Effects of age of menarche and menopause on mental health in postmenopausal women: a cross-sectional survey

The aim of this study was to explore the independent and combined effects of age at menarche (AAM) and age at natural menopause (ANM) on postmenopausal women’s mental health and to evaluate healthy life expectancy (HLE) in different AAM and ANM groups based on mental disease dimensions. Logistic regression was used to assess the associations of AAM and ANM with mental health. A period life table was used to calculate life expectancy, and HLE was calculated via the Sullivan method. A total of 11,908 postmenopausal women were included in this study. Compared with menarche at 12–15 years, multiple adjusted odds ratios (95% confidence intervals) for depression, anxiety and mental disorder were 2.313 (1.079, 4.960), 2.401 (1.161, 4.966) and 2.103 (1.051, 4.205) for menarche age <12 years and 1.219 (1.013, 1.468), 1.244 (1.039, 1.491) and 1.210 (1.029, 1.421) for menarche age >15 years; early menopause was associated with depression and anxiety compared to the normal range of ANM. The early AAM and ANM groups tended to have the lowest HLE. Abnormal AAM and ANM are not only associated with increased risk of mental problems, but also affect mental HLE in postmenopausal women. What is already known on this topic?Previous studies have accessed the relationships of age at menarche (AAM) and age at natural menopause (ANM) with depression or anxiety, but the evidence was inconsistent and limited. In addition, there is no study combining depression with anxiety to explore the associations between AAM, ANM and mental disorder. More importantly, the effect of reproductive factors on healthy life expectancy (HLE) based on mental disease dimensions is unknown.What does this study add?The results of this study revealed the correlation of AAM and ANM with postmenopausal women’s mental health. Abnormal AAM and ANM have independent and combined effects on postmenopausal women’s mental health, respectively. In addition, early menarche and menopause groups had the lowest depression-free life expectancy (DFLE), anxiety-free life expectancy (AFLE) and mental disorder-free life expectancy (MDFLE) at almost all ages. What is already known on this topic? Previous studies have accessed the relationships of age at menarche (AAM) and age at natural menopause (ANM) with depression or anxiety, but the evidence was inconsistent and limited. In addition, there is no study combining depression with anxiety to explore the associations between AAM, ANM and mental disorder. More importantly, the effect of reproductive factors on healthy life expectancy (HLE) based on mental disease dimensions is unknown. What does this study add? The results of this study revealed the correlation of AAM and ANM with postmenopausal women’s mental health. Abnormal AAM and ANM have independent and combined effects on postmenopausal women’s mental health, respectively. In addition, early menarche and menopause groups had the lowest depression-free life expectancy (DFLE), anxiety-free life expectancy (AFLE) and mental disorder-free life expectancy (MDFLE) at almost all ages. This is the first study to explore the associations of AAM and ANM with mental health from different mental domains among Chinese rural women.Abnormal AAM and ANM are risk factors for postmenopausal women’s mental health.More attention should be paid to women with abnormal age of menarche and menopause. This is the first study to explore the associations of AAM and ANM with mental health from different mental domains among Chinese rural women. Abnormal AAM and ANM are risk factors for postmenopausal women’s mental health. More attention should be paid to women with abnormal age of menarche and menopause.