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Kutenaee MA, Dashti S, Rafati S, Moannaei M, Masoudi M, Nejatizadeh A, Shahmoradi M, Roozbeh N. Factors predicting age at menopause among Iranian women in the Bandare-Kong cohort study (a cross-sectional survey of PERSIAN cohort study). Womens Midlife Health 2023; 9:5. [PMID: 37641084 PMCID: PMC10463461 DOI: 10.1186/s40695-023-00088-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Menopause is a natural period in women's life and can be affected by several factors. The aim of this study was to identify the associated factors for age of natural menopause and among women with early and premature menopause based on a cohort study in Iran. METHODS This population-based study was conducted on 894 post menopause women between 35 and 70 years old who participated in the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study, a part of Prospective Epidemiological Research Studies in Iran (PERSIAN) from March 2016 to February 2019. All women completed a standard self-reported questionnaire. Data were analyzed using chi-square test, independent t test, and ANOVA as well as a multivariable linear regression model. RESULTS The mean age at natural menopause was 48.31 ± 6.34 years. After adjusting other variables, gravida, history of cardiac disease, socioeconomic status and residence status were predictive of age at menopause (P < 0.001). Among the premature menopause group, the mean age at menopause was significantly higher among women with diabetes compared to women without diabetes group (35.68 ± 2.92 vs. 33.82 ± 3.06; P = 0.043), while the mean age at menopause was significantly lower in women with infertility compared to women without infertility (29.13 ± 5.22 vs. 34.84 ± 2.826; P = 0.048). CONCLUSIONS This study suggests that the predictors of menopausal age differed in women with premature menopause compared to overall menopause age. Prospective studies are needed to evaluation the effects of these factors on menopausal age.
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Affiliation(s)
- Maryam Azizi Kutenaee
- Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sareh Dashti
- Department of Public Health, Faculty of Paramedicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
- Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
| | - Shideh Rafati
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehrsa Moannaei
- Department of Gynecology and Obstetrics, School of Medicine, Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mojtaba Masoudi
- Fatemiyeh Shiraz Institute of Higher Education, Shiraz, Iran
| | - Abdolazim Nejatizadeh
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Shahmoradi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nasibeh Roozbeh
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Kim C, Wellons M. Sex Hormones and Cardiovascular Disease in Relation to Menopause. Endocrinol Metab Clin North Am 2023; 52:195-210. [PMID: 36948775 DOI: 10.1016/j.ecl.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Natural menopause is defined as the cessation of menstruation among women who have not undergone hysterectomy or bilateral oophorectomy. The implications of menopause management are particularly important with the aging of the population and increasing awareness of the importance of midlife risk upon longevity. Our understanding of the relationships between reproductive milestones and cardiovascular disease continues to evolve particularly regarding shared determinants of health.
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Affiliation(s)
- Catherine Kim
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA; Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.
| | - Melissa Wellons
- Department of Medicine, Vanderbilt University Medical Center, 3841 Green Hills Village Dr #200, Nashville, TN 37215, USA
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Hyvärinen M, Karvanen J, Juppi HK, Karppinen JE, Tammelin TH, Kovanen V, Aukee P, Sipilä S, Rantalainen T, Laakkonen EK. Menopausal symptoms and cardiometabolic risk factors in middle-aged women: A cross-sectional and longitudinal study with 4-year follow-up. Maturitas 2023; 174:39-47. [PMID: 37267866 DOI: 10.1016/j.maturitas.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 05/08/2023] [Accepted: 05/17/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To study associations of menopausal symptoms with cardiometabolic risk factors. STUDY DESIGN A cross-sectional and longitudinal study of a representative population sample of 1393 women aged 47-55 years with a sub-sample of 298 followed for four years. The numbers of vasomotor, psychological, somatic or pain, and urogenital menopausal symptoms were ascertained at baseline through self-report. Their associations with cardiometabolic risk factors were studied using linear regression and linear mixed-effect models. Models were adjusted for age, menopausal status, body mass index, the use of hormonal preparations, education, smoking, and alcohol consumption. MAIN OUTCOME MEASURES Cardiometabolic risk factors included total cholesterol, low-density and high-density lipoprotein cholesterol, blood pressure, glucose, triglycerides, total and android fat mass, and physical activity. RESULTS All cholesterol and fat mass measures had modest positive associations with menopausal symptoms. The number of vasomotor symptoms, in particular, was associated with total cholesterol (B = 0.13 mmol/l, 95 % CI [0.07, 0.20]; 0.15 mmol/l [0.02, 0.28]) and low-density lipoprotein cholesterol (0.08 mmol/l [0.03, 0.14]; 0.12 mmol/l [0.01, 0.09]) in cross-sectional and longitudinal analyses, respectively. However, these associations disappeared after adjusting for confounders. The number of symptoms was not associated with blood pressure, glucose, triglycerides, and physical activity. Menopausal symptoms at baseline did not predict the changes in the risk factors during the follow-up. CONCLUSIONS Menopausal symptoms may not be independently associated with cardiometabolic risk, and they do not seem to predict the changes in risk factors during the menopausal transition.
