Association of age at menarche with gestational hypertension and preeclampsia: A large prospective cohort in China.

This study explored the potential association between age at menarche and the risks of gestational hypertension and preeclampsia in Chinese women. Data were sourced from the China-US Collaborative Project for Neural Tube Defects Prevention, a large population-based cohort study. Our study consisted of 209 411 women pre-registered for pregnancy in two provinces in South China. Trained healthcare workers measured blood pressure at registration and recorded other pertinent health information. Using logistic regression, we assessed the correlations between age at menarche and the likelihood of developing gestational hypertension and preeclampsia, considering confounders such as maternal age, body mass index, ethnicity, parity, folic acid supplementation, education level, and occupation. The observed incidences for gestational hypertension and preeclampsia were 9.65% and 2.54%, respectively. The adjusted odds ratios (ORs) for gestational hypertension, based on age at menarche, were as follows: ≤13 years, 1.18 (95% confidence interval: 1.11-1.26); 14 years, 1.09 (1.04-1.15); 15 years, 1.11 (1.06-1.16); 16 years, 1.06 (1.01-1.12); and ≥17 years, 1.00 (reference; P for trend < .001). The correlation between age at menarche and preeclampsia varied across age groups, with the following respective ORs: 1.35 (1.20-1.52), 1.21 (1.09-1.34), 1.27 (1.15-1.39), 1.14 (1.03-1.26), and 1.00 (reference; P for trend < .001). This association appeared to be more pronounced in women with no folic acid supplementation and those with a lower education level. In conclusion, an earlier age at menarche seems to be linked to increased risks of gestational hypertension and preeclampsia.

"They had the lunch lady coming up to assist": The experiences of menarche and menstrual management for adolescents with physical disabilities.

BACKGROUND: Menarche is a pivotal time in an adolescent's life but can be experienced differently by those with physical disabilities. Parents typically serve as the primary educators and support for their daughters during this time. Little is known about the parent's perspective of their daughter's experience preparing for menarche and learning to manage menses. OBJECTIVE: We sought to understand the parent's perspective of the experience of their daughter with a physical disability around menarche and their preferences for health care provider support. METHODS: Individual semi-structured interviews were conducted with 21 parents of a daughter with a physical disability ages 7-26. Interviews were coded by 2 reviewers using Grounded Theory, with disagreements resolved by consensus. RESULTS: Six themes emerged regarding the parent's perception of the experiences, including 1) variation in emotional responses to menarche, 2) parent's perception of their daughter's experience with menses and menstrual symptoms, 3) cross-section of disability and menstrual management, 4) menstrual management at school, 5) parental knowledge correlating to daughter's preparation for menarche, and 6) desires for health care provider support. CONCLUSIONS: All parents reported that their daughters faced challenges during menarche, ranging from emotional distress to dealing with the inaccessibility of hygiene products. Managing periods at schools was particularly burdensome. Parents who were better educated about what to expect were better able to prepare their daughters, but had difficulties finding informed, supportive providers. Health care providers should provide both anticipatory guidance and holistic, respectful, and equitable options for the management of menstrual symptoms.

Maternal intake of folate and folic acid during pregnancy and pubertal timing in girls and boys: A population-based cohort study.

