scholarly journals Prevalence of premature ovarian insufficiency and its determinants in Iranian populations: Tehran lipid and glucose study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marzieh Rostami Dovom ◽  
Razieh ‌Bidhendi-Yarandi ◽  
Kazem Mohammad ◽  
Maryam Farahmand ◽  
Fereidoun Azizi ◽  
...  
Keyword(s):  
Failure Time ◽  
Population Based ◽  
Normal Weight ◽  
Influential Factors ◽  
Reproductive Age ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Natural Menopause ◽  
Age At Menopause ◽  
Aft Model

Abstract Background Premature ovarian insufficiency (POI) considered as a concerning health issue for women of reproductive age. In this study we aim to estimate the prevalence of POI and assessing the influential factors. Methods Data was obtained from Tehran lipid and glucose study (TLGS). All eligible post-menarcheal female participants of the TLGS, ages 20–65, were recruited (n = 6521). Participants were followed for the event of menopause, and age at menopause was recorded. Kaplan Meier analysis was applied to estimate mean and median for age at menopause. Weibull accelerated failure time survival regression model (AFT), was applied to assess influential determinants of POI. Conditional probability approach was used to provide estimation for prevalence of POI. Results In this population-based study, the prevalence of POI (menopause age < 40 years) and early menopause (menopause age < 45 years) were estimated 3.5% and 24.6%, respectively. AFT model showed that in comparison to normal weight women, time to menopause was decreased by − 0.09 year (95% CI − 0.27, − 0.01, p = 0.023) and − 0.03 year (95% CI − 0.05, − 0.02, p = 0.000) in underweight and overweight women, respectively. Moreover, time to natural menopause was increased by 0.12 year (95% CI 0.07 to 0.17, p = 0.000) in women used oral contraceptives for > 6 months. Conclusion About one quartile of Iranian women experienced menopause at an age less than 45, especially the non-normal weight ones; this high prevalence is a critical public health concerns that needs to be addressed by health policy makers.

scholarly journals Dietary intake and age at natural menopause: results from the UK Women’s Cohort Study

2018 ◽  
Vol 72 (8) ◽  
pp. 733-740 ◽  
Author(s):  
Yashvee Dunneram ◽  
Darren Charles Greenwood ◽  
Victoria J Burley ◽  
Janet E Cade
Keyword(s):  
Cohort Study ◽  
Reproductive Age ◽  
Food Groups ◽  
Natural Menopause ◽  
Age At Menopause ◽  
Oily Fish ◽  
History Of ◽  
The Uk ◽  
Study Participants

BackgroundAge at natural menopause is a matter of concern for women of reproductive age as both an early or late menopause may have implications for health outcomes.MethodsStudy participants were women aged 40–65 years who had experienced a natural menopause from the UK Women’s Cohort Study between baseline and first follow-up. Natural menopause was defined as the permanent cessation of menstrual periods for at least 12 consecutive months. A food frequency questionnaire was used to estimate diet at baseline. Reproductive history of participants was also recorded. Regression modelling, adjusting for confounders, was used to assess associations between diet and age at natural menopause.ResultsDuring the 4-year follow-up period, 914 women experienced a natural menopause. A high intake of oily fish and fresh legumes were associated with delayed onset of natural menopause by 3.3 years per portion/day (99% CI 0.8 to 5.8) and 0.9 years per portion/day (99% CI 0.0 to 1.8), respectively. Refined pasta and rice was associated with earlier menopause (per portion/day: −1.5 years, 99% CI −2.8 to −0.2). A higher intake of vitamin B6 (per mg/day: 0.6 years, 99% CI 0.1 to 1.2) and zinc (per mg/day: 0.3 years, 99% CI −0.0 to 0.6) was also associated with later age at menopause. Stratification by age at baseline led to attenuated results.ConclusionOur results suggest that some food groups (oily fish, fresh legumes, refined pasta and rice) and specific nutrients are individually predictive of age at natural menopause.

REPRODUCTIVE POTENTIAL OF WOMEN WITH PREMATURE OVARIAN INSUFFICIENCY

2021 ◽  
pp. 41-48
Author(s):  
Spiridenko G.Yu. ◽  
Petrov Yu.A. ◽  
Palieva N.V.
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Assisted Reproductive Technologies ◽  
Hormone Replacement ◽  
Reproductive Potential ◽  
Reproductive Technologies ◽  
Pathological Process ◽  
Reproductive Age ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency

