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Julie R. Palmer, ScD, Lynn Rosenberg, ScD, Lauren A. Wise, MSc, Nicholas J. Horton, ScD and Lucile L. Adams-Campbell, PhD

Julie R. Palmer, Lynn Rosenberg, and Lauren A. Wise, are with the Slone Epidemiology Unit, Boston University School of Public Health, Mass. Nicholas J. Horton is with the Department of Epidemiology and Biostatistics, Boston University School of Public Health, Mass. Lucile L. Adams-Campbell is with the Howard University Cancer Center, Washington, DC.

Correspondence: Requests for reprints should be sent to Julie R. Palmer, ScD, Slone Epidemiology Unit, Boston University School of Public Health, 1010 Commonwealth Ave., Boston, MA 02215 (e-mail: jpalmer{at}slone.bu.edu).

Objectives. This study assessed predictors of the onset of natural menopause in African American women.

Methods. We used mailed questionnaires to collect data at baseline in 1995 and during follow-up from Black Women’s Health Study participants. Cox proportional hazards regression was used to assess potential predictors—including experiences of racism—of the onset of natural menopause among 17 070 women aged 35 to 55 years and premenopausal in 1995.

Results. The hazard ratio (HR) was 1.43 for current smokers (95% confidence interval [CI] = 1.24, 1.66) and 1.21 (95% CI = 1.06, 1.38) for ex-smokers and significantly less for obese women and oral contraceptive users. Hazard ratios for most questions about racism were elevated by 10% to 30% but were not statistically significant.

Conclusions.Earlier onset of natural menopause among African American women is strongly associated with smoking and inversely associated with body mass index and oral contraceptive use.

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