Menarche characteristics in association with total and cause-specific mortality: a prospective cohort study of Mexican teachers

Ann Epidemiol. 2021 Oct:62:59-65. doi: 10.1016/j.annepidem.2021.06.007. Epub 2021 Jun 22.

Abstract

Purpose: We evaluated the relation between age at menarche and time to menstrual regularity with all-cause and cause specific mortality in a cohort of Mexican women.

Methods: We followed 113,540 women from the Mexican Teachers' Cohort. After a mean follow-up time of 9.2 years, 1,355 deaths were identified. We estimated hazard ratios from Cox regression models for total mortality and a competitive risk models for cause-specific mortality adjusting for year of birth and childhood factors.

Results: Women with extreme age of menarche were at increased risk of all-cause mortality (HR [95% CI]: <11 years 1.50 [1.20, 1.87]; 14 years 1.19 [0.97, 1.43]) relative to those with menarche at 13 years. Extreme ages at menarche had higher risk of mortality for diabetes (HR: <11 years 1.66 [0.90, 3.05]; 14 years 1.47 [0.90, 2.40]), breast cancer (HR: <11 years 1.34 [0.56, 3.20]), and other cancer (HR:<11 years 1.65 [1.10, 2.48]) compared to menarche at 13 years. Women who took three or more years to achieve menstrual regularity had a higher risk of all-cause mortality compared to those who took less (HR: 1.27 [1.01, 1.58]).

Conclusions: Extreme ages at menarche and longer time to reach menstrual regularity were associated with an increased rate of all-cause and cause-specific mortality.

Keywords: Cancer; Diabetes; Hispanic; Menarche; Mexico; Mortality.

MeSH terms

  • Breast Neoplasms*
  • Cause of Death
  • Child
  • Cohort Studies
  • Female
  • Humans
  • Menarche*
  • Prospective Studies
  • Risk Factors