BACKGROUND: Folate is essential for normal foetal development as it plays an important role for gene expression during different periods of foetal development. Thus, prenatal exposure to folate may have a programming effect on pubertal timing. OBJECTIVES: To study the association between maternal intake of folate during pregnancy and pubertal timing in girls and boys. METHODS: We studied 6585 girls and 6326 boys from a Danish population-based Puberty Cohort, 2000-2021. Information on maternal intake of folate from diet and folic acid from supplements was obtained from a food-frequency questionnaire in mid-pregnancy, and total folate was calculated as dietary folate equivalents. Information on age at menarche in girls, age at first ejaculation and voice break in boys, and Tanner stages, acne and axillary hair in both girls and boys was obtained every 6 months throughout puberty. We estimated mean monthly differences according to exposure groups for each pubertal milestone in addition to a combined estimate for the average age at attaining all pubertal milestones using multivariable interval-censored regression models. Total folate was analysed in quintiles, continuous and as restricted cubic splines. RESULTS: Maternal intake of total folate in mid-pregnancy was not associated with pubertal timing in girls (combined estimate for overall pubertal timing per standard deviation (SD 325 µg/day) decrease in maternal intake of total folate: -0.14 months (95% confidence interval [CI] -0.51, 0.22)). Boys had slightly later overall pubertal timing per standard deviation (SD 325 µg/day) decrease in maternal intake of total folate (combined estimate: 0.40 months, 95% CI 0.01, 0.72). Spline plots supported these findings. CONCLUSIONS: Prenatal exposure to low maternal intake of total folate in mid-pregnancy was not associated with pubertal timing in girls but associated with slightly later pubertal timing in boys. This minor delay is likely not of clinical importance.

Sexual minority status is associated with earlier recalled age of menarche: Evidence from the 2005-2016 National Health and Nutrition Examination Survey.

INTRODUCTION: Menarcheal timing is associated with growth, development, health, wellbeing, and reproduction across the lifespan. Although sexual orientation is a known correlate of health and developmental inequities, relatively little evolutionarily framed research has investigated sexual orientation-based variation in maturational timing. To improve our understanding of menarcheal timing among sexual minority (SM) people, we use a biocultural-evolutionary life history lens that takes into account the stresses of minoritization to examine the relationship between sexual orientation and self-reported age at menarche in a sample of American adults. METHODS: Using the U.S. National Health and Nutrition Examination Survey (NHANES), a large, nationally representative dataset (n = 9757), we fit multiple logistic regression models and survival curves to evaluate associations between sexual orientation, indicators of somatic and material resources during adolescence (e.g., education, citizenship, upper arm length), and self-reported menarche. RESULTS: SM respondents were more likely to report earlier (by 4-5 months) ages of menarche (p < .001). Post-hoc tests revealed that these differences were driven by bisexual (p < .001) and same-sex experienced (p < .001) relative to heterosexual and lesbian/gay respondents. Earlier menarcheal timing among SM respondents persisted after adjusting for socio-demographic factors and proxies of developmental conditions. DISCUSSION: Our findings reveal that SM status is associated with earlier ages of menarche, an important social and reproductive milestone. We argue that uniting life history theory with the minority stress hypothesis better explains differences in menarcheal timing by sexual orientation than previous paradigms. Investigators should attend to sexual orientation-based variation in maturational timing using holistic, inclusive approaches.

Habitual Phytoestrogen Intake Is Associated with Breast Composition in Girls at 2 Years after Menarche Onset.

BACKGROUND: High phytoestrogen intake during adolescence is associated with a reduced risk of breast cancer. Breast density (BD) is a strong predictor of breast cancer and can be considered an early marker. We aim to assess the association between the mean habitual intake of isoflavones, lignans, and total phytoestrogens intake during puberty until 2 years after menarche onset and absolute fibroglandular volume (AFGV) and percentage of fibroglandular volume (%FGV) in Hispanic girls at the end of puberty. METHODS: Longitudinal study set up in the Growth and Obesity Chilean Cohort Study (GOCS). We included 329 girls with dietary data (multiple 24-hours recalls) from puberty until 2 years after menarche onset (81% had 2-4 recalls). Two international datasets were used to estimate isoflavones, lignans, and total phytoestrogens in the diet. Breast composition was measured by dual energy X-ray absorptiometry at 2 years after menarche. Multiple linear regression models were used to assess the association between isoflavones, lignans, and total phytoestrogens intake and AFGV and %FGV. RESULTS: The average total phytoestrogen intake was 1 mg/day and %FGV was 50.7% (SD = 15.2) and AFGV 218.8 cm3 (SD = 79.3). An inverse association was found between consumption of isoflavones and AFGV, as well as, with total phytoestrogens [Q4 vs. Q1 adjusted model ß = -49.2 cm3; 95% CI (-85.5 to -13.0)]. CONCLUSIONS: Girls with a higher intake of total phytoestrogens and isoflavones during puberty until 2 years after menarche onset had significantly lower AFGV. IMPACT: Although the intake of phytoestrogens is low in Western populations, higher consumption of them during a critical period of life like puberty could be beneficial to reduce breast cancer during adulthood.

