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Although menopause is typically defined as the absence of menstruation for 12 consecutive months, deriving age at natural menopause using repeated, prospective data can be challenging. In this data note, we describe our approach developed to assign age at natural menopause using longitudinal data from the Avon Longitudinal Study of Parents and Children (ALSPAC) Mothers cohort and highlight the complexities involved. Between 2008 and 2020, women were asked at up to eight timepoints about their menstrual history, including when they last had a menstrual period (LMP), reasons for period cessation if relevant, and contraception and hormone replacement therapy (HRT) use. Our approach used these repeated menstrual reports to assign the timing of the final menstrual period. Specifically, we combined three key variables - self-reported LMP and menstruation in the last 3\u00a0months and last 12\u00a0months \u2013 and accounted for factors affecting menstruation such as surgery, contraception, and HRT. Age at natural menopause was then derived using these repeated reports across timepoints. Of 5,949 women included in the analysis (mean 3.6 timepoints per participant), age at natural menopause was assigned for 2,422 women. The mean assigned age of menopause was 49.4\u00a0years (SD\u00a0=\u00a04.1, range: 30\u201363\u00a0years, median\u00a0=\u00a050\u00a0years). This data note introduces potential users of the ALSPAC data to our derived menopause variable and highlights key challenges when using longitudinal data to estimate menopause timing including irregular bleeding, missing data, and conflicting reports. Our aim is to support researchers wishing to use this derived variable in future studies of reproductive ageing.<\/ns5:p>","DOI":"10.12688\/wellcomeopenres.24760.2","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:54:08Z","timestamp":1782363248000},"page":"631","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating age of menopause in mothers in the ALSPAC Study: A data note"],"prefix":"10.12688","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4128-6821","authenticated-orcid":false,"given":"Rochelle","family":"Knight","sequence":"first","affiliation":[{"name":"Bristol England MRC Integrative Epidemiology Unit"},{"name":"Population Health Sciences Bristol England University of Bristol Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7741-9470","authenticated-orcid":false,"given":"Abigail","family":"Fraser","sequence":"additional","affiliation":[{"name":"Bristol England MRC Integrative Epidemiology Unit"},{"name":"Population Health Sciences Bristol England University of Bristol Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Joinson","sequence":"additional","affiliation":[{"name":"Bristol England MRC Integrative Epidemiology Unit"},{"name":"Population Health Sciences Bristol England University of Bristol Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2763-4647","authenticated-orcid":false,"given":"Ana Goncalves","family":"Soares","sequence":"additional","affiliation":[{"name":"Bristol England MRC Integrative Epidemiology Unit"},{"name":"Population Health Sciences Bristol England University of Bristol Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"ref1","article-title":"Menopause: identification and management.","year":"2024"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"425-440","DOI":"10.1016\/j.ogc.2011.05.002","article-title":"The timing of the age at which natural menopause occurs.","volume":"38","author":"E Gold","year":"2011","journal-title":"Obstet Gynecol Clin North Am."},{"key":"ref3","article-title":"Amenorrhea.","author":"G Nawaz","year":"2024 Feb 25"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"556-562","DOI":"10.1097\/01.ede.0000165392.35273.d4","article-title":"Age at menopause, cause-specific mortality and total life expectancy.","volume":"16","author":"M Ossewaarde","year":"2005","journal-title":"Epidemiology."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"923-929","DOI":"10.1093\/aje\/kwg066","article-title":"Age at 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A prospective analysis of the Dutch DOM cohort.","volume":"55","author":"E Monninkhof","year":"1999","journal-title":"Breast Cancer Res Treat."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"187-193","DOI":"10.1016\/0028-2243(78)90014-x","article-title":"Age at menarche and menopause of uterine cancer patients.","volume":"8","author":"J Graaff","year":"1978","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"57-60","DOI":"10.1002\/ijc.2910490111","article-title":"Pooled analysis of 3 European case-control studies of ovarian cancer: II. 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peer review: 2 approved].","volume":"7","author":"D Major-Smith","year":"2022","journal-title":"Wellcome Open Res."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"51","DOI":"10.12688\/wellcomeopenres.15132.1","article-title":"The Avon Longitudinal Study of Parents and Children (ALSPAC): an update on the enrolled sample of index children in 2019 [version 1; peer review: 2 approved].","volume":"4","author":"K Northstone","year":"2019","journal-title":"Wellcome Open Res."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"865-874","DOI":"10.1093\/aje\/153.9.865","article-title":"Factors associated with age at natural menopause in a multiethnic sample of midlife women.","volume":"153","author":"E Gold","year":"2001","journal-title":"Am J Epidemiol."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"70-83","DOI":"10.1093\/aje\/kws421","article-title":"Factors related to age at natural menopause: longitudinal analyses from SWAN.","volume":"178","author":"E Gold","year":"2013","journal-title":"Am J Epidemiol."