4 years ago

Cigarette Smoking and Risk of Early Natural Menopause.

Bertone-Johnson, Boutot, Eliassen, Whitcomb, Manson, Hankinson, Willett, Rosner, Szegda, Purdue-Smithe
Menopause before age 45 affects roughly 5%-10% of women and is associated with higher risk of adverse health conditions. Smoking may increase early menopause risk; however, evidence is inconsistent, and data regarding smoking amount, duration, cessation and patterns over time and risk are scant. We used data from the Nurses' Health Study II of 116,429 nurses from 1989 through 2011 and Cox proportional hazards models to estimate hazard ratios (HR) adjusting for confounders. Compared to never-smokers, current smokers had a HR of 1.90 (95% CI: 1.71, 2.11); former smokers had a HR of 1.10 (95% CI: 1.00, 1.21). Increased risks were observed among women reporting current smoking with a HR = 1.72 (95% CI: 1.36, 2.18) for 11-15 pack-years; HR = 1.72 (95% CI: 1.38, 2.14) for 16-20 pack-years; and HR = 2.42 (95% CI: 2.11, 2.77) for >20 pack-years. Elevated risk was observed in former smokers reporting 11-15 (HR = 1.29, 95% CI: 1.07-1.55), 16-20 (HR = 1.42, 95% CI: 1.13, 1.79) or >20 pack-years (HR = 1.54, 95% CI: 1.23, 1.93). Women who smoked ≤10 cigarettes/day but quit by age 25 had comparable risk to never-smokers (HR = 1.03, 95% CI: 0.91, 1.17). A dose-response relation between smoking and early natural menopause risk, and reduced risk among quitters, may provide insights into the mechanisms of cigarette smoking on reproductive health.

Publisher URL: http://doi.org/10.1093/aje/kwx292

DOI: 10.1093/aje/kwx292

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