Abstract
The question of whether or not there has been a secular trend in age of menopause in Europe and the United States from the 1940s to the 1990s has intrigued many investigators. However, since 1978, no attempt has been made to update Flint's 1978 study, from 1948 to 1964, of menopause ages in Denmark, England, France, Germany and the United States. This paper will attempt to describe the problems of doing secular trend research. These include methodological problems such as the use of retrospective dates and population representations, as well as the factors that affect the natural biological age of this reproductive landmark. Suggestions are made for ways to standardize menopause age research cross-culturally. These include having large enough populations studied to be statistically significant and then randomly selecting the same populations in specific areas of a country and studying them every 10 years or more; studying generations of women in same families in various areas of a particular country; or studying cohorts of women, both cross-sectionally and prospectively. An International Menopause Index for worldwide ages of menopause is also proposed.