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Age at natural menopause in women exposed to diethylstilbestrol in utero.

Publication ,  Journal Article
Hatch, EE; Troisi, R; Wise, LA; Hyer, M; Palmer, JR; Titus-Ernstoff, L; Strohsnitter, W; Kaufman, R; Adam, E; Noller, KL; Herbst, AL ...
Published in: Am J Epidemiol
October 1, 2006

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.

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Published In

Am J Epidemiol

DOI

ISSN

0002-9262

Publication Date

October 1, 2006

Volume

164

Issue

7

Start / End Page

682 / 688

Location

United States

Related Subject Headings

  • United States
  • Surveys and Questionnaires
  • Prospective Studies
  • Prenatal Exposure Delayed Effects
  • Pregnancy
  • Middle Aged
  • Menopause
  • Longitudinal Studies
  • Humans
  • Female
 

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Hatch, E. E., Troisi, R., Wise, L. A., Hyer, M., Palmer, J. R., Titus-Ernstoff, L., … Hoover, R. N. (2006). Age at natural menopause in women exposed to diethylstilbestrol in utero. Am J Epidemiol, 164(7), 682–688. https://doi.org/10.1093/aje/kwj257
Hatch, Elizabeth E., Rebecca Troisi, Lauren A. Wise, Marianne Hyer, Julie R. Palmer, Linda Titus-Ernstoff, William Strohsnitter, et al. “Age at natural menopause in women exposed to diethylstilbestrol in utero.Am J Epidemiol 164, no. 7 (October 1, 2006): 682–88. https://doi.org/10.1093/aje/kwj257.
Hatch EE, Troisi R, Wise LA, Hyer M, Palmer JR, Titus-Ernstoff L, et al. Age at natural menopause in women exposed to diethylstilbestrol in utero. Am J Epidemiol. 2006 Oct 1;164(7):682–8.
Hatch, Elizabeth E., et al. “Age at natural menopause in women exposed to diethylstilbestrol in utero.Am J Epidemiol, vol. 164, no. 7, Oct. 2006, pp. 682–88. Pubmed, doi:10.1093/aje/kwj257.
Hatch EE, Troisi R, Wise LA, Hyer M, Palmer JR, Titus-Ernstoff L, Strohsnitter W, Kaufman R, Adam E, Noller KL, Herbst AL, Robboy S, Hartge P, Hoover RN. Age at natural menopause in women exposed to diethylstilbestrol in utero. Am J Epidemiol. 2006 Oct 1;164(7):682–688.
Journal cover image

Published In

Am J Epidemiol

DOI

ISSN

0002-9262

Publication Date

October 1, 2006

Volume

164

Issue

7

Start / End Page

682 / 688

Location

United States

Related Subject Headings

  • United States
  • Surveys and Questionnaires
  • Prospective Studies
  • Prenatal Exposure Delayed Effects
  • Pregnancy
  • Middle Aged
  • Menopause
  • Longitudinal Studies
  • Humans
  • Female