To kick off Mother’s Day, we’re geeking out over what our biological mothers can tell us about our own fertility. After all, you may have gotten your brown eye color, knack for numbers, and extroverted nature from your mom (not to mention a few tried-and-true recipes), so it’s natural to wonder if things like fertility might be passed on to you, too. Turns out, you’re totally right. Getting the answer to the question, “Hey mom, when did you go through menopause?” can reveal a lot about your own fertility status. Skeptical? To be honest, so were we—until we dug into the research.
The Mayo Clinic defines menopause as the time that marks the end of your menstrual cycles. Menopause diagnosed after you've gone 12 months without a menstrual period. The average age in the United States is 51, though this can vary based on a number of factors like ethnicity, smoking and alcohol consumption, body mass index, and even socioeconomic status. Menopause symptoms, like hot flashes, vaginal dryness, can start up to 10 years before you have gone a full year without a period. This potentially wide timespan can impact your fertility window if you’re waiting to start a family later in life.
Next time you have an opportunity to catch up with mom, see if she’s open to chatting about fertility and menopause. Here’s what her answer to the aforementioned question can tell you:
When you’ll experience menopause
Learning when your mom experienced menopause is an estimation of when you’ll experience it. However, there are more accurate ways to go about learning this information, like measuring your AMH (anti-Mullerian hormone) levels. Science has a lot to say about both methods.
In 2004, researchers set out to to determine the heritability of age at menopause based on 164 mother-daughter pairs who had both already gone through menopause. Their findings, published in Fertility and Sterility, revealed a 44 percent menopause heritability rate within the group. Here’s one way of interpreting these results: Of the 164 daughters in the sample, almost half experienced menopause around same age as their mother. On average, the daughters experienced menopause one year earlier than their mothers.
Other studies come to similar conclusions, like this 2014 study that observed 400 postmenopausal Iranian women. Information on their mother’s age at menopause was collected through individual interviews. The authors write, “...we showed an association between a mother’s and a daughter’s age at menopause, as shown previously.” This 1995 study, which observed 344 cases of early menopause (defined by the researchers as before age 46), found that 37.5 percent reported a family history of early menopause 46 years in a mother, sister, aunt, or grandmother. The risk of early menopause was greatest for those who reported a sister or multiple relatives experienced it, or if a family member experienced it before the age of 40.
However, like we mentioned, your AMH levels are a better predictor of when you’ll go through menopause than your mother’s history. First, some background on AMH: It’s a fertility hormone that’s a proven indicator of ovarian reserve (a fancy way of saying the number of eggs you have left in your ovaries). We’re born with a set amount of eggs and lose them each month during our cycle, and at a faster rate as we get older. AMH levels (low, normal, high) are proportional to the number of eggs in your ovaries. So, if your AMH levels fall within the normal range, you’re likely working with a healthy number of eggs. Research, like this 2016 study, shows that your AMH levels (representing how many eggs you currently have left) can predict when you’ll experience menopause (when you’ll no longer have any eggs).
In 2014, researchers asked a group of 150 daughters when their mothers went through menopause. They also measured the daughters’ AMH levels. Ultimately, they wanted to figure out if the mother’s age at menopause or the daughter’s AMH levels was a stronger predictor of when the daughter would experience menopause. When the scientists followed up with the daughters 12 years later, they discovered the AMH measurement had done a better job of forecasting the daughter’s age at menopause than their mother’s age at menopause.
Specifically, a 47 percent improvement in predictive accuracy was offered by adding AMH as a variable to researchers’ predictive model. The authors write, “...AMH and mother's age at menopause both have added value in forecasting time to menopause for the daughter based on her age. In comparison, AMH is a more accurate added predictor of time to menopause than mother's age at menopause.”
Think of it this way: While your mom’s age at menopause can roughly predict when you’ll experience menopause, your AMH levels are a biomarker that can more accurately predict this timing.
How many eggs you have left and how quickly they’re depleting
If your mom dealt with menopause early, this could be a sign that your ovarian reserve is diminishing at a faster rate. Researchers discovered this connection by studying mothers’ ages at menopause and their daughters’ AMH levels and antral follicle counts (AFC). Like AMH, AFC is a common and proven ovarian reserve test determined via ultrasound. During this process, a doctor actually counts the number of follicles (where the eggs are housed) in your ovaries. Usually, providers test AMH before testing AFC.
In this 2013 Human Reproduction study, researchers demonstrated a significant association between a mother’s age at menopause and their daughter’s AMH levels and AFC. The researchers discovered that the daughters who said their moms experienced early menopause onset (45 or younger) experienced a faster rate of AMH level and AFC decline, compared to those who said their mothers went through menopause at an average (46-54) or later (55 or older) age.
If you find out your mom experienced menopause early, don’t freak: Mom might not have had a way to check in on her hormone levels when she was your age, but you do. (Times they are a changin’). Testing your fertility hormones is one of the first and most useful steps to understanding your fertility, so you have real data to truly know where you stand. Once you’re armed with this information, you and your provider can discuss your options and determine the path that aligns with your personal goals.
More meaning for Mother's Day
Who knew that a single question could provide so many insights? Now, while all this science is undeniably cool, Mother’s Day is about much more than things like fertility and menopause. We celebrate Mother’s Day by honoring the many individuals who nurture and care, whether or not we spent nine months chilling out in their uterus. We also understand this holiday can be difficult, perhaps if you’re struggling to conceive or have lost your mom. So, to all the a dog moms, volunteers, mother-in-laws, teachers, new mothers, best friends, aunties, partners, caregivers, godmothers, and plant mamas out there: Happy Mother’s Day from all of us at Modern Fertility. We’re here to support you, no matter where you are on your fertility journey.