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12-07-2011 | Gynaecology | Article

Socioeconomic status increases risk for premature menopause


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MedWire News: Women with a low socioeconomic status and those who smoke are at greater risk for premature ovarian failure (POF) than those with a high socioeconomic status and nonsmokers, say researchers.

The findings emerge from data for nearly 5000 women born in the UK in 1958, and show that POF also causes women to report significantly lower quality of life compared with women without POF.

Rumana Islam from Imperial College in London, UK, presented the results at the 27th annual conference of the European Society for Human Reproduction and Embryology (ESHRE) in Stockholm, Sweden, and suggested that POF needs addressing urgently.

She and her research team believe that "women with POF can benefit from multidisciplinary specialist care, including support for their significant psychological and physical symptoms."

"Their long-term health needs should also be considered," she added.

The 4968 participants of the study were followed up at eight time points (most recently at the age of 50 years) and completed the Short Form (SF)-36 quality of life instrument as well as a questionnaire detailing the date and cause of their menopause.

Participants' socioeconomic status was measured using the UK's National Statistics Socio-Economic Class (NS-SEC) system which takes into consideration the occupation of women, as well as their partners.

POF - known as early menopause, where women cease to menstruate, become infertile, experience sex steroid deficiency, and hypergonadotropism before the age of 40 years - occurred by natural or medical (eg, hysterectomy or chemotherapy) means in 7.4% of the cohort.

After adjustment for smoking, parity, obesity, ethnicity, and physical exercise, a low socioeconomic background (never worked or are long-term unemployed) increased the risk for POF by 13%. Indeed, women from such a background were almost three times as likely to experience POF than their counterparts from the highest socioeconomic background (in higher managerial and professional occupations).

Smoking also increased the risk for POF, with an adjusted odds ratio of 1.025 per cigarette smoked per day.

Notably, the mean SF-36 scores for women with POF were 7.5% lower than those for women in the general population, at a level equivalent to people with rheumatoid arthritis or Type 2 diabetes, say the researchers.

Furthermore, women with POF were almost twice as likely (1.7 times) as those without to report a poor quality of life, defined as an SF-35 score below 50%.

Islam speculated that the possible reasons for an influence of socioeconomic status on menopause could be differences in access to healthcare, or healthcare behaviors.

Commenting on the research, Tobie de Villiers, from the University of Stellenbosch in South Africa, and president of the International Menopause Society (IMS), said: "The IMS supports the conclusions of this important study, especially the need for all health care providers to be aware of the significant medical and social implications of POF, and the need for early diagnosis and appropriate intervention.

As far as possible we also need to guard against inappropriate removal of the ovaries, and of course we also need to counsel women against smoking," he added.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Sarah Guy

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