Relationship of relevant factors of atherosclerosis to menopause in Japanese women.

The relationship of menopause to associated factors of atherosclerosis was investigated during October 1973 to December 1976. The subjects were 1674 premenopausal and 428 postmenopausal women aged 35 to 54, who were living in Toda city, an urban area of Japan. Serum cholesterol and triglyceride were higher in postmenopausal women than in premenopausal women. This trend was also observed in serum uric acid and blood hemoglobin. On the other hand, systolic and diastolic blood pressure and relative body weight had no consistent relationship to menopause.     

Incidence of thyroid cancer in women in relation to reproductive and hormonal factors

Female residents of western Washington state aged 18-80 years in whom thyroid cancer was diagnosed between January 1974 and December 1979 were interviewed concerning their reproductive histories and their prior use of exogenous estrogens. Their responses were compared with those of a sample of women from the same population, individually matched to cases on telephone prefix. Use of each of several estrogen-containing preparations was associated with a small increased risk of thyroid cancer; parous women who had ever used a lactation suppressant had 1.7 times the risk of parous nonusers (95% confidence interval, 1.1-2.8); ever users of oral contraceptives had 1.6 times the risk of never users (95% confidence interval, 0.98-2.5); and ever users of postmenopausal estrogens had 1.4 times the risk of never users (95% confidence interval, 0.89-2.3). Among the low risk group of women, i.e., those who had never undergone radiation therapy and who had never had a goiter, a history of one or more pregnancies was also associated with a small increase in the risk of thyroid cancer (relative risk = 1.8, 95% confidence interval, 1.1-3.1). However, no increase in risk with increasing duration of use of oral contraceptives or menopausal estrogens or with increasing number of pregnancies was noted. While pregnancy and use of exogenous estrogens have an impact on the production of thyroid-stimulating hormone, their effect on the incidence of thyroid carcinoma, if present at all, appears to be small.     

Symptoms experienced by women who enter into natural and surgical menopause and their relation to sexual functions

We carried out this study to determine which symptoms women experienced according to menopause type and the relation of these symptoms to sexual functions. The patricipants of the study were 250 women who underwent natural menopause and 200 women who underwent surgical menopause. A questionnaire, the Menopause Rating Scale (MRS), and the Golombok Rust Inventory of Sexual Satisfaction (GRISS) provided data. According to the MRS, hot flushes and sweating problems were the most common experiences, and, according to the GRISS, sexual infrequency problems rated highest in both groups. There was a positive relationship between multiple sexual functioning problems and the perceived level of menopausal symptom intensity, especially in surgical menopause women.     

Body mass index, exercise, and other lifestyle factors in relation to age at natural menopause: analyses from the breakthrough generations study

The authors examined the effect of women's lifestyles on the timing of natural menopause using data from a cross-sectional questionnaire used in the United Kingdom-based Breakthrough Generations Study in 2003-2011. The analyses included 50,678 women (21,511 who had experienced a natural menopause) who were 40-98 years of age at study entry and did not have a history of breast cancer. Cox competing risks proportional hazards models were fitted to examine the relation of age at natural menopause to lifestyle and anthropometric factors. Results were adjusted for age at reporting, smoking status at menopause, parity, and body mass index at age 40 years, as appropriate. All P values were 2-sided. High adult weight (P(trend) < 0.001), high body mass index (P(trend) < 0.001), weight gain between the ages of 20 and 40 years (P(trend) = 0.01), not smoking (P < 0.001), increased alcohol consumption (P(trend) < 0.001), regular strenuous exercise (P < 0.01), and not being a vegetarian (P < 0.001) were associated with older age at menopause. Neither height nor history of an eating disorder was associated with menopausal age. These findings show the importance of lifestyle factors in determining menopausal age.     

Smoking habits in relation to reproductive events among Japanese women: Findings of the Japanese Nurses' Health Study

Objective

The purposes of this study were to examine smoking habits in relation to the reproductive events of pregnancy and menopause and clarify the reasons for smoking cessation among ex-smokers.

