Epidemiology of Menstruation and Its Relevance to Women's Health

Harlow, Sioḃán D.; Ephross, Sara A.

doi:10.1093/oxfordjournals.epirev.a036193

Cited by 328 publications

(261 citation statements)

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“…Ovulatory cycles may resume in conjunction with supplemental feedings after the first few months of breast-feeding, perhaps accounting for the absence of a dose-response relationship. The reduction of risk associated with breast-feeding is consistent with hypotheses regarding incessant ovulation or ovarian inflammation, and with the hypothesis regarding gonadotropin secretion, which is slowed during breastfeeding (Harlow and Ephross, 1995).…”

Section: Discussionsupporting

confidence: 80%

“…Although one previous study suggested an association between heavier menstrual bleeding and increased risk (Purdie et al, 1995), we found no effect for the duration or the heaviness of menstrual bleeding. While our results suggest that cycle characteristics are unrelated to risk, such factors are poorly recalled (Bean et al, 1979;Harlow and Ephross, 1995), and errors of self-report may have attenuated underlying effects. In our data, there was no association between the type of sanitary product used during menstruation and ovarian cancer risk.…”

Section: Discussioncontrasting

confidence: 68%

“…Menstrual cycles occurring between ages 25 and 39 are most likely to be ovulatory (Harlow and Ephross, 1995), and pregnancies occurring between these ages have a greater potential to interrupt ovulatory cycles. Thus, our observation of reduced risk associated with later ages at first or last birth provides some support for hypotheses regarding incessant ovulation or ovarian inflammation.…”

Section: Discussionmentioning

confidence: 99%

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Menstrual and reproductive factors in relation to ovarian cancer risk

et al. 2001

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The reduced risk of epithelial ovarian cancer associated with parity and oral contraceptive use suggests that pituitary and/or ovarian hormones or ovulatory events are important in the aetiology of these tumours (Cramer, 1986). Nevertheless, despite extensive study, the influence of menstrual and reproductive factors, with the exception of parity, remains uncertain. In this report, we evaluate menstrual and reproductive characteristics in relation to ovarian cancer risk overall, and in relation to the major tumour histologic subtypes. Our findings are considered in light of several current hypotheses regarding ovarian cancer pathogenesis. Briefly, the incessant ovulation hypothesis suggests that risk is increased by chronic post-ovulatory trauma to the epithelial surface of the ovary, and the tendency to form inclusion cysts (Fathalla, 1971;Casagrande et al, 1979). The gonadotrophin hypothesis proposes that excessive gonadotropin secretion and consequent increases in oestrogen stimulation lead to proliferation and malignant transformation of ovarian epithelium . More recent hypotheses have suggested a role for chronic ovarian inflammation (Ness, 1999), androgens and progesterone (Risch, 1998), and the possibility that pregnancies reduce risk by clearing transforming cells from the ovaries (ovarian clearance) (Adami et al, 1994). METHODSWe conducted a population-based, case-control study of epithelial ovarian cancer in eastern Massachusetts (MA) and New Hampshire (NH). The methods used have been previously described Harlow et al, 1998). Briefly, 1033 potentially eligible case women (ages 20 to 74) were ascertained between May 1992 and March 1997 through state-wide cancer registries (NH, MA) and hospital tumour boards (MA). After exclusion of patients who had nonepithelial tumours (n = 52), and those who had died (n = 91), moved out of state (n = 27), had no telephone (n = 24), or did not speak English (n = 14), 825 case women were eligible for the study. Physicians denied permission to contact 126 (14%) of these women, and 136 (16%) of women declined to participate. This analysis is based on 563 cases of epithelial ovarian cancer, including lesions of borderline malignancy.Control women were identified primarily by random digit dialing (RDD) (Waksberg, 1978), and matched to case women by age (within 4 years) and telephone sampling unit. Of approximately 5400 residential households contacted, 10% declined to provide a household census, and 80% provided a census, but lacked a potentially eligible control subject. In the remaining 10% of households, a potentially eligible control was identified. 72% of the potential control women agreed to participate in the study. In MA, control women of age 60 or older were randomly chosen from Town Books, and matched to case women by age and precinct. Of 328 control women selected from Town Books, 21% Summary We assessed menstrual and reproductive factors in relation to ovarian cancer risk in a large, population-based, case-control study. 563 cases in Massachusetts and New Hampsh...