},{"key":"ref30","first-page":"27-34","article-title":"Age at menopause in women participating in the Postmenopausal Estrogen\/Progestins Interventions (PEPI) trial: an example of bias introduced by selection criteria.","volume":"2","author":"G Greendale","year":"1995","journal-title":"Menopause."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"64-76","DOI":"10.1093\/oxfordjournals.aje.a116936","article-title":"Age at natural menopause and sociodemographic status in Finland.","volume":"139","author":"R Luoto","year":"1994","journal-title":"Am J Epidemiol."},{"key":"ref32","first-page":"17-23","article-title":"Age at the menopause and onset of the climacteric in women of Martin District, Czechoslovkia. Statistical survey and some biological and social correlations.","volume":"20","author":"V Magursk\u00fd","year":"1975","journal-title":"Int J Fertil."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"103-115","DOI":"10.1016\/0378-5122(92)90003-m","article-title":"The normal menopause transition.","volume":"14","author":"S McKinlay","year":"1992","journal-title":"Maturitas."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"995-1002","DOI":"10.1016\/0021-9681(87)90113-5","article-title":"Factors influencing the age at natural menopause.","volume":"40","author":"J Stanford","year":"1987","journal-title":"J Chronic Dis."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"105-114","DOI":"10.3109\/13697137.2011.650656","article-title":"Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging.","volume":"15","author":"S Harlow","year":"2012","journal-title":"Climacteric."}],"container-title":["Wellcome Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:54:11Z","timestamp":1782363251000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":38,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.24760.2","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/wellcomeopenres.24760.1","asserted-by":"subject"}]},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.27277.r139243, Annette Dobson, The University of Queensland Integrative Legume Research Group, Saint Lucia, Queensland, 25 Nov 2025, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v1#referee-response-139243","order":0,"name":"referee-response-139243","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Rochelle Knight<\/b>; \n<i>Posted: 08 Jun 2026<\/i>; We thank the reviewer for taking the time to review this manuscript and for their thoughtful comments. In response to your comment regarding censoring dates, we realise that our use of the term \u201ccensor\u201d may have been unclear. In the context of our work, women were not censored in a formal survival-analysis sense. Rather, reported dates of last menstrual period (LMP) from timepoints where factors likely to affect natural menstrual bleeding were reported (e.g., hormonal contraceptive use, HRT use, surgery, chemotherapy, or other conditions affecting menstruation) were excluded from consideration when estimating the final menstrual period (FMP). In practice, this was determined using information reported at each questionnaire timepoint. For example, if a woman reported both a date of LMP and current hormonal contraceptive use at a given questionnaire, the reported menstrual date from that timepoint was excluded because hormonal contraceptives may alter bleeding patterns. If hormonal contraceptive use was no longer reported at a later questionnaire, menstrual information from that subsequent timepoint could again contribute to estimation of the FMP. Following this comment, we have clarified this process in the manuscript and replaced the term \u201ccensor\u201d with \u201cexclude\u201d throughout to avoid confusion with censoring in survival analyses.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v2#referee-comment-6594","order":1,"name":"referee-comment-6594","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.27277.r139241, Madeline Wood Alexander, University of Toronto, Toronto, Ontario, 23 Dec 2025, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v1#referee-response-139241","order":2,"name":"referee-response-139241","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Rochelle Knight<\/b>; \n<i>Posted: 08 Jun 2026<\/i>; We are grateful to the reviewer for reviewing this manuscript and for providing helpful comments and suggestions. We have added to the limitations section that the exclusion of timepoints where hormonal medications were reported may introduce bias and that this should be considered by future researchers. Regarding surgical menopause, unfortunately we are unable to reliably assign an age at surgical menopause. Although participants were asked about surgeries related to the removal of reproductive organs, not all reported procedures would necessarily result in surgical menopause. For example, hysterectomy without bilateral oophorectomy will lead to cessation of menstruation but not menopause itself. In addition, some participants reported having had \u2018surgery\u2019 that stopped periods without specifying the type of surgery or the timing of the procedure. As a result, deriving a reliable variable for age at surgical menopause would require substantial additional considerations beyond the scope of the current data note. We thank the reviewer again for recognising the potential value of our work to researchers using the ALSPAC data for women\u2019s health research.