Early Menopause and Health Outcomes in Brazil: A Multilevel Analysis Using Data from the 2019 PNS, ELSA-Brasil, and ELSI-Brasil
Objective: To investigate the prevalence of early menopause and its association with functional limitations, depressive symptoms, cardiovascular morbidity, and the use of hormone replacement therapy among Brazilian women, taking into account individual characteristics and those of the municipality of residence. Methods: A cross-sectional study with multilevel analysis that integrated microdata from the National Health Survey (PNS 2019), the Longitudinal Study of Adult Health (ELSA-Brasil), and the Longitudinal Study of the Health of Brazilian Older Adults (ELSI-Brasil). The sample included 94,587 women aged 50 years or older with valid information on the age at natural menopause. Early menopause was defined as the permanent cessation of menstruation before age 45. Prevalences and odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using two-level (individual and municipality) multilevel logistic regression models, adjusted for age, education, income, skin color, smoking status, physical activity, body mass index, and number of children. Results: The prevalence of early menopause was 11.8% (95% CI 11.5–12.1). Women with early menopause were more likely to experience functional limitations (OR = 1.42; 95% CI 1.32–1.53), depressive symptoms (OR = 1.35; 95% CI 1.25–1.46), and cardiovascular morbidity (OR = 1.29; 95% CI 1.18–1.41). Approximately 10% of the total variance in these outcomes was concentrated among municipalities. Only 10.8% of women with early menopause used hormone replacement therapy. Conclusion: Early menopause affected more than one in ten women and was associated with worse health outcomes, influenced by individual socioeconomic conditions and the municipality of residence.
Early Menopause and Health Outcomes in Brazil: A Multilevel Analysis Using Data from the 2019 PNS, ELSA-Brasil, and ELSI-Brasil
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DOI: https://doi.org/10.22533/at.ed.01596826170614
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Palavras-chave: Early menopause; Women’s health; Epidemiology; Social determinants of health; Multilevel analysis.
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Keywords: Early menopause; Women’s health; Epidemiology; Social determinants of health; Multilevel analysis.
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Abstract:
Objective: To investigate the prevalence of early menopause and its association with functional limitations, depressive symptoms, cardiovascular morbidity, and the use of hormone replacement therapy among Brazilian women, taking into account individual characteristics and those of the municipality of residence. Methods: A cross-sectional study with multilevel analysis that integrated microdata from the National Health Survey (PNS 2019), the Longitudinal Study of Adult Health (ELSA-Brasil), and the Longitudinal Study of the Health of Brazilian Older Adults (ELSI-Brasil). The sample included 94,587 women aged 50 years or older with valid information on the age at natural menopause. Early menopause was defined as the permanent cessation of menstruation before age 45. Prevalences and odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using two-level (individual and municipality) multilevel logistic regression models, adjusted for age, education, income, skin color, smoking status, physical activity, body mass index, and number of children. Results: The prevalence of early menopause was 11.8% (95% CI 11.5–12.1). Women with early menopause were more likely to experience functional limitations (OR = 1.42; 95% CI 1.32–1.53), depressive symptoms (OR = 1.35; 95% CI 1.25–1.46), and cardiovascular morbidity (OR = 1.29; 95% CI 1.18–1.41). Approximately 10% of the total variance in these outcomes was concentrated among municipalities. Only 10.8% of women with early menopause used hormone replacement therapy. Conclusion: Early menopause affected more than one in ten women and was associated with worse health outcomes, influenced by individual socioeconomic conditions and the municipality of residence.
- denise soares de cirqueira
- Douglas José Nogueira
