Risk Factors Associated with Early and Late Age at Natural Menopause: Evidence from Mishing Tribal Women of Assam in Northeast India

This population-based cross-sectional study investigates the socio-demographic, lifestyle, dietary and reproductive risk factors associated with early and late age at natural menopause among the Mishing tribal women of Upper Assam, Northeast India. The study included a total of 331 postmenopausal women who were categorised into four groups on the basis of age at attaining natural menopause as 41–44 years (early menopausal), and 45–49 years, 50–52 years and ≥53 years (late menopausal), and the relevant data were collected by using a pre-structured open-ended interview schedule. Multinomial logistic regression-significant adjusted odds ratios of characteristics and their association with age at natural menopause were used to examine the association of risk factors, and their 95% confidence intervals were reported. The mean age at natural menopause was found to be 48.44 ± 0.10 years. The ever married and the women with the highest education attained showed a higher risk of attaining menopause late. Regular intake of country liquor increased the risk of early menopause threefold. Underweight women were more likely to experience early menopause, whereas the overweight women were more likely to experience late menopause. The women who entered into marriage at the adolescence age and who spent approximately 24 months or more in post-partum amenorrhea in her entire reproductive span had the higher risk of late age at menopause. Post-partum amenorrhea, which is a potential reproductive variable affecting the timing of menopause, was not considered before. A positive association of consuming fresh and fermented fish or meat for three or more days per week was seen with late age at menopause, and the odds ratios of experiencing late menopause were higher for multiparous women with more than three living children.