Age at natural menopause and life expectancy with and without type 2 diabetes

Objective: Effective interventions of future health care require a better understanding of the health risks associated with early onset of menopause and diabetes, but the necessary data are scarce. Little quantitative information is available about the combined association of early menopause and diabetes on life expectancy and the number of years lived with and without diabetes. Methods: We included 3,650 postmenopausal women aged 45þ years from the Rotterdam Study, a prospective population-based cohort study. Age at menopause categories were defined as follows: early (44 y old), normal (45- 54 y old), and late (55 y old). For life table calculations, we used prevalence, incidence rates, and hazard ratios for three transitions (free of diabetes to diabetes, free of diabetes to death, and diabetes to death) stratifying by age at menopause categories and adjusting for confounders. Results: Compared with late menopause, the difference in life expectancy for women who experienced early menopause was 3.5 (95% CI, 6.6 to 0.8) years overall and 4.6 (95% CI, 8.9 to 0.9) years without diabetes. Compared with age at normal menopause, the difference in life expectancy for women who experienced early menopause was 3.1 (95% CI, 5.1 to 1.1) years overall and 3.3 (95% CI, 6.0 to 0.6) years without diabetes. Conclusions: Women who experienced early menopause lived less long and spent fewer years without diabetes than women who experienced normal or late menopause.

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