Dietary Fat and Polyunsaturated Fatty Acid Intakes during Childhood Are Prospectively Associated with Puberty Timing Independent of Dietary Protein.

Dietary fat and fat quality have been inconsistently associated with puberty timing. The aim of this study was to investigate the prospective associations of dietary fat, saturated fatty acid (SFA), polyunsaturated fatty acid (PUFA), and monounsaturated fatty acid (MUFA) with puberty timing. Using longitudinal data from China Health and Nutrition Survey (CHNS) and Southwest China Childhood Nutrition and Growth (SCCNG) Study, we analyzed dietary data, anthropometric measurements, and potential confounders. Dietary intakes were assessed by 3-day 24-h recalls. Age at Tanner stage 2 for breast/genital development (B2/G2) and age at menarche/voice break (M/VB) were used as puberty development markers. Cox proportional hazard regression models were used to estimate the relevance of dietary intake of total fat, SFA, PUFA, and MUFA on puberty timing. Among 3425 girls and 2495 boys, children with higher intakes of total fat and PUFA were more likely to reach their B2/G2 or M/VB at an earlier age. Associations were not attenuated on additional adjustment for childhood dietary protein intake. However, higher intakes of SFA or MUFA were not independently associated with puberty development. A higher intake of dietary fat and PUFA in prepuberty was associated with earlier puberty timing, which was independent of dietary protein intake.

Body Size Measurements and Physical Performance of Youth Female Judo Athletes with Differing Menarcheal Status.

Purpose: To compare body size measurements and physical performance among female youth judo athletes with differing menarcheal status and to identify indicators of physical performance in post-menarcheal girls. Methods: Nineteen young female judo athletes (age 13.9 ± 2.3 years) were divided into a pre-menarche (n = 7) and a post-menarche (n = 12) group. The athletes were evaluated through neuromuscular tests, including standing long jump (SLJ), medicine ball throw (MBT), and handgrip strength (HGS), and judo-specific assessments, including the Special Judo Fitness Test (SJFT) and the Judogi Grip Strength Test (JGSTISO). Furthermore, years of experience in judo and the age at menarche were determined. Results: The main results showed higher performance for the post-menarche group for most variables (p < 0.05) compared to the pre-menarche group. A multiple linear regression analysis demonstrated that age at menarche, chronological age, and body mass explained close to 70% of JGSTISO, while training experience, chronological age, and age at menarche explained close to 59% of SLJ. Additionally, chronological age and age at menarche explained 40% of MBT, and chronological age and height explained 52% of HGS. Conclusions: Age at menarche and somatic growth variables explained moderate proportions of the variance of physical performance, thereby providing evidence that these parameters are the primary indicators of physical performance in young female judo athletes.

MC3R links nutritional state to childhood growth and the timing of puberty.

The state of somatic energy stores in metazoans is communicated to the brain, which regulates key aspects of behaviour, growth, nutrient partitioning and development1. The central melanocortin system acts through melanocortin 4 receptor (MC4R) to control appetite, food intake and energy expenditure2. Here we present evidence that MC3R regulates the timing of sexual maturation, the rate of linear growth and the accrual of lean mass, which are all energy-sensitive processes. We found that humans who carry loss-of-function mutations in MC3R, including a rare homozygote individual, have a later onset of puberty. Consistent with previous findings in mice, they also had reduced linear growth, lean mass and circulating levels of IGF1. Mice lacking Mc3r had delayed sexual maturation and an insensitivity of reproductive cycle length to nutritional perturbation. The expression of Mc3r is enriched in hypothalamic neurons that control reproduction and growth, and expression increases during postnatal development in a manner that is consistent with a role in the regulation of sexual maturation. These findings suggest a bifurcating model of nutrient sensing by the central melanocortin pathway with signalling through MC4R controlling the acquisition and retention of calories, whereas signalling through MC3R primarily regulates the disposition of calories into growth, lean mass and the timing of sexual maturation.

