Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Age at natural menopause and its associated factors in Canada

cross-sectional analyses from the Canadian Longitudinal Study on Aging

Costanian, Christy MSc1; McCague, Hugh PhD2; Tamim, Hala PhD1

doi: 10.1097/GME.0000000000000990
Original Articles

Background: Early onset of menopause is associated with long-term disease and higher mortality risks. Research suggests that age at natural menopause (ANM) varies across populations. Little is known about factors that affect ANM in Canadian women.

Objective: This study aims to estimate the median ANM and examine factors associated with earlier ANM among Canadian women.

Methods: Baseline data from the Tracking cohort of the Canadian Longitudinal Study on Aging was used for this analysis. The relation of sociodemographic, lifestyle, and health-related factors with ANM was examined among 7,719 women aged 40 and above. Nonparametric Kaplan-Meier cumulative survivorship estimates were used to assess the timing of natural menopause. Univariate and multivariate Cox proportional hazard regression models were used to characterize ANM and its association with relevant covariates.

Results: Overall, median ANM was 51 years. Having no partner, low household income and education levels, current and former smoking, and cardiovascular disease were all associated with an earlier ANM, whereas current employment, alcohol consumption, and obesity were associated with later ANM.

Conclusions: These findings provide a national estimate of ANM in Canada and show the importance of lifestyle factors and health conditions in determining menopausal age. These factors might help in risk assessment, prevention and early management of chronic disease risk during the menopausal transition.

1School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada

2Institute for Social Research, York University, Toronto, Ontario, Canada.

Address correspondence to: Christy Costanian, MSc, School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON M3J1P3, Canada. E-mail:;

Received 13 June, 2017

Revised 24 August, 2017

Accepted 24 August, 2017

The contributions of the authors are as follows: C.C. contributed to the conception and study design, performed analysis and write up of the manuscript; H.M. provided statistical support of the analysis and critically revised the manuscript; H.T. supervised the analysis, interpretation of the results and write up of the manuscript, revision and editing of the manuscript.

Funding/support: Funding for the Canadian Longitudinal Study on Aging (CLSA) was provided by the Government of Canada through the Canadian Institutes of Health Research (CIHR) under grant reference: LSA 9447 and the Canada Foundation for Innovation.

Financial disclosure/conflicts of interest: This research has been conducted using the CLSA dataset [Baseline Tracking version 3.0], under Application Number [20160304]. The CLSA is led by Drs Parminder Raina, Christina Wolfson and Susan Kirkland. No potential conflict of interest was reported by the authors.

© 2018 by The North American Menopause Society.