This chapter provides a very scholarly and up-to-date review of the epidemiology of the menopause and point out areas that are still not clear, stressing the importance of the need for more longitudinal studies. A number of demographic, menstrual and reproductive, and lifestyle factors appear to be important determinants of the age at which natural menopause occurs and to have meaningful relationships to the varied symptom experiences of women. However, a number of the relationships are inconsistent possibly due to varying methodological approaches and limitations, and others remain largely unexplored. Therefore, much remains to be learned about how these factors affect hormones at the physiologic level and thus determine the onset of the perimenopause, the timing of the final menstrual period, and the occurrence of the constellation of symptoms that are associated with the menopause transition. Furthermore, increased understanding of the underlying physiologic bases of these influences needs to include potential racial/ethnic differences in physiologic responses to lifestyle factors and other environmental exposures, as well as increased understanding of the cultural contexts, cultural differences, and cultural sensitivities that affect the presentation and experience of the menopausal transition. Increasing knowledge about these relationships ultimately offers women and their health care providers enhanced choices and alternatives, based on deeper understanding, to deal with the individual presentations of menopause.
ASJC Scopus subject areas