Association between factors related to the pregnancy, neonatal period, and later complications (especially asthma) and menarcheal age in a sample of Lebanese girls.

BACKGROUND: Studies about the majority of the factors that may potentially influence the pubertal timing and menarche were controversial. The objective was to evaluate the association between factors related to the pregnancy, neonatal period, and the complications that may happen later in life and the menarcheal age in a sample of Lebanese girls admitted or not to the NICU at birth. Our secondary objective was to try to find, for the first time in literature, a correlation between respiratory distress at birth and the need of oxygen therapy with the age of the first menses in these girls. METHODS: It is a cross-sectional retrospective study, conducted between January and March 2019. Our sample included all the 2474 girls born in Notre-Dame-de-Secours hospital, between 2000 and 2005; the sample consisted of 297 girls (97 girls admitted to the NICU and 200 randomly chosen to participate in our study with a ratio of 1:2 (1 girl admitted to the NICU vs 2 girls born in the nursery). RESULTS: Asthma later in life was significantly associated with lower age at menarche in girls, whereas a higher mother's age at menarche and a higher gestational age were significantly associated with higher age at menarche in girls. When taking each cause of NICU admission as an independent variable, showed that a higher mother's age at menarche was significantly associated with higher age at menarche in girls, whereas a higher number of days of phototherapy, a preeclampsia in the mother during pregnancy and asthma later in life in the girl were significantly associated with a lower age at menarche in girls. CONCLUSION: The timing of menarche seems to be associated with many factors in Lebanese girls that should not be disregarded by physicians.

Karate Training Improves Skeletal Status Assessed by Quantitative Ultrasound in Girls and Premenopausal Women.

PURPOSE: The aim of the study was to assess the influence of regular karate training on the skeletal status evaluated by quantitative ultrasound (QUS) in females. METHODS: A group of 132 karate training girls and women at mean age 19.57 (standard deviation [SD] 7.64) yr (range 7.3-45.3 yr) and 322 age-, sex- and body size-matched controls were enrolled into the study. Mean training duration in the karate group was 7.52 (SD 5.05) yr and mean training frequency was 2.97 (SD 1.21) per wk. The QUS measurements were performed at hand proximal phalanges, using a DBM Sonic 1200 (IGEA, Carpi, Italy) sonographic device, which measures amplitude-dependent speed of sound (Ad-SoS [m/s]). RESULTS: The results of Ad-SoS obtained in karatekas were generally higher than in controls with significant difference for prepubertal girls (1966.2 [SD 46.2] vs 1942.7 [SD 38.4]; p < 0.05) and for adult women (2124.4 [SD 48.0] vs 2105.3 [SD 54.0]; p < 0.05). CONCLUSIONS: Regular karate training is a factor that is positively associated with results of the QUS measurements at hand phalanges in exercising females and its impact is most strongly pronounced in prepuberty and adulthood.

Migraine: navigating the hormonal minefield.

Migraine affects 959 million people worldwide,1 with the highest prevalence being in women of childbearing age. The interplay between female hormones and migraine can be a challenging area to navigate since issues relating to pregnancy, contraception and the menopause are often out of the neurology comfort zone. This review aims to help the neurologist to manage women with migraine, from menarche to menopause.

Fish consumption during menarche, menstruation, pregnancy and postpartum in Sikuani women from Meta, Colombia.