Infertility is currently a priority problem for women of reproductive age. One of the reasons for this condition may be premature ovarian insufficiency. This is a pathological process causes by primary hypogonadism that occurs in women under 40 years of age. Its prevalence varies from 1:10,000 at the age of 20 to 1:100 at an older age. The absence of specific clinical manifestations of the disease complicates its early diagnosis and timely treatment. This pathological process manifests itself as secondary oligo-or amenorrhea, infertility. Less often, before the onset of reproductive disorders, there are manifestations of estrogenic insufficiency - vasomotor disorders - hot flashes, hyperhidrosis, cephalgia, tachycardia, arterial hypertension, emotional and vegetative disorders-irritability, asthenic manifestations, anxiety, depression, hypo - thymia, decreased libido. The lack of accurate data on etiological factors makes it harder to find methods for preventing this disease. The main direction of treatment is hormone replacement therapy, aimed at eliminating the insufficiency of natural estrogens in the woman's body. The chances of successful realization of the reproductive potential depend on the value of the follicle-stimulating hormone, since its high concentration affects the mitotic activity of granulosa cells of the follicle, which confirms the validity of hormone replacement therapy. The non-occurrence of pregnancy after therapy forces the patient to use assisted reproductive technologies using donor embryos and oocytes, while the effectiveness of in vitro fertilization does not exceed 58%. To prevent this outcome, if a woman has risk factors for developing premature ovarian insufficiency, it is necessary to timely assess the ovarian reserve with the preservation of her own oocytes for subsequent assisted reproductive technologies.

scholarly journals Modeling Age at Menopause Using Serum Concentration of Anti-Mullerian Hormone

2013 ◽  
Vol 98 (2) ◽  
pp. 729-735 ◽  
Author(s):  
Fahimeh Ramezani Tehrani ◽  
Masoud Solaymani-Dodaran ◽  
Maryam Tohidi ◽  
Mahmood Reza Gohari ◽  
Fereidoun Azizi
Keyword(s):  
Serum Concentration ◽  
Failure Time ◽  
Population Based ◽  
Accelerated Failure Time Model ◽  
Correct Prediction ◽  
Eligibility Criteria ◽  
Time Model ◽  
Age At Menopause ◽  
Reproductive Aged Women

Abstract Context: Anti-Mullerian hormone (AMH) has already been used for prediction of age at menopause with promising results. Objective: We aimed to improve our previous prediction of age at menopause in a population-based cohort by including all eligible subjects and additional follow-up time. Design and Setting: All reproductive-aged women who met our eligibility criteria were selected from the Tehran Lipid and Glucose Study. The serum concentration of AMH was measured at the time of recruitment, and participant's date of menopause was recorded over a 10-year follow-up. Subjects: A total of 1015 women, aged 20 to 50 years, with regular and predictable menstrual cycles at the initiation of the study were recruited. Main Outcome Measure: The actual ages at menopause were compared with the predicted ones obtained from accelerated failure time model. Results: We observed 277 occurrences of menopause. Median menopausal age was 50 years (range 30.1–58.2 years). The median (SD) of differences between the actual menopausal age and those predicted by our model was 0.5 (2.5) years. Model adequacy (measured by C-statistics) for correct prediction of age at menopause was 92%. The estimated ages at menopause and their 95% confidence intervals for a range of values of AMH and age were calculated and summarized in a table. Conclusions: Using a model built on age and AMH, we can predict age at menopause many years earlier. This could provide opportunities for interventions in those who are at risk of early or late menopause.

scholarly journals Early menopause and premature ovarian insufficiency are associated with increased risk of type 2 diabetes: a systematic review and meta-analysis

2019 ◽  
Vol 180 (1) ◽  
pp. 41-50 ◽  
Author(s):  
Panagiotis Anagnostis ◽  
Konstantinos Christou ◽  
Aikaterini-Maria Artzouchaltzi ◽  
Nifon K Gkekas ◽  
Nikoletta Kosmidou ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Premature Ovarian Insufficiency ◽  
Early Menopause ◽  
Ovarian Insufficiency ◽  
Pubmed Central ◽  
Age At Menopause ◽  
Increased Risk ◽  
Comprehensive Search

Objective/Design Menopausal transition has been associated with a derangement of glucose metabolism. However, it is not known if early menopause (EM, defined as age at menopause <45 years) or premature ovarian insufficiency (POI, defined as age at menopause <40 years) are associated with increased risk of type 2 diabetes mellitus (T2DM). To systematically investigate and meta-analyze the best evidence regarding the association of age at menopause with the risk of T2DM. Methods A comprehensive search was conducted in PubMed, CENTRAL and Scopus, up to January 31, 2018. Data are expressed as odds ratio (OR) with 95% confidence intervals (CI). The I 2 index was employed for heterogeneity. Results Thirteen studies were included in the qualitative and quantitative analysis (191 762 postmenopausal women, 21 664 cases with T2DM). Both women with EM and POI were at higher risk of T2DM compared with those of age at menopause of 45–55 years (OR: 1.15, 95% CI: 1.04–1.26, P = 0.003; I 2: 61%, P < 0.002 and OR: 1.50, 95% CI: 1.03–2.19, P = 0.033; I 2: 75.2%, P < 0.003), respectively). Similar associations emerged when women with EM and POI were compared with those of age at menopause >45 years (OR: 1.12, 95% CI: 1.01–1.20, P < 0.02; I 2: 78%, P < 0.001 and OR: 1.53, 95% CI: 1.03–2.27, P = 0.035; I 2: 78%, P < 0.001), respectively). Conclusions Both EM and POI are associated with increased risk of T2DM.

