Relationship between menopausal status and suicidal behavior among the Korean population

Objective

We investigated whether, in the Korean population, the risk of suicidal behavior is associated with menopausal status and especially age at menopause. For a deeper understanding of suicidal behavior, participants were asked about suicidal ideation and plans, and actual suicide attempts.

Methods

This cross-sectional, population-based study involved 27,524 women for analyzing suicidal ideation, 26,893 women for suicidal plans, 28,682 women for suicide attempts, registered in the Korea National Health and Nutrition Examination Survey (2010−2022). Data on menopausal status, including age at menopause, and suicidal behavior were obtained from a self-reported questionnaire. A logistic regression model was applied to examine whether premature ovarian insufficiency, early menopause, and normal menopause significantly impact rates of suicidal behavior, which was further stratified by depression. Weighted prevalence of suicidal behavior according to age at menopause was also analyzed.

Results

Compared with premenopausal status, the risk of suicidal ideation was increased in women with premature ovarian insufficiency by an odds ratio (95 % confidence interval) of 1.53 (1.17–2.01), in women with early menopause by 1.57 (1.28–1.92), and in women with clinically normal menopause by 1.17 (1.00–1.37). The risk of suicidal planning was also increased in women in each of these three respective menopausal groups: 1.92 (1.06–3.47), 1.55 (0.96–2.51), and 1.61 (1.13–2.30). The risk of suicide attempt was also increased in women with premature ovarian insufficiency, by an odds ratio of 2.01 (0.91–4.44), and in women with a clinically normal menopause, by 1.97 (1.22–3.18). The weighted prevalence of suicidal ideation decreased with age at menopause, grouped as $\le$30 (21.5 %), 31–40 (14.8 %), 41–50 (11.1 %), and $\ge$50 (9.4 %).

Conclusion

The risks of suicidal ideation and planning were higher in women with premature ovarian insufficiency, early menopause, and clinically normal menopause. The risk of suicide attempt was also higher in women with premature ovarian insufficiency and normal menopause, compared with premenopausal women. Younger age at menopause led to a higher risk of suicidal ideation and planning in general. Due to the limitations of this study's cross-sectional design, longitudinal studies must be conducted to establish more strongly this relationship between menopause and suicidal behavior.