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v2#referee-comment-6595","order":3,"name":"referee-comment-6595","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.27277.r139244, Zailing Xing, University of South Florida, Tampa, Florida, 24 Dec 2025, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v1#referee-response-139244","order":4,"name":"referee-response-139244","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Rochelle Knight<\/b>; \n<i>Posted: 08 Jun 2026<\/i>; We appreciate the reviewer\u2019s careful consideration of our work and their helpful feedback. Regarding the point on predictive performance metrics, we would like to clarify that this study is not intended as a predictive model of future age at menopause. Rather, it is a data note describing the derivation of age at menopause using prospectively collected longitudinal menstrual data within ALSPAC. For this reason, predictive performance metrics would not be appropriate to include. Unlike most studies, in which age at menopause is reported retrospectively at a later age, ALSPAC assessed prospective information on women\u2019s menstrual history, i.e., what was the date of your last menstrual period? Using these questions we have estimated the women\u2019s age at menopause based on identifying a period of amenorrhea of more than 12 months and have accounted for factors affecting menstruation such as surgery, contraception, and HRT. We have also dealt with missing data and inconsistent responses. Given your comments, we have revised the manuscript wording to clarify that the approach is intended for estimation of age at menopause from longitudinal data, rather than prediction, and we have adjusted terminology accordingly where needed. We have decided to keep Tables 2 and 3 in the main document.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v2#referee-comment-6596","order":5,"name":"referee-comment-6596","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.27277.r139237, Sostina Spiwe Matina, Wits University, Johannesburg, Gauteng, 27 Dec 2025, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v1#referee-response-139237","order":6,"name":"referee-response-139237","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Rochelle Knight<\/b>; \n<i>Posted: 08 Jun 2026<\/i>; We thank the reviewer for their careful review of this manuscript and for their constructive and helpful comments. In response to all points raised:  Rational and methodological background  We have added further detail on the background and rationale of our study. Whilst previous studies have derived the timing of the FMP within ALSPAC, detailed description of the derivation methods were not provided and some only considered data assessed at the clinic questionnaires. The STRAW+10 criteria provide a framework for classifying menopausal stage (e.g., reproductive, perimenopausal, and postmenopausal stages). However, deriving a specific age at menopause from longitudinal menstrual data involves additional methodological considerations, including missing data and conflicting responses, which are not the focus of the STRAW+10 staging system. Similarly, in other cohorts, there is often limited methodological detail on how age at menopause was derived beyond stating that a 12-month period of amenorrhea was identified. The method presented here was developed to provide a transparent and reproducible approach to estimating age at menopause using all the prospectively collected menstrual data available within ALSPAC.  Women with irregular cycles  In response to your comments regarding women with irregular cycles, menopause was defined retrospectively based on 12 months of amenorrhea, consistent with standard definitions of natural menopause. Therefore, women with irregular cycles could still be assigned an estimated age at menopause if they subsequently met the criterion of 12 consecutive months without menstruation and did not report another explanation for cessation of periods (e.g., hormonal contraceptive use, HRT use, surgery, chemotherapy, or other medical causes). &nbsp;  Tolerance thresholds  Given the nature of self-reported longitudinal data, some questionnaire responses were conflicting or internally inconsistent. To ensure these cases were handled in the same way, tolerance thresholds were required. These decisions were informed through detailed discussion within the research team and a clinician, consideration of clinical knowledge regarding menopausal timing and menstrual patterns, and examination of patterns within the data. Whilst sensitivity analyses may be informative, implementing multiple alternative derivation thresholds was beyond the scope of the current data note.  Use of the most recent plausible LMP  We appreciate this point and have added further discussion of this within the limitations section.  Missingness in age at menopause variable  We summarise under \u2018Description of the population\u2019 those women who we were unable to derive age at menopause. In the limitations section we discuss the long gaps between assessment timepoints. We thank the reviewer again for these constructive comments, which have helped strengthen the clarity of the manuscript.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-631\/v2#referee-comment-6597","order":7,"name":"referee-comment-6597","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by Wellcome [092830] [092830] [228278] [218495]; Lifelong Health and Wellbeing (LLHW) via the MRC [G1001357]; the British Heart Foundation [SP\/07\/008\/24066]; the John Templeton Foundation [61356]; the MRC [MR\/M009351\/1]. RK is supported by the Wellcome trust [228278\/Z\/23\/Z, 218495\/Z\/19\/Z]. AGS is supported by the European Union\u2019s Horizon 2020 research and innovation programme [874739 LongITools and 101137146 STAGE]. AF and AGS work in a Unit that is funded by the UK Medical Research Council [MC_UU_00011\/1&6] and the University of Bristol. The UK Medical Research Council and Wellcome [217065\/Z\/19\/Z] and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and Rochelle Knight will serve as guarantor for the contents of this paper. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. A comprehensive list of grants funding is available on the ALSPAC website: http:\/\/www.bristol.ac.uk\/alspac\/external\/documents\/grant-acknowledgements.pdf. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":8,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}