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Aim. The purpose of this study is to confirm in our population the decreasing secular trend in the age of menarche (AAM) observed in other European countries. Another aim is to investigate the association between early menarche and breast cancer, metabolic disorders risk or early menopause. Materials and Methods We conducted a nationwide population-based study of 1980 Caucasoid Spanish postmenopausal women from 2003 to 2006 to investigate the AAM, the duration of the fertile period and the relation of early menarche with breast cancer and some metabolic disorders. Results Regression analysis of AAM demonstrates a trend towards the younger AAM in our population during the past decades ( P > 0.001). Parallel to this decrease we observe a significant increase in the fertility period and the height of our population ( P < 0.001). In the women with AAM less than 11 years, there is an increased risk of hypercholesterolaemia, being overweight and obesity. However, early menarche does not raise the risk of adult onset diabetes, hypertension or breast cancer. Conclusions These data indicate a decreasing secular trend of AAM in a Spanish population in the last decades. Furthermore, hypercholesterolaemia and obesity, but not breast cancer, appears to be influenced by younger AAM. Only women who have their menarche at the age of nine years or less are more likely to have an earlier menopause.

Objective Age at natural menopause (ANM) can be considered a complex parameter that depends on the interaction of multiple factors. In the present study, the role of interaction between genetic variants within estrogen synthesis and signalling pathways in the ANM in Spanish women is studied. Material and methods Nine single nucleotide polymorphisms (SNPs) located at different candidate genes related to the estrogen signalling pathway were analysed in 1980 Spanish postmenopausal women. Results Independently, none of the nine markers were significantly associated with early ANM. Only heterozygosis at the NRIP rs2229741 locus could be associated with early menopause; however, this marker does not maintain statistical significance. In contrast, linear regression analysis suggests several epistatic interactions including these markers in relation to ANM, especially between ESR2, NRIP1 and BMP15. The genetic variant that appears most in these interactions is that of the BMP15 rs3897937. It was observed that AA-TC combined genotype for NRIP-BMP15 (rs3897937), respectively, appears to be associated with a lower ANM than other possible combinations of these SNP (46.1±5.9 versus 50.4±3.3; P = 0.002). In the multilocus analysis, the multigenic interaction formed by ESR2 (AA), BMP15 rs3897937 (TC) and NRIP1 (AA) has the lower ANM (45.37±6.8 versus 48.69±5; P = 0.038). Conclusions The results suggest that epistatic interactions of estrogen-related alleles may contribute to variance in ANM in Spanish women. Moreover, BMP15 and NRIP1 also appear as attractive candidate genes for premature menopause but require further investigation to confirm them.

ObjectiveThe aim of this study was to evaluate the knowledge, attitudes and expectations of patients receiving treatment for postmenopausal osteoporosis, analysing the factors related to good compliance with treatment.MethodsA national, epidemiological, cross-sectional study collected information on personal medical history, family history, bone densitometry, and treatment and compliance of patients over 45 years who were receiving treatment for osteoporosis and provided their informed consent. The patients anonymously completed a questionnaire about their knowledge of osteoporosis and the Morisky and Green treatment compliance evaluation test.ResultsThree hundred and fifteen specialists in gynaecology participated, recruiting 1179 patients with postmenopausal osteoporosis. The mean age was 59.9 years (standard deviation [SD] = 7.5). Only 22.6% of the patients showed an acceptable knowledge of osteoporosis (the criterion established was correct response to 80% of the questions). Treatment compliance was evaluated using a combination of Morisky–Green and Haynes–Sackett criteria. Of the patients 39.2% were classified as compliant, 74.6% of the patients were very or quite concerned about their condition and 53.3%; described their health status as excellent or good. However, 63.6% of the patients indicated that they needed more information about osteoporosis. The factors related to good compliance were the existence of one or no concomitant disease (odds ratio [OR] = 1.38, P = 0.025) and the type of knowledge about their disease (acceptable knowledge: OR = 1.33, P = 0.043).ConclusionsCorrect knowledge about osteoporosis would increase the possibility of appropriate compliance with the prescribed treatment, thus reducing the risk of osteoporotic fractures.