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Section: Discussionsupporting

confidence: 80%

Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Menstrual and reproductive factors in relation to ovarian cancer risk

et al. 2001

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“…Thus, there might be a concern that dietary fiber intake may be associated with anovulation rather than menstrual pain. However, when we reanalyzed data restricted to subjects with normal cycle lengths of 25-35 days, whom we thought to be ovulatory (Harlow & Ephross, 1995), the association between dietary fiber and the menstrual pain scale was not altered.…”

Section: Discussionmentioning

confidence: 97%

Associations of menstrual pain with intakes of soy, fat and dietary fiber in Japanese women

et al. 2004

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Objective: Intakes of soy, fat, and dietary fiber may be associated with the symptoms of dysmenorrhea through their biological effects on estrogens or prostaglandin production. The present study was to examine the relationships between intakes of soy, fat, and dietary fiber and the severity of menstrual pain. Design: Cross-sectional study. Setting: Three colleges and two nursing schools. Subjects: A total of 276 Japanese women aged 19-24 y. Methods: Intakes of nutrients and foods including soy products, isoflavones, fats and dietary fiber were estimated by a validated semiquantitative food frequency questionnaire. Severity of menstrual pain was assessed by the multidimensional scoring system reported by Andersch and Milson. Results: Intake of dietary fiber was significantly inversely correlated with the menstrual pain scale (r ¼ À0.12, P ¼ 0.04) after controlling for age, smoking status, age at menarche and total energy intake. Neither soy nor fat intake was significantly correlated with menstrual pain after controlling for the covariates. Conclusions: The cross-sectional difference in dietary fiber intake across the level of menstrual pain was small in magnitude but warrants further studies. Sponsorship: None.

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“…It is generally accepted that the average age at menopause is about 51 years in indus-trialized countries (2,3), but data are inconsistent for the developing world (3) because of methodological problems (4). There are also recent reviews of the epidemiologic literature about determinants of age at menarche and patterns of menstruation (5) and about age at menopause (6). In addition, while information on the timing of reproduction-related events can, in principle, be retrieved from many epidemiologic studies of breast cancer (e.g., Kelsey et al (7)), published data usually report the information on reproductive events as categories rather than as continuous variables.…”

mentioning

confidence: 99%

International Variability in Ages at Menarche, First Livebirth, and Menopause

Morabia

Costanza

1998

American Journal of Epidemiology

226

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The occurrences and timing of reproduction-related events, such as menarche, first birth, and menopause, play major roles in a woman's life. There is a lack of comparative information on the overall patterns of the ages at and the timing between these events among different populations of the world. This study describes the variability in reproductive factors across populations in Europe, the Americas, Asia, Australia, and Africa. The study sample consisted of 18,997 women from 13 centers in 11 countries interviewed between 1979 and 1988 who comprised the control group in a World Health Organization international, multicenter case-control study of female cancers. All were surveyed with the same questionnaire and methodology. Overall, a typical woman in this study reached menarche at age 14 years and delivered her first live child 8 years later, at age 22. She was 50 years old at natural menopause and had had 36 years of reproductive life. The median ages at menarche varied across centers from 13 to 16 years. For all centers, the median age at first livebirth was 20 or more years, with the largest observed median (25 years) occurring in China. The median delay from menarche to first livebirth ranged from 5 to 11 years. Among the centers, the median age at natural menopause ranged between 49 and 52 years. In most populations, younger women had a first birth at a later age than did older women. This tendency was more accentuated in some populations. These results reveal, perhaps for the first time, the variability of reproductive histories across different populations in a large variety of geographic and cultural settings. Except for menopause, international variability is substantial for both biologically related variables (age at menarche) and culturally related variables (age at first birth). There is a generational effect, characterized by more variability of age at first birth and delay to first birth in the younger than in the older generations. Am J Epidemiol 1998;148:1195-1205 menstruation; reproductive history; surveysThe occurrences and timing of reproduction-related events, such as menarche, first birth, and menopause, play major roles in a woman's life. In this context, it is striking that the variations in reproductive histories among different populations of the world are not well known.International comparisons on a single reproductive variable (e.g., age at menarche, characteristics of the menstrual cycle, age at menopause) conducted through the 1970s appear in reviews by Gray and Doyle (1) and Richardson (2). It is generally accepted that the average age at menopause is about 51 years in indus-

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Epidemiology of Menstruation and Its Relevance to Women's Health

Cited by 328 publications

References 0 publications

Menstrual and reproductive factors in relation to ovarian cancer risk

Menstrual and reproductive factors in relation to ovarian cancer risk

Associations of menstrual pain with intakes of soy, fat and dietary fiber in Japanese women

International Variability in Ages at Menarche, First Livebirth, and Menopause

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