Improving Prediction of Age at Menopause Using Multiple Anti-Müllerian Hormone Measurements: the Tehran Lipid-Glucose Study

2020 ◽  
Vol 105 (5) ◽  
pp. 1589-1598 ◽  
Author(s):  
Fahimeh Ramezani Tehrani ◽  
Razieh Bidhendi Yarandi ◽  
Masoud Solaymani-Dodaran ◽  
Maryam Tohidi ◽  
Faezeh Firouzi ◽  
...  
Keyword(s):  
Failure Time ◽  
Reproductive Age ◽  
Accelerated Failure Time Model ◽  
Accelerated Failure Time ◽  
Time Model ◽  
Age At Menopause ◽  
Decline Rate ◽  
Accelerated Failure ◽  
Failure Time Model

Abstract Context Several statistical models were introduced for the prediction of age at menopause using a single measurement of anti-müllerian hormone (AMH); however, individual prediction is challenging and needs to be improved. Objective The objective of this study was to determine whether multiple AMH measurements can improve the prediction of age at menopause. Design All eligible reproductive-age women (n = 959) were selected from the Tehran Lipid and Glucose Study. The serum concentration of AMH was measured at the time of recruitment and twice after that at an average of 6-year intervals. An accelerated failure-time model with Weibull distribution was used to predict age at menopause, using a single AMH value vs a model that included the annual AMH decline rate. The adequacy of these models was assessed using C statistics. Results The median follow-up period was 14 years, and 529 women reached menopause. Adding the annual decline rate to the model that included single AMH improved the model’s discrimination adequacy from 70% (95% CI: 67% to 71%) to 78% (95% CI: 75% to 80%) in terms of C statistics. The median of differences between actual and predicted age at menopause for the first model was –0.48 years and decreased to –0.21 in the model that included the decline rate. The predicted age at menopause for women with the same amount of age-specific AMH but an annual AMH decline rate of 95 percentiles was about one decade lower than in those with a decline rate of 5 percentiles. Conclusion Prediction of age at menopause could be improved by multiple AMH measurements; it will be useful in identifying women at risk of early menopause.

scholarly journals Predicting under- and overnutrition among women of reproductive age: a population-based study in central Java, Indonesia

2000 ◽  
Vol 3 (2) ◽  
pp. 193-200 ◽  
Author(s):  
Anna Winkvist ◽  
Detty Siti Nurdiati ◽  
Hans Stenlund ◽  
Mohammad Hakimi
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Significant Risk ◽  
Population Based ◽  
Normal Weight ◽  
International Standards ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Energy Deficiency ◽  
Central Java

AbstractObjectivesTo evaluate changes over 1 year in weight and body mass index (BMI) among a population-based sample of non-pregnant women in Indonesia and to identify risk factors for developing under- and overnutrition.DesignCross-sectional studies in 1996 and 1997 in the same population.SettingPurworejo District, central Java, Indonesia.SubjectsNon-pregnant women (n = 4132) aged 15–49 years of age who participated in both 1996 and 1997. Based on BMI, women were classified as having chronic energy deficiency (CED), and as being either of normal weight or obese.ResultsThe mean height of the women was below the fifth percentile of international standards. In 1996, 16.2% had CED, 72.2% were normal and 11.6% were obese. In 1997, the corresponding figures were 14.4%, 71.2% and 14.3%, respectively, revealing a significant mean increase in weight and BMI. Among women classified as normal in 1996, 3.0% developed CED in 1997. Significant risk factors for developing CED were experiences of child deaths and non-use of contraceptives. Among women classified as normal in 1996, 5.3% developed obesity in 1997. Here, significant risk factors included most indicators of wealth as well as occupation.ConclusionsThe results should be important for future efforts to prevent CED and obesity in the general population; conditions which are both associated with health risks.

