Childhood adversity linked to slightly earlier menopause in two large cohorts

Women who reported more adverse childhood experiences tended to reach menopause slightly earlier, according to a cross-sectional analysis published in BMC Women’s Health that drew on two of the largest datasets available for studying reproductive aging: the UK Biobank and the US Health and Retirement Study.

The study, led by Weiqian Zhang and colleagues, included 34,872 women from the UK Biobank and 5,163 women from the Health and Retirement Study. The researchers used validated instruments to derive cumulative adverse childhood experience, or ACE, scores, which summarize exposures such as abuse and household or family-level adversity during childhood.

Using multivariable linear and logistic regression models, the team examined two outcomes: age at menopause as a continuous measure, and the odds of menopause occurring before age 40, 45, and 48 years. Because the analysis is cross-sectional, it captures associations reported at a single point in time rather than tracking how childhood adversity changes menopause timing over the life course.

In both cohorts, higher ACE scores were significantly associated with a small shift toward earlier menopause. In the UK Biobank, the estimated coefficient was -0.074 years (95% CI: -0.116 to -0.032), and in the Health and Retirement Study it was -0.254 years (95% CI: -0.372 to -0.136). Translated into absolute terms, each additional adverse childhood experience was associated with a difference of roughly 0.9 months in age at menopause in the UK Biobank and roughly 3 months in the Health and Retirement Study.

Higher ACE scores were also associated with increased odds of menopause before age 40, before age 45, and before age 48 in the analysis. The authors emphasized that the absolute difference in age at menopause was small and that its clinical significance should be interpreted with caution.

Exploratory analyses of individual ACE components suggested that different exposures were linked to earlier menopause in the two cohorts. In the UK Biobank, the signal was driven by direct maltreatment, including physical abuse, emotional abuse, and sexual abuse. In the Health and Retirement Study, the component most clearly associated with earlier menopause was parental death. The authors describe these component-level findings as exploratory, and the two cohorts did not point to the same specific exposures.

The researchers also tested whether the association varied across socioeconomic and behavioral subgroups. The direction of the association was generally similar across subgroups in both cohorts. In the UK Biobank, the association appeared stronger among women living in more socioeconomically deprived areas, but this interaction was not replicated in the Health and Retirement Study, leaving the question of effect modification by deprivation unresolved.

The authors note in their background that evidence on childhood adversity and menopause timing has been mixed and has largely come from single-cohort studies, which motivated the two-cohort design. Replicating the direction of association across the UK Biobank and the Health and Retirement Study, with their different populations and instruments, adds weight to the overall finding, even though the magnitude estimates differ between the two datasets.

Several limitations follow from the study design. The absolute difference of a few months per additional ACE is modest, and the authors explicitly caution against overinterpreting its clinical significance. The stronger deprivation interaction seen in the UK Biobank, and the differing component-level results, highlight that the association patterns are not fully consistent across settings.

The authors conclude that adverse childhood experiences were associated with earlier menopause in both large-scale cohorts, with a similar direction of association, and that these findings warrant further investigation into the relationship between childhood adversity and earlier menopause. They frame the work as a step toward clarifying how early-life conditions may relate to reproductive aging, while noting that the small absolute differences observed should be interpreted with care.

Subject of Research: The association between adverse childhood experiences and age at menopause in the UK Biobank and the US Health and Retirement Study

Article Title: Adverse childhood experiences and age at menopause: a cross-sectional analysis in the UK Biobank and US Health and Retirement Study

Article References: Zhang, W., Tan, Y., Qu, R., Liang, J., Guan, Y., Yin, T., Tang, D., & Zhang, Y. (2026). Adverse childhood experiences and age at menopause: a cross-sectional analysis in the UK Biobank and US Health and Retirement Study. BMC Women's Health. https://doi.org/10.1186/s12905-026-05017-6

Image Credits: AI Generated

DOI: 10.1186/s12905-026-05017-6

Keywords: adverse childhood experiences, menopause, reproductive aging, UK Biobank, Health and Retirement Study, cross-sectional study, childhood adversity, early menopause, women's health, epidemiology, Adverse, childhood