BACKGROUND: Societies have selected their food for health, cultural, religious, political, economical, and environmental reasons. Most of the food included in Sikuani traditional diet still comes from wild natural resources and involves numerous species of fish, mammals, birds, reptiles, amphibians, insects, and plants. During certain periods of the Sikuani women's reproductive cycle, fish intake is avoided. The objective of this research is to study the conceptions underlying fish consumption regulations among Sikuani women at the Wacoyo Reservation, in Meta, Colombia. METHODS: We conducted a field study through interviews and participant observation with Sikuani Indigenous from the Wacoyo Reservation (Colombia). We inquired about the conceptions of fish consumption regulation by Sikuani women during the stages of the reproductive cycle. PCA (principal component analysis) was used to identify the most important characteristics of fish that are related to the avoidance of fish intake by Sikuani women during pregnancy. This study combines qualitative and quantitative analysis. RESULTS: It was found that during menarche and postpartum fish consumption is avoided by Sikuani women only before the ritual known as the prayer of the fish is performed. The menstruation does not imply significant regulations for fish intake, while during pregnancy there are multiple and specific avoidances for the consumption of fish. According to our results, there are some features of fish associated with their regulation on the diet of pregnant Sikuani women. The consumption of some fish is avoided during pregnancy because it is related to the appearance of disease caused by ainawi, protector spirits of aquatic animals. CONCLUSIONS: The traditional diet of Sikuani women includes numerous fish species and an important proportion of them are avoided during menarche, menstruation, gestation, and postpartum. According to our results, there are some features of fish associated with their regulation on the diet of pregnant Sikuani women. The main reasons underlying the avoidance of fish consumption by Sikuani women are the prevention of human disease as well as the strengthening of communities and ecosystems resilience.

Dysmenorrhea among high-school students and its associated factors in Kuwait.

BACKGROUND: Although dysmenorrhea is not a life-threatening condition, it can cause a substantial burden on individuals and communities. There is no data on the prevalence of dysmenorrhea in Kuwait. This study aimed to estimate the prevalence of dysmenorrhea among female public high-school students in Kuwait and investigate factors associated with dysmenorrhea. METHODS: A cross-sectional study using multistage cluster sampling with probability proportional to size method was conducted on 763 twelfth grade female public high-school students (aged 16-21 years). We used face-to-face interview with a structured questionnaire to collect data on dysmenorrhea and presumed risk factors. Weight and height of the students were measured using appropriate weight and height scales in a standardized manner. The association between dysmenorrhea and potential risk factors was assessed using multiple logistic regression. RESULTS: The one-year prevalence of dysmenorrhea was found to be 85.6% (95%CI: 83.1-88.1%). Of the participants with dysmenorrhea, 26% visited a public or a private clinic for their pain and 4.1% were hospitalized for their menstrual pain. Furthermore, 58.2% of students with dysmenorrhea missed at least one school day and 13.9% missed at least one exam. Age of menarche (p-value = 0.005), regularity and flow of the menstrual period (p-value = 0.025, p-value = 0.009; respectively), and drinking coffee (p-value = 0.004) were significantly associated with dysmenorrhea in multivariable analysis. CONCLUSION: Dysmenorrhea seems to be highly prevalent among female high-school students in Kuwait, resembling that of high-income countries. Because of the scale of the problem, utilizing school nurses to reassure and manage students with primary dysmenorrhea and referring suspected cases of secondary dysmenorrhea is recommended.

Impact of zinc on sexual maturation of female sickle cell anemia (SCA) children in Enugu, Southeast Nigeria.

Adolescence is an important developmental period of childhood. Good health and adequate nutrition consisting major food constituents and trace elements like zinc are fundamental for optimal sexual maturation. To determine the relationship between zinc levels and pattern of breast and pubic hair development, as well as menarcheal age of female SCA children aged 6-18 years and their matched controls with hemoglobin genotype AA. Cross sectional, case-control study. Information on biodata, age at menarche, medical and drug history as well as 24-hour dietary recall was documented using interviewer administered questionnaire. Sexual maturation was assessed using Tanner staging and zinc levels determined using Atomic absorption spectrophotometer. Eighty-one subjects were compared with 81 controls. There was significant delay in the mean age of attainment of various Tanner stages of breast and pubic hair in the subjects. Mean age of 14.81 ± 1.07 years at menarche in subjects was significantly higher than 12.62 ± 1.18 years in controls (p = 0.001). Serum zinc of 58.01 ± 10.58 µg/dl in subjects was significantly lower than 68.37 ± 8.67 µg/dl in controls (p = 0.001). Serum zinc levels were found to have a significant positive relationship with stages of sexual maturation and mean age at menarche. Reduced serum zinc in children with SCA was associated with delayed sexual maturation.