Premature and Early Menopause in Relation to Cardiovascular Disease

2021 ◽  
Author(s):  
Izaäk Schipper ◽  
Yvonne V. Louwers
Keyword(s):  
Cardiovascular Disease ◽  
Postmenopausal Women ◽  
Cardiovascular Events ◽  
Premature Ovarian Insufficiency ◽  
Premature Menopause ◽  
Bilateral Oophorectomy ◽  
Early Menopause ◽  
Ovarian Insufficiency ◽  
Age At Menopause ◽  
Increased Risk

AbstractPostmenopausal women have an increased risk for cardiovascular diseases. It has been postulated that the loss of ovarian function and subsequent deficiency of endogenous estrogens after menopause contributes to this elevated risk of cardiovascular disease in postmenopausal women. Compared with woman entering menopause at the mean age of 51 years, in women with early menopause or premature ovarian insufficiency the risk for cardiovascular disease is even greater. These women lack the cardioprotective effect of endogenous estrogens for many more years than do women entering natural menopause. The majority of data assessing the risk of cardiovascular disease in relation to age at menopause and specifically premature menopause are derived from large epidemiological cohort studies. In addition, observations in women undergoing bilateral oophorectomy at an early age provide convincing evidence regarding association between early menopause or POI and the development of cardiovascular events and mortality. Moreover, genetic variants associated with earlier age at menopause have also been found to increase the risk of cardiovascular events in women. It has been substantiated that hormone replacement therapy (HRT) decreases the risk for ischemic heart disease and eliminates the increased cardiovascular disease mortality. It is therefore crucial to start HRT as soon as possible, particularly in women with premature ovarian insufficiency.

scholarly journals How to Protect Ovarian Function before and during Chemotherapy?

2021 ◽  
Vol 10 (18) ◽  
pp. 4192
Author(s):  
Luca Arecco ◽  
Tommaso Ruelle ◽  
Valentino Martelli ◽  
Andrea Boutros ◽  
Maria Maddalena Latocca ◽  
...  
Keyword(s):  
Ovarian Function ◽  
Premenopausal Women ◽  
Protective Role ◽  
Premature Ovarian Insufficiency ◽  
Negative Consequences ◽  
Key Factors ◽  
Ovarian Insufficiency ◽  
Natural Menopause ◽  
Premenopausal Patients

A significant number of women receive a cancer diagnosis before their age of natural menopause. Among these patients, the most frequent neoplasms are breast cancer, gynecological, and hematological malignancies. Premature ovarian insufficiency and infertility are among the most feared short- to long-term consequences of anticancer treatments in premenopausal patients. Both patient- and treatment-related characteristics are key factors in influencing the risk of gonadotoxicity with the use of chemotherapy. The cryopreservation of oocytes/embryos is a standard strategy for fertility preservations offered to young women interested in future family planning, but it does not allow gonadal function protection during chemotherapy. Ovarian suppression with gonadotropin-releasing hormone agonist (GnRHa) during chemotherapy is now recommended as an option to reduce the risk of gonadotoxicity in order to avoid the negative consequences of premature ovarian insufficiency in premenopausal women receiving cytotoxic therapy, including those not interested in fertility preservation. This review summarizes the risk of treatment-induced gonadotoxicity in premenopausal patients and the evidence available on the protective role of administering GnRHa during chemotherapy to preserve ovarian function.

scholarly journals Anthropometric Indices and Age at Natural Menopause: A 15-Year Follow-Up Population-Based Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Maryam Farahmand ◽  
Fahimeh Ramezani Tehrani ◽  
Maryam Rahmati ◽  
Fereidoun Azizi
Keyword(s):  
Longitudinal Study ◽  
Failure Time ◽  
Shape Index ◽  
Population Based ◽  
Anthropometric Indices ◽  
Eligibility Criteria ◽  
Natural Menopause ◽  
Time Ratio ◽  
Study Results

Background: Following menopause, the risk of many diseases is increased, and this situation may be due to changes in anthropometric indices (AI), while the association between adiposity and age at natural menopause (ANM) is not clear yet. Objectives: This longitudinal study was conducted to investigate the ability of AI in predicting ANM. Methods: For this purpose, a total of 3,876 women aged > 20 years old from participants of the Tehran lipid and glucose study (TLGS) met our eligibility criteria. The association between ANM and various AIs was assessed using the Accelerated Failure Time (AFT) model, and time ratio (TR) with 95% confidence intervals were reported in this longitudinal study. Results: The median [interquartile range (IQR) 25 - 75] of the survival time was 12.5 (7.9 - 15.8) years. At the end of the follow-up, 1,479 (38.2%) of the participants reached menopause. The median time to natural menopause was decreased by about 2% with one standard deviation (SD) increase of both a body shape index (ABSI) (time ratio (TR): 0.98, 95% CI: 0.97, 0.99) and lipid accumulation product (LAP) (TR: 0.98, 95% CI: 0.98, 0.99) z-scores; and this time was increased by about 1% (TR: 1.01, 95% CI: 1.00, 1.02) with one SD increase in body mass index (BMI) z-score. Conclusions: The ABSI, LAP, and BMI were the most useful AIs for identification of the time to menopause onset, and ABSI and LAP were inversely associated with the ANM. Also, the BMI was directly associated with the ANM.

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