use. In a multivariate model including smoking status and body mass index, ovulatory cycles were a significant predictor of early menopause, especially after an estimated 300 ovulations. CONCLUSION: The reproductive histories of women who experienced an early menopause suggest a pattern of more rapid oocyte loss ("incessant" ovulation).
- oral contraceptives