BACKGROUND: Premature menopause, defined as natural menopause before age 40, is associated with diminished ovarian reserve. Despite growing concerns regarding environmental pollutants, no large-scale population-based studies have systematically examined the association between urinary polycyclic aromatic hydrocarbon metabolites (UPAHMs) and premature menopause. METHODS: This cross-sectional study analyzed 2001-2020 NHANES data, including urinary levels of six PAH metabolites: 1-naphthol (1-NAP), 2-naphthol (2-NAP), 3-fluorene (3-FLU), 2-fluorene (2-FLU), 1-phenanthrene (1-PHE), and 1-pyrene (1-PYR). Premature menopause was self-reported as natural menopause occurring before age 40. Multivariable logistic regression assessed UPAHMs' association with premature menopause, with restricted cubic splines (RCS) evaluating nonlinear trends. Subgroup analyses examined demographic interactions. RESULTS: Among 2,565 participants, 662 reported premature menopause. Multivariable logistic regression showed significant associations between elevated urinary levels of 1-NAP (OR: 1.01, 95% CI: 1.00-1.02, P = 0.02), 2-NAP (OR: 1.01, 95% CI: 1.00-1.02, P = 0.02), and 3-FLU (OR: 1.03, 95% CI: 1.01-1.05, P = 0.01) and increased risk of premature menopause. RCS analysis revealed significant nonlinear relationships for 2-NAP, 3-FLU, 2-FLU, 1-PHE, and 1-PYR with premature menopause risk. White participants showed greater susceptibility to UPAHMs. CONCLUSION Elevated UPAHMs, particularly 1-NAP, 2-NAP, and 3-FLU, were linked to higher premature menopause risk, with nonlinear trends observed. White individuals demonstrated greater vulnerability, emphasizing the need for targeted interventions to reduce PAH exposure.
Humans ; Female ; Cross-Sectional Studies ; United States/epidemiology* ; Polycyclic Aromatic Hydrocarbons/urine* ; Adult ; Middle Aged ; Environmental Pollutants/urine* ; Nutrition Surveys ; Menopause, Premature/urine* ; Young Adult ; Environmental Exposure

Female ; Humans ; Consensus ; Menopause, Premature ; Primary Ovarian Insufficiency/therapy*

BACKGROUND: Previous studies have reported that fasting insulin and blood glucose levels are higher in postmenopausal than in premenopausal women and that insulin resistance was more serious in postmenopausal women. The effects of menopause on glucose metabolism have been well studied, but it is unclear whether age at menopause onset is associated with fasting blood sugar and HbA1c levels. The purpose of this study is to determine the effect of menopause age on diabetes and prediabetes.METHODS: We retrospectively analyzed data from the Sixth Korea National Health and Nutrition Examination Survey (2013–2015). The participants were 2,156 naturally menopausal women, except diabetes, stroke, coronary artery disease and cancer patients. The study population was divided into four groups according to the age of natural menopause onset ( < 40, 40–44, 45–55, and ≥56 years). Diagnosis of diabetes and prediabetes was based on the American Diabetes Association guideline. The association between menopause age and diabetes or prediabetes was analyzed by multiple logistic regression.RESULTS: Women reaching menopause at 40–44 years were 4.901 times more likely to have diabetes (odds ratio [OR], 4.901; 95% confidence interval [95% CI], 1.353–17.756, P=0.016) than those who reached menopause at an age of ≥56 years. Women with menopause at age < 40 years were 2.839 times more likely to have diabetes or prediabetes (OR, 2.839; 95% CI, 1.012–7.968, P=0.047).CONCLUSION: Women with premature menopause (< 40 years) have high risk of developing diabetes or prediabetes, and women with a menopause age of 40–44 years have high risk of developing diabetes.
Blood Glucose ; Coronary Artery Disease ; Diabetes Mellitus ; Diagnosis ; Fasting ; Female ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Korea ; Logistic Models ; Menopause ; Menopause, Premature ; Metabolism ; Nutrition Surveys ; Prediabetic State ; Retrospective Studies ; Stroke

The purpose of this study was to evaluate the relationship between early menopause and periodontal disease in postmenopausal women using data from the 6th Korean National Health and Nutrition Examination Survey (2013~2015). A study was conducted with 2,048 postmenopausal women aged 45 to 74 years. Participants were divided into the early menopause group (menopause occurring at age 45 years or before) and normal menopause group (menopause occurring after age 45 years). A community periodontal index greater than or equal to code 3 was used to define periodontal treatment needs. A chi-square test was used to confirm the bivariate relationship between the variables. Multinomial logistic regression analysis was used to adjust for covariates (age, education, family income, body mass index, alcohol drinking, smoking, visiting dentist in the last year, use of oral care products, frequency of tooth brushing per day). The risk of periodontal disease was higher in the early menopause group after adjusting for potential confounders (odds ratio, 1.59). In particular, the relationship between early menopause and periodontal disease was more evident in women with low education and those who did not use oral care products. The findings of this study suggest that early menopause is a significant factor of periodontal disease in Korean women.
Alcohol Drinking ; Body Mass Index ; Dentists ; Education ; Female ; Humans ; Logistic Models ; Menopause* ; Menopause, Premature ; Nutrition Surveys ; Periodontal Diseases* ; Periodontal Index ; Smoke ; Smoking ; Tooth