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Affiliation(s)
- Matti Hyvärinen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Finland.
| | - Juha Karvanen
- Department of Mathematics and Statistics, University of Jyväskylä, P.O. Box 35, 40014, Finland.
| | - Hanna-Kaarina Juppi
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Finland.
| | - Jari E Karppinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Finland.
| | - Tuija H Tammelin
- LIKES, JAMK University of Applied Sciences, Piippukatu 2, 40100 Jyväskylä, Finland.
| | - Vuokko Kovanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Finland
| | - Pauliina Aukee
- Department of Obstetrics and Gynecology, The Wellbeing Services County of Central Finland, 40620 Jyväskylä, Finland.
| | - Sarianna Sipilä
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Finland.
| | - Timo Rantalainen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Finland.
| | - Eija K Laakkonen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Finland.
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Chatziandreou E, Eustathiou A, Augoulea A, Armeni E, Mili N, Boutas I, Tsoltos N, Kapetanaki A, Kalantaridou S. Antimüllerian Hormone as a Tool to Predict the Age at Menopause. Geriatrics (Basel) 2023; 8:geriatrics8030057. [PMID: 37218837 DOI: 10.3390/geriatrics8030057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/24/2023] Open
Abstract
This study aimed to assess an eligible cut-off value of anti-Müllerian hormone (AMH) to detect ovarian senescence in a group of premenopausal Greek women to evaluate the possible link between AMH-values and the severity of climacteric symptoms during a follow-up of 24 months. This study included 180 women (group A, 96 women of late reproductive stage/early perimenopause; group B, 84 women in late perimenopause). We measured AMH blood levels and assessed climacteric symptoms using the Greene scale. Log-AMH is inversely associated with postmenopausal status. The AMH cut-off of 0.012 ng/mL predicts the postmenopausal status with a sensitivity of 24.2% and specificity of 30.5%. The postmenopausal stage associated with age (OR = 1.320, 95%CI: 1.084-1.320) and AMH (values ≥ vs. <0.012 ng/mL, OR = 0.225, 95%CI: 0.098-0.529, p-value < 0.001). Moreover, the severity of vasomotor symptoms (VMS) was only associated inversely with AMH (b-coefficient = -0.272, p-value = 0.027). In conclusion, AMH levels measured in the late premenopausal period are inversely associated with the time to ovarian senescence. In contrast, AMH levels measured in the perimenopausal period are inversely associated only with the severity of VMS. Therefore, a cut-off of 0.012 ng/mL predicts menopause with low sensitivity and specificity, making it challenging to use in a clinical setting.
