New study links primary infertility to accelerated reproductive aging

The average woman spends more than one-third of her life in menopause. Some women, however, must deal with menopause-related symptoms longer and face added health problems because of premature menopause (before age 40) or early menopause (before age 45). A new study found that infertility may be a risk factor for early menopause. Results of the study are published online today in Menopause, the journal of The Menopause Society.

Infertility is a common condition, affecting one in six people globally. Not only does infertility affect family planning, but it also affects long-term health. People with infertility have been found to have higher rates of cancer and cardiovascular disease. The cause of infertility varies but is often linked to genetic, hormone, in utero, or lifestyle factors.

Previous studies have been conducted to determine whether there is a link between infertility and both premature and early menopause but with mixed results. These prior studies did not consider the effect of different types of infertility.

A new study involving nearly 700 persons (of which roughly half had been diagnosed with primary infertility) found that women with a history of primary infertility underwent natural menopause 1 year earlier than those without such history, and more notably, those with a history of unexplained infertility or endometriosis had an increased risk of early menopause. There was no association found between infertility and premature menopause.

Premature and early menopause are concerns because they are associated with long-term health consequences such as cardiovascular disease, osteoporosis, and neurocognitive disorders. Risks for premature and early menopause include tobacco use, low body mass index, nulliparity, and early menarche. In contrast, women with increased parity (childbirths) and a history of oral contraceptive use have been linked to later menopause.

According to the researchers, given the systemic and long-term health effects of early menopause, women with a diagnosis of primary fertility may benefit from additional counseling and should be encouraged to pursue evaluation and treatment if they experience new-onset loss of menstrual cycles.

Survey results are published in the article "Infertility and age of menopause in a longitudinal cohort of women with primary infertility."

This study shows that women with primary infertility, specifically those with unexplained infertility or a history of endometriosis, were at risk for early menopause. Given that early menopause is linked to adverse long-term health consequences, these women may benefit from counseling that they are at risk of early menopause. This will allow them to monitor for early menopause and to seek treatment with hormone therapy, if indicated."

Dr. Stephanie Faubion, Medical Director, The Menopause Society