P0567 - A Cohort Study of the Age of Menopause in Female Patients With and Without Inflammatory Bowel Disease

Varun Moktan, MD¹, Nader Daoud, MD¹, William Tremaine, MD², Edward V. Loftus, MD, FACG², Sunanda V. Kane, MD, MSPH, FACG², Alexander Hochwald, MS¹, David Hodge, MS¹, Stephanie Faubion, MD, MBA¹, Francis A. Farraye, MD, MSc^1
1Mayo Clinic, Jacksonville, FL; ²Mayo Clinic, Rochester, MN

Introduction: Menopause is defined by the complete cessation of menstrual cycles for 12 continuous months. In the United States, the average age of menopause is 51 years. Menopause is most often related to naturally declining reproductive hormones, but there are other causes, including bilateral oophorectomy, radiation and chemotherapy. Some women undergo menopause at an earlier age related to genetic mutations, immune-mediated disease or other causes. Menopause may occur at a younger age in women with inflammatory bowel disease (IBD) given its immune-mediated pathophysiology. Our goal was to determine whether women with IBD experience an earlier onset of menopause compared to women without IBD.

Methods: We performed a retrospective cohort study using the Rochester Epidemiological Project which is a collaboration between clinics, hospitals and medical facilities in Minnesota. We used the traditional Olmsted Country based cohort. This online database has been used for a variety of population studies on chronic diseases. We created an age matched case cohort of women with IBD and a control cohort without IBD. ICD codes for Ulcerative Colitis and Crohn’s Disease were K51.90 and K50.00 respectively. Data collection included age, gender, BMI, ethnicity, smoking status, age at onset of menopause and use of hormone therapy. The onset of menopause was determined by review of provider notes. Patients who had undergone hysterectomy or oophorectomy were excluded. We used the Wilcoxon rank-sum test for numeric variables and Fisher’s exact test for categorical variables.

Results: The data for 171 women who met the inclusion criteria were analyzed and are presented in Table 1. The average age of menopause in IBD patients was 49.8 years and non IBD patients was 51.1 years (P=.01). The average BMI values in IBD patients and controls were 28.7 and 28.2 (P=.9). Smoking status was also found to be statistically significant with a P value of .01 between both groups. There were more former (33.7%) and current (6%) smokers in the IBD group.

Discussion: Our data demonstrates that women with IBD have an earlier onset of menopause. It is unclear if this difference is clinically significant. Further research on the mechanisms underpinning this finding is needed.

	Case Patients (N=83)		Control Patients (N=88)
Variable	N	Mean (Standard Deviation) or No. (%) of patients	N	Mean (Standard Deviation) or No. (%) of patients	p-value
Age at Menopause (Years)	83	49.8 (3.8)	88	51.1 (4.6)	0.01
BMI, kg/m2	83	28.7 (7.5)	88	28.2 (6.5)	0.9
IBD Type	83		0
Crohn’s		39 (47%)		0 (0%)
Ulcerative Colitis		44 (53%)		0 (0%)
Race	83		88		0.3
White		81 (97.6%)		83 (94.3%)
Black		0 (0%)		3 (3.4%)
Asian		2 (2.4%)		2 (2.3%)
Smoking	83		88		0.01
Never Smoked		50 (60.2%)		71 (80.7%)
Former Smoker		28 (33.7%)		13 (14.8%)
Current Smoker		5 (6%)		4 (4.5%)
Hormone Therapy (No)	83	46 (55.4%)	88	50 (56.8%)	0.9

Disclosures:
Varun Moktan indicated no relevant financial relationships.
Nader Daoud indicated no relevant financial relationships.
William Tremaine indicated no relevant financial relationships.
Edward Loftus: AbbVie – Advisory Committee/Board Member, Consultant, Grant/Research Support. Amgen – Consultant. Arena – Consultant. Boehringer Ingelheim – Consultant. Bristol-Myers Squibb – Advisory Committee/Board Member, Consultant, Grant/Research Support. Calibr – Consultant. Celgene – Advisory Committee/Board Member, Consultant, Grant/Research Support. Eli Lilly – Advisory Committee/Board Member. Genentech – Advisory Committee/Board Member, Consultant, Grant/Research Support. Gilead – Advisory Committee/Board Member, Consultant, Grant/Research Support. Iterative Scopes – Consultant. Janssen – Advisory Committee/Board Member, Consultant, Grant/Research Support. Ono Pharma – Consultant. Pfizer – Grant/Research Support. Receptos – Grant/Research Support. Robarts Clinical Trials – Grant/Research Support. Sun Pharma – Consultant. Takeda – Advisory Committee/Board Member, Consultant, Grant/Research Support. Theravance – Grant/Research Support. UCB Pharma – Consultant, Grant/Research Support.
Sunanda Kane: Bristol Myers Squibb – Consultant. Janssen – Consultant. Spherix – Consultant. TechLab – Consultant. United Healthcare – Consultant. UpToDate – Other Financial or Material Support, Section Editor.
Alexander Hochwald indicated no relevant financial relationships.
David Hodge indicated no relevant financial relationships.
Stephanie Faubion indicated no relevant financial relationships.
Francis Farraye indicated no relevant financial relationships.


Varun Moktan, MD¹, Nader Daoud, MD¹, William Tremaine, MD², Edward V. Loftus, MD, FACG², Sunanda V. Kane, MD, MSPH, FACG², Alexander Hochwald, MS¹, David Hodge, MS¹, Stephanie Faubion, MD, MBA¹, Francis A. Farraye, MD, MSc¹. P0567 - A Cohort Study of the Age of Menopause in Female Patients With and Without Inflammatory Bowel Disease, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.