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Down Syndrome Abstract
of the Month: May 2001

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A prospective study of menopause in women with Down's syndrome

Seltzer GB, Schupf N, Wu HS
J Intellect Disabil Res 2001 Feb;45(Pt 1):1-7

The Waisman Center and School of Social Work, University of Wisconsin-Madison, USA.

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The present study prospectively examined the age at menopause of 92 women with Down's syndrome (DS) and the influence of hypothyroidism on the age of menopause. Three methods were used to determine the distribution and median age at onset of menopause: (1) Kaplan-Meier life tables; (2) Cox proportional hazards modelling; and (3) maximum likelihood logistic regression. All three methods provided distributions and similar estimates of the median age at menopause, which was approximately 46 years. The presence of hypothyroidism did not influence age at menopause. The earlier-than-expected age at onset of menopause suggests that women with DS are at an increased risk for post-menopausal health disorders.

My comments:

This report is basically a statistical analysis based on interviews and studying past medical records of 92 women with DS living in or near the Madison, Wisconsin area. Even though this is a limited study, it gives two important pieces of information: women with DS have menopause significantly earlier than other women, and that having treated hypothyroidism has no effect on the age of menopause. The study does not address the question as to whether untreated hypothyroidism would have any effect on the age of menopause in women with DS.

The question of why premature menopause occurs in Down syndrome isn't addressed in this study. I assume it's part of the premature aging seen in adult men and women with DS, but the exact reasons haven't yet been established.

Women without DS who are post-menopausal are known to be at higher risk for certain medical conditions related to estrogen loss, such as heart disease, breast cancer, osteoporosis and depression. While breast cancer and heart disease have been more uncommon in the Down syndrome population than in the general population, that may change as adults with DS are now living longer than in previous generations. Whether women with DS who are post-menopausal are more at risk for these conditions is a subject that requires further study, but these risk factors should be kept in mind by all family caretakers and health professionals involved in the care of these women.

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