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Affiliation(s)
- Efstathia Chatziandreou
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, GR-11528 Athens, Greece
| | - Andreas Eustathiou
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, GR-11528 Athens, Greece
| | - Areti Augoulea
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, GR-11528 Athens, Greece
| | - Eleni Armeni
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, GR-11528 Athens, Greece
| | - Nikoletta Mili
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, GR-11528 Athens, Greece
| | - Ioannis Boutas
- 3rd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, GR-11528 Athens, Greece
| | - Nikolaos Tsoltos
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, GR-11528 Athens, Greece
| | - Antigoni Kapetanaki
- Hormonal Laboratory, Aretaieio Hospital, National and Kapodistrian University of Athens, GR-11528 Athens, Greece
| | - Sofia Kalantaridou
- 3rd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, GR-11528 Athens, Greece
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Huang Z, Chang X, Wang L, Liu J, Heng CK, Khor CC, Yuan JM, Koh WP, Dorajoo R. Interaction between cigarette smoking and genetic polymorphisms on the associations with age of natural menopause and reproductive lifespan: the Singapore Chinese Health Study. Hum Reprod 2022; 37:1351-1359. [PMID: 35413122 PMCID: PMC9156846 DOI: 10.1093/humrep/deac075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/09/2022] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Are there genetic variants that interact with smoking to reduce reproductive lifespan in East-Asian women? SUMMARY ANSWER Our study corroborates several recently identified genetic loci associated with reproductive lifespan and highlights specific genetic predispositions that may interact with smoking status to adversely affect reproductive lifespan in East-Asian women. WHAT IS KNOWN ALREADY Epidemiological data as well as evaluations on genetic predisposition to smoke indicate on the importance of smoking in adverse effects on reproductive lifespan in women. However, there are no previous smoking and gene interaction studies for reproductive traits in East-Asian women. STUDY DESIGN, SIZE, DURATION This population-based prospective cohort study comprised 11 643 East-Asian Chinese women with overlapping genome-wide genotyping and reproductive data. PARTICIPANTS/MATERIALS, SETTING, METHODS We performed a genome-wide association study for reproductive lifespan in women (n = 11 643) from the Singapore Chinese Health Study (SCHS) and carried out a genome-wide interaction study to identify loci that interacted with smoking status to affect age of natural menopause and reproductive-time. MAIN RESULTS AND THE ROLE OF CHANCE Two known loci associated with menopause, rs113430717 (near HMCES, chromosome 3, Pmeta = 5.72 × 10-15) and rs3020136 (near RAD21, chromosome 8, Pmeta = 1.38 × 10-8) were observed beyond genome-wide levels of association with age at menopause in this study. For reproductive lifespan, the genome-wide association observed at rs79784106 (chromosome 3, Pmeta = 5.05 × 10-12) was in linkage disequilibrium with the menopause lead single-nucleotide polymorphism (SNP) (rs113430717). Four additional loci, first reported to be associated with menopause, were also associated with reproductive lifespan in our study (PAdj between 7.42 × 10-5 to 4.51 × 10-3). A significant interaction was observed between smoking and an East-Asian specific SNP, rs140146885, for reduced reproductive lifespan, per copy of the minor C allele (beta = -1.417 years, Pinteraction = 2.31 × 10-10). This interaction was successfully replicated in additional independent samples (beta = -1.389 years, Pinteraction = 6.78 × 10-3). Another known variant associated with menopause, rs11031006 (near FSHB), was also observed to interact with smoking status to reduce age at menopause in our dataset (beta = -0.450 years, Padj = 0.042). LIMITATIONS, REASONS FOR CAUTION The modest sample size of the replication datasets used likely affected the statistical power to firmly replicate all identified novel loci observed in our smoking interaction analyses. WIDER IMPLICATIONS OF THE FINDINGS Age of natural menopause and reproductive lifespan have clear genetic predispositions with distinct ethnic differences, and they may be adversely truncated by lifestyle factors such as smoking, which can pose a significant impact on the reproductive lifespan and future health outcomes in women. STUDY FUNDING/COMPETING INTEREST(S) The Singapore Chinese Health Study is funded by the National Medical Research Council, Singapore (NMRC/CIRG/1456/2016), National Institutes of Health (R01 CA144034 and UM1 CA182876) and National Research Foundation, Singapore (Project Number 370062002). W.-P.K. is supported by the National Medical Research Council, Singapore (MOH-CSASI19nov-0001). The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. The authors do not report conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Zhongwei Huang
- Institute of Molecular and Cell Biology, Agency of Science Research and Technology, Singapore, Singapore
- Department of Obstetrics & Gynaecology, National University Health Systems, Singapore, Singapore
- NUS Bia-Echo Asia Centre of Reproductive Longevity and Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xuling Chang
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat—National University Children’s Medical Institute, National University Health System, Singapore, Singapore
- Department of Infectious Diseases, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Ling Wang
- Genome Institute of Singapore, Agency of Science Research and Technology, Singapore, Singapore
| | - Jianjun Liu
- Genome Institute of Singapore, Agency of Science Research and Technology, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chew-Kiat Heng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat—National University Children’s Medical Institute, National University Health System, Singapore, Singapore
| | - Chiea-Chuen Khor
- Genome Institute of Singapore, Agency of Science Research and Technology, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute of Clinical Sciences, Agency of Science Research and Technology, Singapore, Singapore
| | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency of Science Research and Technology, Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore, Singapore
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