The purpose of this study was to investigate the relationship between hormone replacement therapy (HRT) and periodontal disease in postmenopausal women using data from the 4th and 5th Korea National Health and Nutrition Examination Survey. A total of 5,482 postmenopausal women aged 45~75 years were included as study subjects in the final analysis. The HRT group comprised 1,035 postmenopausal women who had received HRT for at least one month, and the non-HRT group comprised 4,447 postmenopausal women who did not receive HRT. The chi-square test was used to confirm the bivariate relationship between the variables. Multinomial logistic regression analysis was used to adjust for covariance (age, education, family income, body mass index, age of menopause, alcohol, smoking, dental visit < 1 per year, use of oral care products, and frequency of tooth brushing per day). After adjusting for all covariates, HRT was found to be associated with periodontal disease. In particular, the relationship between HRT and periodontal disease was more evident in older women and women younger than 45 years of menopausal age. The relationship between HRT and periodontal disease was stronger in women who brushed their teeth less than 3 times per day, women without regular oral examination, and women who did not use oral hygiene products. The results of this study confirmed the importance of actively considering hormone therapy when determining policy recommendations for postmenopausal women. Especially, health programs such as HRT, regular dental examination, and oral care are needed for older women who have undergone premature menopause.
Body Mass Index ; Diagnosis, Oral ; Education ; Female ; Hormone Replacement Therapy ; Humans ; Korea ; Logistic Models ; Menopause ; Menopause, Premature ; Nutrition Surveys ; Oral Hygiene ; Periodontal Diseases ; Smoke ; Smoking ; Tooth

Premature ovarian failure (POF) is a kind of gynecological disease that causes amenorrhea, infertility, menopause and urogenital symptoms. Currently hormone replacement therapy (HRT) is the most popular choice for women with POF to get rid of menopausal syndrome. However, as the popularization of Chinese herbs made Chinese medicine (CM) shine new lights, physicians are able to treat POF with both meno-herbs and integrated therapy. HRT has its own indications and contraindications. For example, unexplained vaginal bleeding, acute liver damage, liver dysfunction, vascular embolization, and breast cancer are all contraindications of HRT, and CM is taken by more physicians as an adjuvant therapy. This review, including a range of common Chinese herbs and formulations according to the existing literature, provides a general description of CM treating POF from the aspects of mechanisms and clinical application. It also highlights acupuncture as a unique physiotherapy for POF. Although the validity of CM has been supported by the evidence of many preclinical trials, clinical trials and meta-analysis, the adverse events with CM therapy still exist and no guarantee has been made for its safety. This review concludes the updated information for CM treating POF contributing to further studies.
Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infertility, Female ; etiology ; therapy ; Medicine, Chinese Traditional ; methods ; Menopause, Premature ; drug effects ; physiology ; Primary Ovarian Insufficiency ; complications ; therapy

Premature ovarian failure (POF) is a condition in which the ovarian functions of hormone production and oocyte development become impaired before the typical age for menopause. POF and early menopause are present in a broad spectrum of gonad dysgenesis, from a complete cessation of ovarian function to an intermittent follicle maturation failure. Actually POF has been identified as a genetic entity (especially chromosome X), but data on genetic factors of premature menopause are limited. Until now, several cases revealed that inactivation of X chromosomes has an effect on ages of premature menopause and females with balanced or unbalanced X-autosome translocations can have several reproductive problems. On the other hand, there have been a few data that was caused by autosome-autosome translocation can lead. Therefore we report a relevant case of POF with translocation between chromosomes 1 and 4. She had her first menstrual period at the age of 12, and after 7 years she stopped menstruation. Chromosomal analysis showed 46, XX, t (1;4) (p22.3;q31.3). While evaluating this rare case, we could review various causes (especially genetic factors) of POF. To remind clinicians about this disease, we report a case of POF caused by autosome-autosome translocation with a literature review.
Female ; Gonads ; Hand ; Humans ; Menopause ; Menopause, Premature* ; Menstruation ; Oocytes ; Primary Ovarian Insufficiency ; X Chromosome

