title: Indicators of lifetime endogenous estrogen exposure and risk of venous thromboembolism.
abstract: BACKGROUND
  Lifetime estrogen exposure has been related to breast cancer risk, osteoporosis, and cardiovascular disease but data on venous thromboembolism (VTE) risk are limited.
  
  
  METHODS
  Data from a hospital-based case-control study among 608 postmenopausal women (191 with a first episode of idiopathic VTE and 417 age-matched controls) were used to determine whether estrogen exposure, as assessed by age at menopause [classified as early (< or = 45 years), normal (46-54 years) and late menopause (> or = 55 years)] and parity, was associated with the risk of VTE.
  
  
  RESULTS
  After adjustment for potential confounding variables, the risk of VTE was increased with each year's delay in the menopause [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.02-1.10, P < 0.0075]. When compared with women with normal menopause used as a reference, the adjusted OR for VTE was 0.59 (95% CI = 0.36-0.97) and 2.53 (95% CI = 1.28-4.99) for women with early menopause and late menopause, respectively (P = 0.001). Adjusted OR for VTE was also higher for women with more than two children when compared with those with less than or equal to two children (1.56, 95% CI = 1.03-2.34, P = 0.03). The lowest risk of VTE was observed in women with early menopause and lower parity (adjusted OR = 0.60, 95% CI = 0.30-1.24), the highest risk was among women with late menopause who have had more than two children (adjusted OR = 3.41, 95% CI = 1.46-9.25).
  
  
  CONCLUSIONS
  These results show that the longer exposure to endogenous estrogen is associated with an increased VTE risk.
authors.affiliation: Cardiovascular Epidemiology, Villejuif, France.
authors.forename: T
authors.initials: T
authors.lastname: Simon
authors.forename: M
authors.initials: M
authors.lastname: Beau Yon de Jonage-Canonico
authors.forename: E
authors.initials: E
authors.lastname: Oger
authors.forename: D
authors.initials: D
authors.lastname: Wahl
authors.forename: J
authors.initials: J
authors.lastname: Conard
authors.forename: G
authors.initials: G
authors.lastname: Meyer
authors.forename: J
authors.initials: J
authors.lastname: Emmerich
authors.forename: M-T
authors.initials: MT
authors.lastname: Barrellier
authors.forename: A
authors.initials: A
authors.lastname: Guiraud
authors.forename: P-Y
authors.initials: PY
authors.lastname: Scarabin
mesh_terms: D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D004967:Estrogens / Q000097:blood*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology; D012306:Risk; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*
chemical_list: D004967:Estrogens