Menopause Timing, and Symptom burden in Norwegian women

Abstract

Abstract Background: Menopause significantly impacts women's health, with early menopause linked to an increased chronic disease risk. Understanding how reproductive history influences menopausal age and symptom severity is vital for preventive strategies and optimal management.

Aim: This thesis investigated how reproductive history (number of pregnancies, age at first/last live birth) influences the timing of natural menopause (early and premature onset) and subsequent symptom severity within the Norwegian MoBa cohort.

Methodology: This cohort study utilized MoBa data (Q1 pregnancy questionnaire and Q2024 ‘Women’s Health questionnaire’). Outcomes included age at natural menopause and symptom severity; exposures were number of pregnancies and age at first/last live birth. Logistic regression, controlling for confounders (education, smoking, BMI), was used to examine associations with early/premature menopause.

Results: Among 9497 women (mean age at first/last live birth: 29.5/35.6 years), parity was not associated with menopause timing. However, later age at first (>30 years) and last live birth (>35 years) increased early menopause likelihood. Women with early menopause (<45 years) reported more severe symptoms (e.g., fatigue, low libido, sleep problems). Supplementary analyses showed that higher parity (≥3 pregnancies) was associated with lower odds of premature menopause (<40 years) after adjustment; for premature menopause, later first (>30) and last live birth increased odds, while early first live birth (<25) reduced odds.

Conclusion: Childbirth timing was a more robust determinant of menopausal onset than parity. Later first and last live births consistently increased early/premature menopause risk; early first live birth was protective against premature menopause. Early menopause was linked to more severe symptoms. Findings highlight the reproductive timeline influences both the onset of menopause and subsequent quality of life, with important implications for nursing—such as improved assessment and proactive counseling—and future research, including studies exploring underlying biological and social pathways, qualitative investigations, and the development of targeted nursing interventions. Keywords: Childbirth; Menopausal symptoms; Natural Menopause; Parity; Pregnancy