Associations between lifetime tobacco exposure with infertility and age at natural menopause: the Women's Health Initiative Observational Study

Hyland, Andrew; Piazza, Kenneth M; Hovey, Kathleen M.; Tindle, Hilary A.; Manson, JoAnn E.; Messina, Catherine R.; Rivard, Cheryl; Smith, Danielle M.; Wactawski‐Wende, Jean

doi:10.1136/tobaccocontrol-2015-052510

Cited by 56 publications

(53 citation statements)

References 42 publications

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“…Many previous studies, including a meta-analysis, have confirmed that exposure to cigarette smoke is a risk factor for early menopause [23,32,33]. This conclusion was further supported by our study.…”

Section: Discussionsupporting

confidence: 91%

Menopausal Age and Chronic Diseases in Elderly Women: A Cross-Sectional Study in Northeast China

Wang

et al. 2016

IJERPH

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Many factors affect menopausal age, and early or late onset of menopause may be associated with many chronic health problems. However, limited data are available regarding this phenomenon in the Northeast China population. For this study, 2011 elderly women were selected as a sample from participants in a cross-sectional survey performed using stratified, clustered multistage, and random sampling methods. Early menopause was more prevalent in subjects born from 1943 to 1947 (OR = 1.708, 95% CI = 1.205, 2.420) and 1933 to 1937 (OR = 2.445, 95% CI: 1.525, 3.921) and in physical laborers (OR = 1.413, 95% CI = 1.021, 1.957). Women with less than nine years of education (OR = 0.515, 95% CI: 0.327, 0.812) and who were current smokers (OR = 0.577, 95% CI: 0.347, 0.959) were less likely to have late menopause. BMIs between 25 and 30 (OR = 1.565, 95% CI: 1.152, 2.125) and greater than 30 (OR = 2.440, 95% CI: 1.482, 4.016) were associated with later menopausal age. Late menopause was positively associated with diabetes (OR = 1.611, 95% CI: 1.142, 2.274) but protective against chronic gastroenteritis/peptic ulcers (OR = 0.533, 95% CI: 0.333, 0.855). Results showed that (1) Being born in an earlier year, having a lower education, and engaging in physical labor were associated with an earlier menopausal age, while a higher BMI was associated with a later menopausal age; and that (2) menopausal age was associated with diabetes and gastroenteritis in elderly women living in Northeast China.

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Section: Discussionsupporting

confidence: 91%

Menopausal Age and Chronic Diseases in Elderly Women: A Cross-Sectional Study in Northeast China

Wang

et al. 2016

IJERPH

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“…Fifth, no data on secondhand smoking was available in our study, despite the fact that it has been shown to influence fertility. 37 Separate analyses were conducted for women and men as a significant ( p=0.001) interaction was found between gender and smoking status regarding the number of children and age at first birth, and also because it would have been difficult to justify an adjustment on contraception in men. Still, we conducted a joint analysis in men and women, the results of which are summarised in online supplementary table S4; the results were comparable to those reported separately for each gender, that is, no association with the number of children but lower age at first birth among current smokers.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Impact of smoking on fertility and age of menopause: a population-based assessment

et al. 2016

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Background and aimsStudies in patients seeking medically assisted reproduction have shown that smoking reduces fertility, but little information is available in the general population. We assessed the associations between smoking and the number of children, childbearing planning and age at menopause in a representative sample of the population of Lausanne, Switzerland.MethodsData from 6711 participants (3530 women, age range 35–75 years) collected between 2003 and 2006 and again in 2009 and 2012. Smoking status, number of offsprings and age of menopause were assessed.ResultsWomen who currently smoke had significantly less children than former or never smokers: the number of children per women (average±SD) was 1.38±1.05, 1.45±1.07 and 1.576±1.16, respectively (p<0.001). Women who currently smoke had their first child at an earlier age than the others: 26.7±5.2, 27.4±5.4 and 26.9±5.2 years old for current, former and never smokers, respectively, (p=0.01). Similar findings were found for men: number of children per men 1.475±1.16, 1.67±1.13 and 1.55±1.22 for current, former and never smokers, respectively (p<0.001); no difference was found regarding age at the first child. The difference persisted after multivariate adjustment (adjusted for age, body mass index, Caucasian origins, alcohol consumption, caffeinated drinks consumption, educational level, receiving social help and women taking contraceptives) for the age at first child among women. No association was found between Heaviness of Smoking Index and the number of children among current smokers in both genders. Women who smoke had their menopause more than 1 year prior than never-smoking women (48.9±0.2 years compared with 47.8±0.3 years, respectively, p=0.002).ConclusionsSmoking is associated with an earlier age of having the first child and of menopause among women.

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“…Parity and breastfeeding variables are generally reported to have good validity in the NOWAC Study . Missing information on age at menopause was treated according to smoking status, as women who smoke have been shown to have earlier menopause . Mean age at menopause for current and former smokers in our study (49 and 50 years, respectively) was used to complete missing data for participants who were current or former smokers.…”

Section: Methodsmentioning

confidence: 99%

Lifetime number of years of menstruation as a risk index for postmenopausal endometrial cancer in the Norwegian Women and Cancer Study

Gavrilyuk

Braaten

Weiderpass

et al. 2018

Acta Obstet Gynecol Scand

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IntroductionLifetime number of years of menstruation (LNYM) reflects a woman's cumulative exposure to endogenous estrogen and can be used as a measure of the combined effect of reproductive factors related to endometrial cancer (EC) risk.Material and methodsWe aimed to study the association between LNYM and EC risk among postmenopausal women and calculate the population attributable fraction of EC for different LNYM categories. Our study sample consisted of 117 589 women from the Norwegian Women and Cancer (NOWAC) Study. All women were aged 30‐70 years at enrollment and completed a baseline questionnaire between 1991 and 2006. Women were followed up for EC to December 2014 through linkages to national registries. We used Cox proportional hazards models to estimate hazard ratios with 95% confidence intervals (95% CIs), adjusted for potential confounders.ResultsIn all, 720 women developed EC. We found a statistically significant, positive dose‐response relationship between LNYM and EC, with a 9.1% higher risk for each additional year of LNYM (P for trend < .001). Using the LNYM category ≥40 as a reference, the hazard ratios for LNYM <25, 25‐29, 30‐34, 35‐39 were 0.17 (95% CI 0.22‐0.27), 0.25 (95% CI 0.17‐0.36), 0.43 (95% CI 0.32‐0.58), and 0.68 (95% CI 0.51‐0.92), respectively. The association between LNYM and EC was independent of incomplete pregnancies, menopausal hormone therapy, diabetes, and body mass index. When considering the population attributable fraction, 67% of EC was estimated to be attributable to LNYM ≥25 years.ConclusionsOur study supports that increasing LNYM is an important and independent predictor of EC risk.

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Associations between lifetime tobacco exposure with infertility and age at natural menopause: the Women's Health Initiative Observational Study

Abstract: Active smoking and SHS exposure are associated with increased risk of infertility and natural menopause occurring before the age of 50 years.

Cited by 56 publications

References 42 publications

Menopausal Age and Chronic Diseases in Elderly Women: A Cross-Sectional Study in Northeast China

Menopausal Age and Chronic Diseases in Elderly Women: A Cross-Sectional Study in Northeast China

Impact of smoking on fertility and age of menopause: a population-based assessment

Lifetime number of years of menstruation as a risk index for postmenopausal endometrial cancer in the Norwegian Women and Cancer Study

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