Association between reproductive history and menopausal timing: exploring rural-urban differences in a cross-sectional survey.

backgroundAs women spend nearly one-third of their lives postmenopausal, this transition warrants greater public health attention. Menopausal timing is affected by biological, lifestyle, and socioeconomic characteristics of women. While previous studies emphasize biomedical correlations, few account for how urban-rural differences and reproductive health variables influence menopausal timing. This study examines the influence of reproductive history on menopausal timing among women in urban and rural areas in Nigeria and provides evidence that can help target interventions aimed at improving midlife and post-reproductive health.

methodsData were collected from 294 women (181 urban, 113 rural) using structured questionnaires from March to June 2025. Descriptive, chi-square, and multinomial logistic regression analyses were used to describe, determine associations, and predictors of menopausal timing (early, normal, late) based on reproductive history. Data analysis was carried out in SPSS. Menopausal timing was the dependent variable, and independent variables included reproductive history with multiple variables such as menarche, number of pregnancies, number of children, breastfeeding, family planning, and miscarriages, while controlling for the area type (i.e., urban or rural).

resultsAmong the 294 respondents, mean age at menopause was 49.6 years and modal age was 48 years. Overall, 5.5% of women experienced early menopause (42–44 years), 77.2% experienced normal menopause (45–53 years), and 17.3% experienced late menopause (54–60 years). Stratified by residence, 7.2% of urban women and 2.7% of rural women had early menopause, while 20.0% of urban and 13.3% of rural women experienced late menopause. Chi-square analyses indicated significant associations (p < 0.05) between menopausal timing and reproductive history variables such as age at menarche, number of pregnancies and children, breastfeeding history, use of family planning, and history of miscarriage among urban women. In rural women, similar associations were observed, except for menstrual regularity, breastfeeding status, and duration of breastfeeding, which were not statistically significant. Regression analysis showed that in urban areas, early menarche (OR = 8.75, p < 0.05) and a higher number of children (OR = 49.3, p < 0.05) significantly increased the odds of early menopause, whereas a higher number of pregnancies reduced the likelihood of late menopause (OR = 0.69, p < 0.05). In rural areas, only the number of pregnancies was significantly associated with late menopause (OR = 1.85, p < 0.05). Reproductive history exerted greater influence in urban settings than in rural environments.

conclusionMenopausal timing among women in the study area occurred predominantly within the normal age range, although variations were observed between urban and rural populations. The findings indicate that reproductive history factors, particularly age at menarche, number of pregnancies, and number of children, play an important role in menopausal timing, with stronger associations observed among urban women. These results highlight the importance of incorporating reproductive life-course factors into women’s health policies and interventions aimed at improving midlife reproductive health and menopause related care in Nigeria.