Longer reproductive lifespan tied to lower multimorbidity for postmenopausal Chinese women

Key takeaways:

• Postmenopausal women with reproductive periods of 35 years or longer had lower risk for multimorbidity.
• Each additional reproductive year was associated with a 4.2% reduction in chronic disease risk.

Among postmenopausal women in China, a longer reproductive lifespan was associated with a lower prevalence of experiencing multimorbidity, according to findings published in Menopause.

“To the best of our knowledge, only one study in a developed country has focused on the association between age at natural menopause and multimorbidity in older postmenopausal women,” Jiao Jiao, MD, from the department of reproductive medicine at The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine in China, and colleagues wrote. “It is unclear whether reproductive lifespan is associated with multimorbidity, particularly in developing countries.”

Jiao and colleagues conducted a cross-sectional study of 1,310 postmenopausal women (mean age, 56.9 years) to evaluate the association between reproductive lifespan in women and multimorbidity. All participants were categorized by reproductive lifespans of 32 years or fewer (n = 377), 33 to 34 years (n = 275), 35 to 37 years (n = 371) and 38 years or longer (n = 287). Researchers defined reproductive lifespan as the interval between menarche and menopause and defined multimorbidity as having two or more self-reported chronic diseases.

Overall, postmenopausal women had an average reproductive lifespan of 34.3 years with a multimorbidity prevalence of 22.2%.

Postmenopausal women with reproductive periods spanning 35 to 37 years (OR = 0.53; 95% CI, 0.35-0.81) or 38 years or longer (OR = 0.51; 95% CI, 0.31-0.84) had lower likelihoods of experiencing multimorbidity compared with postmenopausal women with reproductive periods spanning 33 to 34 years or 32 years or fewer.

In addition, researchers observed a linear trend in the association between reproductive lifespans and multimorbidity, with longer reproductive lifespans tied to lower multimorbidity risk. In a sensitivity analysis, each additional reproductive year was associated with a 4.2% reduction in multimorbidity risk (OR = 0.96; 95% CI, 0.92-0.99).

The researchers noted several mechanisms may explain the association between reproductive lifespan and multimorbidity, including greater estrogen exposure with a delayed onset of menopause.

“Considering the protective effects of estrogen, a short reproductive lifespan indicates that postmenopausal women may experience a longer period of estrogen deficiency, resulting in a much higher risk of multimorbidity,” the researchers wrote.

They added that health care professionals should screen and assess reproductive factors to identify high-risk women.