Girl talk: puberty hits younger and younger Martin Barraud/Compassionate Eye Foundation/Getty

Women are more likely to go through menopause early if they started menstruating before their 12th birthday.

This is the conclusion of the largest study of its kind, involving 50,000 postmenopausal women in the UK, Australia, Japan and Scandinavia.

On average, a first period arrived around age 13 and the last when the women were 50. But 14 per cent had their first period before they were 12, and 10 per cent had their last period before they turned 45.


To investigate whether there was a link between early menstruation and early menopause, Gita Mishra at the University of Queensland, Australia, and her colleagues performed a statistical analysis, adjusting for possible confounding variables like weight and smoking.

They found that women who began menstruating before the age of 12 were 31 per cent more likely to have an early menopause – between the ages of 40 and 44.

Of the women who had their first period when they were 13, only 1.8 per cent had premature menopause (before the age of 40), and 7.2 per cent reached menopause early. But in women who had their first period when they were 11 or younger, 3.1 per cent had premature menopause, and 8.8 per cent went through it early.

Infertility link

Factors in early life may underpin this relationship, says Mishra. “We know, for instance, that stress during childhood tends to produce earlier menstruation, but it could also influence the age of menopause down the track,” she says.

Not having children was also related to earlier menopause age. Women without children who had their first period before 12 were five times more likely to reach menopause prematurely than women with two or more children, who started menstruating at 12 or older.

Often, these women had difficulty falling pregnant, Mishra says. This suggests there is a link between early menstruation, infertility and premature menopause. If a woman goes through menopause in her 30s, her fertility could start to decline in her 20s, Mishra says.

Now that girls are getting their periods younger and younger, we could see increases in fertility problems and premature menopause rates in the coming decades, Mishra says.

However, it is important not to be alarmist, says William Ledger at the University of New South Wales. “Yes, the study found a higher risk, but the effect size was small. Most of the women who had early menstruation still did not have early menopause,” he says.

Life choices

Nevertheless, women should know they might have a premature menopause if they began menstruating at a young age, Ledger says. “This might change their life plan – they may start trying to have children earlier,” he says.

“The big thing is to stop smoking, because it increases the risk of premature menopause further,” says Mishra.

Women also need to be prepared for the chronic conditions that may accompany menopause, such as osteoporosis and heart disease, says Mishra. This may involve eating a healthier diet or upping their physical activity, she says. “Menopause is a marker of biological age for women and has a variety of health implications, so you need to look after yourself.”

Journal reference: Human Reproduction, DOI: 10.1093/humrep/dew350