Heterogeneity across race and ethnicity for menopause onset

The heterogeneity onset of menopause varies across racial and ethnic groups, yet this heterogeneity may partially reflect methodological differences rather than true biological differences. Using the All of Us Research Program Controlled Tier dataset (v8), we analyzed age at first menopause diagnosis across three progressively refined cohorts: a full ICD-based cohort (Cohort 1, n = 11,306), a survey-linked subcohort adjusted for neighborhood deprivation, smoking, and alcohol use (Cohort 2, n = 10,639), and a confirmatory sensitivity cohort applying SNOMED-based surgical exclusions to the same adjusted framework (Cohort 3, n = 10,222). Asian & Pacific Islander and Indigenous/Other individuals