Method

This is a cross-sectional study based on a baseline survey of a prospective cohort study. From 2001 to 2007, a self-administered questionnaire survey was conducted on 49,927 female nurses from all 47 prefectures in Japan. Logistic regression models were used to estimate age-adjusted odds ratios.

Results

Of the respondents, 17.2% were current smokers, 11.6% were ex-smokers and 69.8% had never smoked. The prevalence of smoking during pregnancy was 7.8%. Among ex-smokers, 30.3% gave “reproductive events” as their reason for smoking cessation. Current smoking and the number of cigarettes smoked per day before menopause were significantly related to onset of menopause.

Conclusion

Women's smoking habits have mutual relationships with reproductive events such as pregnancy and menopause. Although “reproductive events” were an important reason for smoking cessation among women, 7.8% of women still smoked during pregnancy. Smoking was correlated with onset of menopause. Support for smoking cessation is an important healthcare issue throughout women's lifetimes.     

Menstrual and reproductive characteristics and age at natural menopause

Data from women who enrolled between 1935 and 1939 in a long-term prospective study of menstrual and reproductive health, in which menstrual cycles and other events were recorded as they occurred, were analyzed to examine factors associated with age at natural menopause. Analysis was restricted to 561 women who enrolled before age 25 years and recorded data through at least age 44 years. Women with a median cycle length that was less than 26 days at ages 20-35 years reached menopause 1.4 years earlier than those with cycles between 26 and 32 days. The difference in mean menopausal age between women with short cycle length (less than 26 days) and women with long cycle length (33 days or longer) was 2.2 years. Women who had ever been pregnant reached menopause slightly, but statistically significantly, later than women who had never been pregnant. Similarly, women who had ever had a live birth had a slightly later age at menopause compared with nulliparous women. A trend of later age at menopause with increasing parity was also observed. There was no association with age at menarche. Certain of these observations are consistent with proposed mechanisms of cessation of menstrual function.     

Age at natural menopause in women exposed to diethylstilbestrol in utero

Age at natural menopause is related to several health outcomes, including cardiovascular disease and overall mortality. Age at menopause may be influenced by the number of follicles formed during gestation, suggesting that prenatal factors could influence menopausal age. Diethylstilbestrol (DES), a nonsteroidal estrogen widely prescribed during the 1950s and 1960s, is related to reproductive tract abnormalities, infertility, and vaginal cancer in prenatally exposed daughters but has not been studied in relation to age at menopause. The authors used survival analyses to estimate the risk of natural menopause in 4,210 DES-exposed versus 1,829 unexposed US women based on responses to questionnaires mailed in 1994, 1997, and 2001. DES-exposed women were 50% more likely to experience natural menopause at any given age (hazard ratio = 1.49, 95% confidence interval: 1.28, 1.74). Among women for whom dose information was complete, there were dose-response effects, with a greater than twofold risk for those exposed to >10,000 mg. The causal mechanism for earlier menopause may be related to a smaller follicle pool, more rapid follicle depletion, or changes in hormone synthesis and metabolism in DES-exposed daughters. Age at menopause has been related, albeit inconsistently, to several exposures, but, to the authors' knowledge, this is the first study to suggest that a prenatal exposure may influence reproductive lifespan.     

Onset of natural menopause in African American women

OBJECTIVES: This study assessed predictors of the onset of natural menopause in African American women. METHODS: We used mailed questionnaires to collect data at baseline in 1995 and during follow-up from Black Women's Health Study participants. Cox proportional hazards regression was used to assess potential predictors-including experiences of racism-of the onset of natural menopause among 17 070 women aged 35 to 55 years and premenopausal in 1995. RESULTS: The hazard ratio (HR) was 1.43 for current smokers (95% confidence interval [CI] = 1.24, 1.66) and 1.21 (95% CI = 1.06, 1.38) for ex-smokers and significantly less for obese women and oral contraceptive users. Hazard ratios for most questions about racism were elevated by 10% to 30% but were not statistically significant. CONCLUSIONS:Earlier onset of natural menopause among African American women is strongly associated with smoking and inversely associated with body mass index and oral contraceptive use.     