BACKGROUND: Amenorrhea may occur in patients with lupus treated with cyclophosphamide. This is commonly attributed to primary ovarian failure leading to infertility -- a possible complication of cyclophosphamide. Urogenital tuberculosis (TB) can be a rare cause of amenorrhea and infertility in lupus patients.
OBJECTIVE: To present a case of endometrial TB causing amenorrhea and abnormal uterine bleeding in a patient with lupus nephritis treated with cyclophosphamide.
CASE: A 32-year-old Filipino female, who was diagnosed with lupus nephritis, was managed with high dose steroid and intravenous (IV) cyclophosphamide. Lupus nephritis improved with treatment, but she subsequently developed amenorrhea and vaginal spotting for two months. Symptoms were initially attributed to premature ovarian failure due to cyclophosphamide.Gynecologic examination showed thickened endometrium with normal ovaries and uterus on ultrasound. Dilatation and curettage was performed. Histopathology of endometrial curetting revealed chronic granulomatous endometritis with Langhans giant cells. Endometrial TB was diagnosed, and anti-Koch's therapy was started. The patient showed a favourable response, with resumption of normal menstruation after only the first month of treatment.
CONCLUSION: This paper emphasizes the importance of considering a wide range of differential diagnosis for gynecologic symptoms in patients with lupus. Tuberculosis should be considered in areas of high endemicity

Human ; Female ; Adult ; Primary Ovarian Insufficiency ; Lupus Nephritis ; Endometritis ; Amenorrhea ; Giant Cells, Langhans ; Cyclophosphamide ; Menopause, Premature ; Tuberculosis, Urogenital ; Infertility ; Uterine Hemorrhage

OBJECTIVE: Cisplatin is a widely used chemotherapeutic agent in the treatment of cancers in clinic; but it often induces adverse effects on ovarian functions such as reduced fertility and premature menopause. Mesna could attenuate the cisplatin-induced ovarian damages; however, the underlying mechanism is still unknown. This study aimed to figure out the underlying mechanism of the protection of mesna for ovaries against cisplatin therapy in cancers. METHODS: We performed female adult Sprague-Dawley rats into normal saline control (NS), low-dose cisplatin (CL), high-dose cisplatin (CH), CL plus mesna (CL+M), and CH plus mesna (CH+M) groups and detected anti-Mullerian hormone (AMH)-positive follicle, oxidative stress status and anti-oxidative capability in ovaries. RESULTS: AMH-positive follicles were significantly decreased after cisplatin administration, which was significantly reversed when mesna was co-administered with cisplatin. The end product of lipid peroxidation, malondialdehyde (MDA), was significantly increased, but the anti-oxidative enzymatic activity of superoxide dismutase (SOD) and glutathione (GSH) were significantly decreased in cisplatin groups when compared with NS group. In contrast, after co-administration of cisplatin with mesna, MDA was significantly decreased whereas the activity of SOD and the concentration of GSH were increased. Moreover, mesna did not decrease the anti-tumor property of cisplatin in HePG2 cell lines. CONCLUSION: Cisplatin damages the granulosa cells by oxidative stress to deplete the ovarian reserve and mesna could protect ovarian reserve through anti-oxidation. These results might highlight the mechanism of the protection of mesna for ovarian reserve and open an avenue for the application of mesna as a protective additive in cisplatin chemotherapy in clinical practise.
Adult ; Animals ; Anti-Mullerian Hormone ; Cisplatin ; Female ; Fertility ; Glutathione ; Granulosa Cells ; Hep G2 Cells ; Humans ; Lipid Peroxidation ; Malondialdehyde ; Menopause, Premature ; Mesna ; Ovary ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase

BACKGROUND: Bone mineral density (BMD) screening guidelines for women younger than 65 years are inconsistent. We investigated BMD-related factors in postmenopausal women younger than 65 years to help clinicians identify which women in this age group should undergo this investigation. METHODS: The study subjects included 108 postmenopausal women, younger than 65 years, who visited one university hospital from January to June 2007 and had a BMD by DEXA. Information on socio-demographic characteristics, menarche, menopause, smoking, alcohol use, past history of fracture and diet were gathered using a self-reported questionnaire. Height and weight were measured. The association between each risk factor and BMD was assessed using Pearson's correlation and ANOVA test. Finally, multiple regression analysis was done, using the model including significant variables of baseline analysis. RESULTS: In our subjects, age was negatively and body weight was positively correlated with BMD of lumbar spine and femur. The reproductive years was positively correlated with BMD of lumbar spine and past history of fragility fracture was negatively associated with BMD of femur. Moderate alcohol users had higher BMDs of lumbar spine and femur. CONCLUSIONS: In postmenopausal women younger than 65 years, age and body weight are major determinants of BMD of lumbar spine and femur, negatively and positively, respectively. Our data suggest women younger than 65 years with low lean body mass, past history of fracture, and premature menopause could be good candidates for BMD.
Body Weight ; Bone Density ; Diet ; Female ; Femur ; Humans ; Mass Screening ; Menarche ; Menopause ; Menopause, Premature ; Risk Factors ; Smoke ; Smoking ; Spine ; Surveys and Questionnaires