Objective: There is no universal consensus on the relationship between body mass index (BMI) and age at natural menopause (ANM). The primary bias was confounding by cigarette smoking because smoking was a strong confounding factor related to lower BMI and earlier menopause. This meta-analysis was conducted to estimate the effect of BMI on ANM.
Methods: Medline and EMBASE databases were searched for relevant studies up to December 2013. Studies were selected for analysis based on certain inclusion and exclusion criteria. Hazard ratios (HRs) with 95% CI were extracted to assess the association between BMI and early ANM.
Results: Nine studies were selected for this meta-analysis. The HR of early ANM was 1.08 (95% CI, 1.03-1.14; P < 0.01) in underweight women compared with women of normal BMI. Compared with women of normal BMI, overweight women (HR, 0.93; 95% CI, 0.91-0.96; P < 0.001) and obese women (HR, 0.95; 95% CI, 0.79-1.15; P = 0.59) were associated with late ANM. In addition, the HRs of early ANM in overweight and obese women were 0.92 (95% CI, 0.90-0.94; P < 0.001) and 0.88 (95% CI, 0.82-0.95; P < 0.001), respectively, compared with underweight women. A separate meta-analysis indicated that the results (HR, 0.85; 95% CI, 0.81-0.90; P < 0.001) changed markedly in the comparison of obese versus normal-weight women in studies that controlled for smoking.
Conclusions: The results of our study indicate that increased BMI modestly associates with later ANM. The relationship between BMI and ANM needs further clarification in well-designed studies, especially studies well-controlled for smoking status.
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