Endocrine disrupting chemicals lead to earlier age of menopause: a cross-sectional study using the US population-based NHANES database N.M. Grindler, J.E. Allsworth, K.A. Roehl, A.R. Cooper. Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington Univer- sity, St Louis, MO; bObstetrics and Gynecology, Division of Clinical Re- search, Washington University, St Louis, MO. Monday, October 22, 2012 Objective Endocrine-disrupting chemicals (EDC) are exogenous agents that interfere with the synthesis & metabolism of hormones responsible for reproduction & development. Little is known regarding the impact of EDC on ovarian function. Our objective was to evaluate whether specific EDC impacted age at menopause & FSH values using the US publically available National Health & Nutrition Examination Survey (NHANES) database. Design Cross-sectional study. Materials and methods We examined NHANES data from 1999-2002 (n=5,708 women). Included were those ≥ 18 years not currently pregnant or breastfeeding, not currently using estrogen therapies, and no prior bilateral oophorectomy. Age at last menstrual period and FSH levels were the primary outcomes. Regression analyses using weighted data from the complex survey design were performed controlling for race/ethnicity, BMI, smoking, alcohol consumption, parity, & breastfeeding history. EDC exposure was a dichotomized variable based on the presence of lipid-adjusted serum or urine values above the 90th percentile of one of the following categories: dioxin, polychlorinated biphenyls/persistent pesticide (PCB), phthalate, phytoestrogen. Results After adjusting for confounding, women reported a mean age at last menstrual cycle 2.5 years earlier if exposed to PCB (P=0.025) & 2.3 years earlier with phthalate (P=0.045) as compared to those not exposed. Dioxin & phytoestrogen were not associated with an earlier age of menopause. No relationship was found between FSH levels in menstruating women & any EDC, likely due to variability in FSH throughout the cycle. Conclusion This is the first study to demonstrate the potential effect of EDC on ovarian reserve. PCB & phthalates, products known for their long half-lives & worldwide human exposure through diet and plastics, are associated with a significantly earlier age of menopause. This is similar to previously reported effects of tobacco on menstrual age and warrants significant future research to evaluate such associations.
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