Breast cancer in relation to some reproductive factors

Breast cancer is one of the most commonly occurring cancers in females in the Eastern Mediterranean Region. In Egypt women's breast cancer had the highest frequency. The present study was conducted to study the association between breast cancer and some reproductive factors as well as to find out (if possible) predictors for occurrence of breast cancer. A hospital based case control study was carried out in Alexandria Main University Hospital where, 129 histopathologically confirmed incident primary breast cancer cases were included. An equal number of a control group matched by age were selected from the visitors of the same hospital. Data related to women's reproductive period were collected from both cases and controls. The results revealed that there was no statistically significant difference between cases and controls as regards menopausal status, menstruation span, number of births, spontaneous and induced abortion, twin birth, breast feeding and use of oral contraceptives. There was an increasing risk of breast cancer, with the presence of positive family history of breast cancer decreasing age at menarche, increasing age at first full-term pregnancy, widening of the interval between menarche and first full-term pregnancy, increasing age at last full-term pregnancy and shortening of the interval since last birth. Multiple logistic regression analysis revealed that positive family history of breast cancer, young age at menarche, late age at last full-term pregnancy and wide inter-birth interval were significant predictors for occurrence of breast cancer. The results of the study pinpoint that conduction of public health education programmes focusing on the modifiable risk factors are required.     

Twinning rates among women at the end of their reproductive span and their relation to age at menopause;.

A review of studies on twinning has shown that dizygotic (DZ) twinning rates among women from general populations characteristically peak at ages 35-39, then decline sharply. Analysis of genealogical data from the Archives of the Mormon Church indicates that women who are dizygous twins themselves or the sibs of dizygous twins have a higher twinning rate among their offspring than do women from the general population. The dizygotic twinning rates of women who are twins or the sibs of twins classified by maternal age also peak at ages 35-39 but remain high at ages 40-44, then decline. It is well known that Negro women have high DZ twinning rates; a less well knwon finding is that the DZ twinning rates of Negro women also remain high after age 39. It has been suggested that high DZ twinning rates at later maternal ages may be related to a delayed age at menopause; However, published reports on age at natural menopause and analysis of our data from contemporary white US women indicate the contrary; Women who have borne unlike-sexed (DZ) twins and Negro women have a lower age at natural menopause then do white women from general populations, and a lower age in comparison with women who have borne like-sexed twins.     

Alcohol and other dietary factors in relation to serum hormone concentrations in women at climacteric.

The relationships between concentrations of endogenous hormones in serum and dietary intakes of alcohol, fats, fiber, and caffeine were examined in 325 healthy Massachusetts women aged 50-60 y who reported having a normal menstrual period within the previous 12 mo. Diet was assessed by a semiquantitative food frequency questionnaire. Hormones assayed were estrone, estradiol, percent free estradiol, sex-hormone-binding globulin (SHBG), cortisol, and gonadotropins. Alcohol intake was not associated with concentrations of estrogens or gonadotropins. Neither total fat intake nor the fat composition of the diet influenced hormone concentrations. Fiber intake was positively correlated with SHBG; no associations with estrogens were seen. Caffeine intake was inversely correlated with free estradiol and positively correlated with SHBG. These data suggest that fat, fiber, and alcohol intakes of US women at climacteric are not determinants of variations in estrone and either total or percent free estradiol.     

中国城市女性绝经年龄影响因素调查

目的:探讨中国城市妇女自然绝经年龄及影响女性自然绝经年龄的相关因素。方法:采取横断面调查,在全国8个城市41～60岁女性中进行方便抽样,采用问卷方式调查绝经年龄、既往月经、生育状况、生活方式等,采用SPSS 13.0软件包,进行t检验、χ2检验、Logistic回归等统计分析。结果:共收集3 343份有效问卷,其中已自然绝经1 268例,平均自然绝经年龄为(48.72±3.51)岁。初潮年龄、孕次、产次、职业、经济状况、体重指数、饮用牛奶是可能影响妇女自然绝经年龄的相关因素。结论:中国城市女性自然绝经年龄为48.72岁,可能影响自然绝经年龄的因素有初潮年龄、孕次、产次、职业、经济状况、体重指数、饮用牛奶。     

