Living in disadvantaged neighborhoods linked to earlier menopause

A new study led by the Harvard Pilgrim Health Care Institute highlights the significant impact of living in disadvantaged neighborhoods on the onset of menopause. The research followed 691 women from pregnancy to midlife and found that those residing in highly vulnerable neighborhoods, particularly within 10 years of perimenopause onset, experienced menopause approximately two years earlier than those in less vulnerable areas.

The study, "Neighborhood Vulnerability and Age of Natural Menopause and Menopause Symptoms Among Midlife Women" was published May 22 in JAMA Network Open.

Women experiencing more intense menopausal symptoms have demonstrated lower quality of life and cognitive performance. Additionally, women who undergo menopause at an earlier age face a higher risk of developing long-term health issues; specifically, a 1-year decrease in menopause age is linked to 2-3% higher risks of coronary heart disease, stroke, and mortality. At present, there are significant gaps in understanding how neighborhood contexts may affect reproductive aging in midlife women.

Identifying risk factors for earlier menopause is important for public health, potentially informing strategies to reduce the potential for adverse outcomes. Our research indicates that living in less vulnerable neighborhoods may be a key factor in preventing earlier menopause and reducing future disease risk."

Izzuddin Aris, Harvard Medical School Assistant Professor of Population Medicine, Harvard Pilgrim Health Care Institute and senior author of the study

The study included nearly 700 women from Project Viva, a prospective cohort in eastern Massachusetts, followed from April 1999 to August 2021. Researchers used geocoded residential addresses to assess neighborhood vulnerability and its effects on menopause onset and symptoms. The Social Vulnerability Index (SVI) was used to measure neighborhood disadvantage, considering factors such as socioeconomic status, household composition, and racial and ethnic minority status. Study findings showed women who resided in neighborhoods with very high (vs. very low) vulnerability exhibited higher risk of earlier natural menopause onset (by approximately 2 years), driven primarily by socioeconomic status and household composition. No associations with menopause symptom severity were observed.

The findings underscore the necessity of addressing neighborhood contexts to level reproductive health outcomes across populations.

"As certain characteristics of disadvantaged neighborhoods, such as limited access to social and economic resources, can be modified through community-led initiatives or policies implemented at the local and federal levels, future research is warranted to investigate whether such strategies could alleviate the association between neighborhood disadvantage and early menopause," added Aris.