title: Persistent organic pollutants and early menopause in U.S. women.
abstract: OBJECTIVE
  Endocrine-disrupting chemicals (EDCs) adversely affect human health. Our objective was to determine the association of EDC exposure with earlier age of menopause.
  
  
  METHODS
  Cross-sectional survey using National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2008 (n = 31,575 females). Eligible participants included: menopausal women >30 years of age; not currently pregnant, breastfeeding, using hormonal contraception; no history of bilateral oophorectomy or hysterectomy. Exposures, defined by serum lipid and urine creatinine-adjusted measures of EDCs, data were analyzed: > 90th percentile of the EDC distribution among all women, log-transformed EDC level, and decile of EDC level. Multi linear regression models considered complex survey design characteristics and adjusted for age, race/ethnicity, smoking, body mass index. EDCs were stratified into long (>1 year), short, and unknown half-lives; principle analyses were performed on those with long half-lives as well as phthalates, known reproductive toxicants. Secondary analysis determined whether the odds of being menopausal increased with EDC exposure among women aged 45-55 years.
  
  
  RESULTS
  This analysis examined 111 EDCs and focused on known reproductive toxicants or chemicals with half-lives >1 year. Women with high levels of β-hexachlorocyclohexane, mirex, p,p'-DDE, 1,2,3,4,6,7,8-heptachlorodibenzofuran, mono-(2-ethyl-5-hydroxyhexyl) and mono-(2-ethyl-5-oxohexyl) phthalate, polychlorinated biphenyl congeners -70, -99, -105, -118, -138, -153, -156, -170, and -183 had mean ages of menopause 1.9 to 3.8 years earlier than women with lower levels of these chemicals. EDC-exposed women were up to 6 times more likely to be menopausal than non-exposed women.
  
  
  CONCLUSIONS
  This study of a representative sample of US women documents an association between EDCs and earlier age at menopause. We identified 15 EDCs that warrant closer evaluation because of their persistence and potential detrimental effects on ovarian function. Earlier menopause can alter the quantity and quality of a woman's life and has profound implications for fertility, human reproduction, and our global society.
authors: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Colorado Denver, Aurora, Colorado, United States of America; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Washington University in St. Louis, Barnes-Jewish Hospital, St. Louis, Missouri, United States of America.
authors: Natalia M
authors: NM
authors: Grindler
authors: Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, United States of America.
authors: Jenifer E
authors: JE
authors: Allsworth
authors: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Washington University in St. Louis, Barnes-Jewish Hospital, St. Louis, Missouri, United States of America.
authors: George A
authors: GA
authors: Macones
authors: Wadsworth Center, New York State Department of Health and Department of Environmental Health Sciences, State University of New York at Albany, Albany, New York, United States of America.
authors: Kurunthachalam
authors: K
authors: Kannan
authors: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Washington University in St. Louis, Barnes-Jewish Hospital, St. Louis, Missouri, United States of America.
authors: Kimberly A
authors: KA
authors: Roehl
authors: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Washington University in St. Louis, Barnes-Jewish Hospital, St. Louis, Missouri, United States of America.
authors: Amber R
authors: AR
authors: Cooper
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D052244:Endocrine Disruptors / Q000009:adverse effects*; D004785:Environmental Pollutants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008594:Menopause, Premature; D008875:Middle Aged; D009930:Organic Chemicals / Q000009:adverse effects*; D062486:Public Health Surveillance; D012098:Reproduction / Q000187:drug effects; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D052244:Endocrine Disruptors; D004785:Environmental Pollutants; D009930:Organic Chemicals
references: Vital Health Stat 2. 2012 May;(155):1-39
references: 22788053
references: Environ Health Prev Med. 2009 Jan;14(1):7-19
references: 19568863
references: Environ Health Perspect. 2005 Jan;113(1):43-8
references: 15626646
references: Environ Health Perspect. 1998 Dec;106(12):775-92
references: 9831538
references: Environ Health Perspect. 2004 Mar;112(3):331-8
references: 14998749
references: Reprod Toxicol. 2007 Aug-Sep;24(2):131-8
references: 17768031
references: Environ Health Perspect. 2013 Feb;121(2):231-6
references: 23151773
references: Hum Reprod. 2009 Jun;24(6):1452-9
references: 19228760
references: Epidemiology. 1999 Nov;10(6):771-3
references: 10535795
references: J Clin Endocrinol Metab. 2011 Jun;96(6):1747-53
references: 21411548
references: Cancer Epidemiol Biomarkers Prev. 2005 Aug;14(8):1847-50
references: 16103423
references: J Clin Epidemiol. 1998 Dec;51(12):1271-6
references: 10086819
references: Mol Reprod Dev. 1999 Oct;54(2):126-34
references: 10471472
references: Obstet Gynecol. 2013 Oct;122(4):931-5
references: 24084567
references: Biol Reprod. 2014 Jun;90(6):136
references: 24804967
references: Environ Res. 2001 Jun;86(2):128-39
references: 11437459
references: Mol Cell Endocrinol. 2012 May 6;354(1-2):74-84
references: 22249005
references: Endocrinology. 2012 Sep;153(9):4097-110
references: 22733974
references: Menopause. 2008 Nov-Dec;15(6):1103-8
references: 18626414
references: Toxicol Sci. 2012 Mar;126(1):213-26
references: 22157103
references: Cancer Epidemiol Biomarkers Prev. 2008 Oct;17(10):2729-36
references: 18843016
references: Environ Health Perspect. 2011 May;119(5):641-6
references: 21156396
references: Am J Epidemiol. 1979 Feb;109(2):181-5
references: 425957
references: Toxicol Appl Pharmacol. 2012 Jan 15;258(2):288-95
references: 22155089
references: Lancet. 2010 Sep 11;376(9744):911-21
references: 20708256
references: Pediatrics. 2005 Feb;115(2):e127-34
references: 15653789
references: Reprod Toxicol. 1996 May-Jun;10(3):227-30
references: 8738560
references: Biol Reprod. 2013 Jan;88(1):23
references: 23242528
references: Chemosphere. 2000 May-Jun;40(9-11):943-9
references: 10739030
references: Environ Health Perspect. 2014 Feb;122(2):145-50
references: 24280566
references: Toxicol Appl Pharmacol. 2002 May 1;180(3):157-63
references: 12009855
references: Menopause. 2006 Mar-Apr;13(2):265-79
references: 16645540
references: Fertil Steril. 2013 May;99(6):1681-8
references: 23419929
references: Environ Health Perspect. 2012 Nov;120(11):1613-8
references: 23124194
references: Reprod Toxicol. 1998 Nov-Dec;12(6):575-80
references: 9875692
references: Am J Epidemiol. 1986 Aug;124(2):254-61
references: 3728441
references: J Acad Nutr Diet. 2012 Nov;112(11):1709
references: 23102169
references: J Natl Cancer Inst. 1997 Dec 3;89(23):1774-82
references: 9392618
references: Reprod Toxicol. 1994 Jan-Feb;8(1):69-73
references: 8186627