Longitudinal change in plasma total homocysteine during pregnancy and postpartum in Brazilian women and its relation with folate status and other factors

Fasting plasma total homocysteine (tHcy) concentration was determined in a cohort of pregnant Brazilian women (n = 46) supplemented with folic acid from the second trimester of pregnancy. Blood samples were obtained in the first and third trimesters from all women, and 30-40 days postpartum from seventeen women. Plasma tHcy decreased during pregnancy from 10.3 to 8.7 micromol/L, and was 11.6 micromol/L in the postpartum. Plasma and erythrocyte folate increased, consistent with use of the folate supplement, but decreased slightly in the postpartum, whereas the opposite occurred for plasma vitamin B12. tHcy was inversely correlated with plasma and erythrocyte folate in the third trimester (r = -0.585 and -0.460, respectively). This relationship occurred despite the fact that all women had attained what could be considered adequate levels of folate indices. Furthermore, the change (third trimester minus first trimester levels) of tHcy was inversely correlated (p < 0.01) with the changes in plasma (r = -0.573) and erythrocyte folate (r = -0.525). tHcy had no correlation in any of the periods tested with plasma vitamin B12, plasma albumin, hematocrit, hemoglobin, iron indices, dietary intakes of folate, vitamins B12 and B6, and levels of folate supplement.     

Weight change and psychological state in obese women

Data were collected during a three-month double-blind trial of evening primrose oil (EPO) in 100 obese females attending a hospital obesity clinic. Initial weight was not related to subsequent weight loss. There was, however, a significant correlation between change in mood and change in weight, with weight loss being associated with improved mood state and weight gain with increased disturbance. Such associations were strongest for patients who were new to the clinic, as opposed to refractory patients, and for patients who were initially depressed, as opposed to those who were not psychologically disturbed. It is suggested that new patients have a swift psychological response to even minor changes in weight and that, because of a risk of increasing depression, particular attention should be given to obese patients who fail to show any weight loss.     

Work-related factors associated with age at natural menopause in a generation of French gainfully employed women

This study's purpose was to identify occupational factors that may influence the age at natural menopause in a random sample of gainfully employed French women born in 1938 (n=1,594). Occupational physicians selected the subjects from their files and interviewed them during their annual visits in 1990 and 1995. The authors used Kaplan-Meier survival curves to estimate median age at menopause (52 years) and multiple Cox models to estimate associations among women's characteristics, occupational factors, and age at menopause separately within two strata distinguished by a self-reported history of depression. Among women without such a history, earlier menopause was associated with smoking more than 10 cigarettes per day in 1990 (p<0.001), a high-strain job (p=0.01) in 1990, and difficult schedules before 1990 (p=0.03). Later menopause was associated with higher educational status (p=0.003) and repetitive work in 1990 (p=0.005). Among women with a history of depression, a later menopause was associated with having at least one child (p<0.001) and menarche later than the age of 13 years (p=0.004). Earlier menopause was associated with a high job control in 1990 (p=0.03) and high school education (p<0.01). These results suggest that certain physical job stressors may be related to age at menopause.     

Weight gain among women in the late reproductive years

BACKGROUND: Given the impact of obesity on mortality and morbidity in women, we evaluated correlates of weight gain in women ages 35-47 years. METHODS: Three hundred and thirty-six African American and Caucasian American women, randomly selected from among urban residents aged 35-47 years and pre-menopausal at baseline, were included in the prospective cohort study. Participants were followed over a 4-year period. Baseline measures included anthropometric variables, socio-demographic factors, measures of anxiety, depressed mood, quality of life, and self-reported measures of diet, vigorous physical activity, alcohol consumption and cigarette smoking. Hormone measurements were obtained during the follicular phase of the menstrual cycle. Weight gain was assessed by comparing the baseline weight with weight measured at the end of the 4-year period. RESULTS: Over 25% of the cohort gained > or =10 lb during follow-up. Five of the 14 women (36%) who were considered menopausal gained weight. Women aged 45-47 were 61% less likely to gain > or =10 lb compared with women aged 35-39 [odds ratio (OR) = 0.39, 95% confidence interval (CI) 0.18-0.87]. Depressed mood was a major correlate of weight gain (OR = 1.9, 95% CI 1.09-3.31). Other psychological measures, including anxiety and quality of life, were similarly correlated with weight gain. No association was detected for levels of sex hormones or self-reported measures of physical activity. Most recalled dietary factors were not predictive of subsequent weight gain in our population. CONCLUSIONS: In this population-based sample of women aged 35-47 years, psychological factors were the major predictors of gaining > or =10 lb during a 4-year follow-up period. Few of the other measures, including baseline hormone values, were correlated with subsequent weight gain. These findings suggest that screening for depression and anxiety may be important clinical assessments to identify women at increased risk of substantial weight gain.     

