Factors affecting age at menopause and their relationship with ovarian reserve: a comprehensive review

Abstract

Objective

The aim of this article was to discuss all the factors affecting the age at menopause and their correlation with ovarian reserve.

Materials and methods

A narrative review of original articles was performed using PubMed until December 2023. The following keywords were used to generate the list of citations: ‘menopause’, ‘ovarian reserve’ ‘oocytes quality and quantity’, ‘ovarian ageing’.

Results

Menopause is the final step in the process of ovarian ageing and is influenced by the oocyte pool at birth. Conditions that accelerate follicle depletion during the reproductive lifespan lead to premature ovarian insufficiency (POI) and premature ovarian failure (POF), while a higher ovarian reserve is associated with a delayed time to menopause. Reproductive history, sociodemographic, lifestyle and iatrogenic factors may impact ovarian reserve and the age at menopause.

Conclusions

Some factors affecting the age at menopause are modifiable and the risks of early menopause may be preventable. We hypothesise that by addressing these modifiable factors we may also preserve ovarian reserve. However, further interventional studies are needed to evaluate the effects of the described strategies on ovarian reserve.

SHORT CONDENSATION

The age of menopause is determined by the process of follicle depletion, which leads to a decrease in the quantity and quality of oocytes. Various factors such as demographics, menstrual patterns, reproductive history, family history, genetics, and lifestyle choices appear to influence the age at which natural menopause occurs. Some of these factors can be modified. Considering the relationship between ovarian reserve and the age of natural menopause, is it possible to intervene on these modifiable factors to preserve ovarian reserve?

Keywords:

• Menopause
• ovarian reserve
• oocytes quality
• oocytes quantity
• ovarian ageing

Disclosure statement

All authors have no conflicts of interest to disclose.

Ethics statement

This study involved a narrative review of existing literature to discuss the factors influencing the age at menopause and their correlation with ovarian reserve. Since it did not involve direct research on human or animal subjects, and solely relied on the analysis of previously published material, it did not require approval from a committee/board of a university/institution.

Data availability statement

The data that support the findings of this review derived from data available in the literature. No original data have been reported in this narrative review.