Association of Lifestyle and Reproductive Factors with Age at Natural Menopause among Postmenopausal Women in Gampaha District

Background: Menopause is a natural transition marking the end of a woman's reproductive capacity, defined by the cessation of menstruation for 12 consecutive months without pathological cause or intervention. International studies have shown that lifestyle and reproductive factors may influence its onset. However, research on Sri Lankan women under this topic is limited.
Objectives: To describe the age at natural menopause and lifestyle and reproductive factors of a group of postmenopausal women in Gampaha district and to determine any association between lifestyle and reproductive factors with the age at natural menopause.
Method: A descriptive cross-sectional study with an analytical component was done, with 126 postmenopausal women in a selected Public Health Midwife (PHM) area in Gampaha. Study participants were selected via a multistage cluster sampling method. Data was collected via an interviewer-administered questionnaire which was prepared based on 24-hour dietary recall, International Physical Activity Questionnaire, National Health Interview Survey Tobacco Use Questionnaire, The Alcohol Use Disorders Identification Test and Reproductive History Questionnaire of Women's Health Initiative. Lifestyle factors were studied under four components; dietary factors, physical activities, smoking and alcohol consumption. Age at menarche, parity, total breastfeeding duration and contraceptive usage were assessed under reproductive factors.
Results: The mean age ± standard deviation (SD) at natural menopause was 48.37 (±5.40) years. Premature menopause was experienced by 4.8%. The mean (±SD) daily calorie intake was 961.02 (±233.70) calories. Participants had a mean (±SD) total MET (Metabolic Equivalent of Task) score of 6864.15 (±7574.11) minutes, with 72.2% categorized as having high levels of physical activity. None of the participants were active smokers while 7.9% were exposed to passive smoking. The mean (±SD) age at menarche was 13.73 (±1.32) years, while the mean (±SD) parity was 2.39 (±1.12). A majority (67.5%) had breastfed for over four years in total. Only 35.71% had used contraceptives during their lifetime. No statistically significant associations were observed between the age at natural menopause and lifestyle or reproductive factors.
Conclusion and Recommendations: The mean age at natural menopause of the study population was 48.37 which aligns with previous studies done among Sri Lankan post-menopausal women under natural conditions. High level of physical activity and a low-calorie intake was observed in the majority emphasizing the need for exploring and improving the nutritional status of postmenopausal women. Lifetime contraceptive use was observed in only about 1/3^rd of the participants, highlighting the need for promoting contraceptive practices among women. There was no association between lifestyle or reproductive factors with the natural age of menopause. Future studies with larger and more diverse populations, as well as detailed data collection, are recommended to enable a more comprehensive analysis of associations.