Association of diet with the onset of menopause in Japanese women

A prospective study was conducted in Takayama, Gifu, Japan, to evaluate the association between diet and the onset of menopause. A total of 1,130 female residents aged 35-54 years who were premenopausal and completed a validated semiquantitative food frequency questionnaire in 1992 were contacted by mail with a follow-up questionnaire in 1998 to update information on menopause. Onset of menopause was defined as a woman's age at the last menstrual period prior to stopping menstruation for 12 months. During the 6-year study period, 296 women experienced natural menopause. The Cox proportional hazards model was used to estimate hazard ratios of the onset of menopause after controlling for age, total energy, body mass index, years of smoking, and age at which regular menstrual cycle began. The authors found that green and yellow vegetable intake was significantly inversely associated with the 6-year incidence of menopause (hazard ratio = 0.71, 95% confidence interval: 0.54, 0.95 for the highest vs. lowest tertile of intake, p for trend = 0.02). Association of carotene intake with the incidence of menopause was of borderline significance (hazard ratio = 0.78, 95% confidence interval: 0.59, 1.04, p for trend = 0.07).     

Oral contraception and other factors in relation to back disorders in women: findings in a large cohort study

The Oxford-Family Planning Association contraceptive study includes 17,032 women, initially aged 25-39 years, recruited at 17 British family planning centers during the interval 1968-1974 and subsequently followed-up for periods up to 26 years. This article examines the pattern of referral to hospital for back disorders among these women. Certain back disorders have been reported to occur more frequently in oral contraceptive users than in other women, and back pain has also been reported in some women consequent to using an intrauterine device. The disorders considered were spinal osteoarthritis, displaced cervical disc, displaced lumbar disc, other and unspecified displaced disc, cervicalgia, unspecified back pain, and sprains and strains of the back. Spinal osteoarthritis and unspecified backache were the only two conditions significantly related (both positively) to age. Displaced lumbar disc and other and unspecified displaced disc were strongly positively related to height and weight. Unspecified backache showed similar, but less striking (in terms of the magnitude of the relative risks), associations with height and weight. Little evidence was found of any association between oral contraceptive use and any of the back disorders, and the same was true for intrauterine device use.     

Environmental phthalate exposure in relation to reproductive outcomes and other health endpoints in humans

After briefly discussing human exposure to phthalates—diesters of 1,2-benzenedicarboxylic acid (phthalic acid)—this article first presents recent findings from the Study for Future Families, a multi-center pregnancy study in which the human analogue of the phthalate syndrome was first identified. This is one of an increasing number of studies that have investigated human endpoints in relation to environmental exposure to these ubiquitous compounds. This literature, which includes a range of human health endpoints following prenatal, neonatal, childhood, and adult exposures, is then summarized. At least one significant association has been reported for urinary metabolites of di-n-butyl phthalate (DBP), butylbenzyl phthalate (BzBP), diethyl phthlate (DEP), and di-isononyl phthalate (DINP) and for three of the urinary metabolites of di(2-ethylhexyl) phthalate (DEHP). Many of the findings reported in humans—most of which have been in males—are consistent with the anti-androgenic action that has been demonstrated for several phthalates. Replication of the results described here and further mechanistic studies are needed to strengthen links between phthalates and adverse health outcomes.