Human Reproduction, Vol. 16, No. 8, 1657-1662,
August 2001
© 2001 European Society of Human Reproduction and Embryology
Oral contraceptive use in relation to age at menopause in the DOM cohort
1 International Health Foundation, Utrecht, 3526 KS, 2 Julius Center for Patient Oriented Research, and 3 Department of Obstetrics and Gynaecology, University Medical Centre, Utrecht, 3508 GA, The Netherlands
BACKGROUND: We investigated the hypothesis that long-term use of oral contraceptives (OCs), in particular high-dose OCs, could postpone age at menopause. METHODS: Data was used from 8701 women who participated in a breast cancer screening programme in Utrecht (DOM-3 cohort), and who did not use hormone replacement therapy (HRT) or OCs in the 4 years prior to their last menses. Data on OC-use, menopausal status, age at menopause, year of birth, parity, smoking behaviour, socio-economic status, body mass index and age at menarche was available. Use of high-dose OCs has been defined in this study as OC-use before 1972. The data was analysed by means of linear regression and Cox's proportional hazards analysis. Women still menstruating, women with surgical menopause and women lost to follow-up were censored at their last known date of menstruation. Endpoint was the natural menopause (n = 4589). RESULTS: The use of high-dose OCs advanced the onset of menopause by ~1.2 months for every year of OC-use compared with no OC-use. High-dose OC-use for 
3 years, adjusted for confounding variables, increased the risk of earlier menopause compared with no OC-use (adjusted hazard ratio 1.12; 95% CI 1.03–1.21). The use of lower dose OCs did not increase the risk of earlier menopause (adjusted hazard ratio 1.00; 95% CI 0.91–1.09). CONCLUSIONS: These results are inconsistent with the hypothesis that long-term use of OCs could postpone the onset of menopause by inhibiting follicle depletion. Possible explanations are discussed.
Key words: cohort study/follicular depletion/menopause/oral contraceptive/risk factors
4 To whom correspondence should be addressed at: International Health Foundation, Europalaan 506, 3526 KS Utrecht,The Netherlands. E-mail: identonkelaar{at}ihf.nl
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