Climacteric : the journal of the International Menopause Society · 2026
Age and diagnostic assessment of natural menopause in low-weight women.
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Stockman Sara L, Ayinon Caroline M, Nawash Baraa, Desai Nikita, Siegel Lauren B, Eljamri Soukaina, Fazeli Pouneh K
Аннотация
OBJECTIVE: This study aimed to determine the age of natural menopause in low-weight women and assess how often laboratory evaluation confirms menopausal status.
METHOD: A retrospective study was conducted of 3000 women aged >50 years with a history of body mass index (BMI) <18.5 kg/m2 seen at a large academic health system between 2004 and 2020. Women with indeterminate menopausal age, BMI ≥18.5 kg/m2 at menopause or known causes of early menopause were excluded. Clinical data including menopausal age, BMI, reproductive history and laboratory tests were extracted. Associations between BMI and menopausal age were analyzed using unadjusted and multivariable analyses controlling for tobacco use and age at menarche.
RESULTS: Among 239 women included, menopausal age correlated with BMI (ρ = 0.13, p = 0.04) and remained significant in multivariate regression (p = 0.02). Median menopausal age was 51 years for BMI 18.0 to <18.5 kg/m2, 50 years for BMI 17.0 to <18.0 kg/m2, 50 years for BMI 16.0 to <17.0 kg/m2 and 48 years for BMI <16.0 kg/m2. Only 30 women (12.6%) had postmenopausal follicle stimulating hormone (FSH) measured; 30% were below the diagnostic threshold for menopause (<25 mIU/ml).
CONCLUSION: Low BMI is associated with earlier menopause. The substantial proportion of low-weight women classified as menopausal who had non-diagnostic FSH levels highlights the complexity of determining menopausal status and the potential for misclassification in this population.
METHOD: A retrospective study was conducted of 3000 women aged >50 years with a history of body mass index (BMI) <18.5 kg/m2 seen at a large academic health system between 2004 and 2020. Women with indeterminate menopausal age, BMI ≥18.5 kg/m2 at menopause or known causes of early menopause were excluded. Clinical data including menopausal age, BMI, reproductive history and laboratory tests were extracted. Associations between BMI and menopausal age were analyzed using unadjusted and multivariable analyses controlling for tobacco use and age at menarche.
RESULTS: Among 239 women included, menopausal age correlated with BMI (ρ = 0.13, p = 0.04) and remained significant in multivariate regression (p = 0.02). Median menopausal age was 51 years for BMI 18.0 to <18.5 kg/m2, 50 years for BMI 17.0 to <18.0 kg/m2, 50 years for BMI 16.0 to <17.0 kg/m2 and 48 years for BMI <16.0 kg/m2. Only 30 women (12.6%) had postmenopausal follicle stimulating hormone (FSH) measured; 30% were below the diagnostic threshold for menopause (<25 mIU/ml).
CONCLUSION: Low BMI is associated with earlier menopause. The substantial proportion of low-weight women classified as menopausal who had non-diagnostic FSH levels highlights the complexity of determining menopausal status and the potential for misclassification in this population.