Elucidating the genetic architecture of reproductive ageing in the Japanese population.

Population studies elucidating the genetic architecture of reproductive ageing have been largely limited to European ancestries, restricting the generalizability of the findings and overlooking possible key genes poorly captured by common European genetic variation. Here, we report 26 loci (all P < 5 × 10-8) for reproductive ageing, i.e. puberty timing or age at menopause, in a non-European population (up to 67,029 women of Japanese ancestry). Highlighted genes for menopause include GNRH1, which supports a primary, rather than passive, role for hypothalamic-pituitary GnRH signalling in the timing of menopause. For puberty timing, we demonstrate an aetiological role for receptor-like protein tyrosine phosphatases by combining evidence across population genetics and pre- and peri-pubertal changes in hypothalamic gene expression in rodent and primate models. Furthermore, our findings demonstrate widespread differences in allele frequencies and effect estimates between Japanese and European associated variants, highlighting the benefits and challenges of large-scale trans-ethnic approaches.

A cosmopolítica da gestação, do parto e do pós-parto: autoatenção e medicalização entre os índios Munduruku / The cosmopolitics of pregnancy, childbirth and postpartum: self-attention and medicalization among Munduruku Indians

A pesquisadora Raquel Paiva Dias-Scopel, do Instituto Leônidas e Maria Deane (ILMD/Fiocruz Amazônia), levanta questões sobre a valorização e respeito à diversidade étnica e cultural dos povos indígenas e a difícil interface com o processos de medicalização e do direito ao acesso aos serviços de saúde biomédicos. O livro é parte da Coleção Saúde dos Povos Indígenas, da Editora Fiocruz e partiu da tese de doutorado defendida em 2014 no Programa de Pós-Graduação em Antropologia Social da Universidade Federal de Santa Catarina (UFSC). Foi publicado pela primeira vez em 2015 pela Associação Brasileira de Antropologia com o título A Cosmopolítica da Gestação, Parto e Pós-Parto: práticas de autoatenção e processo de medicalização entre os índios Munduruku. No prefácio da primeira edição, sua orientadora, a doutora em antropologia e professora titular da UFSC, Esther Jean Langdon, ressalta que o conceito fundamental deste livro é da autoatenção, que aponta para o reconhecimento da autonomia e da criatividade da coletividade, principalmente da família, como núcleo que articula os diferentes modelos de atenção ou cuidado da saúde.

The relationship of lung cancer with menstrual and reproductive factors may be influenced by passive smoking, cooking oil fumes, and tea intake: A case-control study in Chinese women.

The aim of this study was to investigate the association of menstrual and reproductive factors with risk of lung cancer in women. Potential etiological clues related to lung cancer in women are identified to inform preventive strategies.Case-control study of 477 newly diagnosed women with lung cancer and 479 age-matched (±2 years) controls. Data on menstrual and reproductive factors and history of oral contraceptive use were obtained on personal interviews using a structured questionnaire. Risk factors were analyzed by unconditional logistic regression analysis.Maternal age ≥25 years at first birth appeared to protect against female lung cancer [odds ratios (ORs): 0.511, 95% confidence interval (CI), 0.376-0.693]. Age at menopause > 50 years and use of contraceptives was associated with an increased risk of lung cancer in women (OR: 1.471, 95% CI, 1.021-2.119 and OR: 1.844, 95% CI: 1.111-3.061, respectively). Age ≥13 years at menarche was associated with a decreased risk of lung adenocarcinoma (OR: 0.563, 95% CI, 0.317-0.997). There was significant heterogeneity in the levels of cooking oil fume (COF) exposure (Pheterogeneity = .015). Higher levels of exposure to passive smoking, COF, and lack of tea intake were associated with an increased risk of lung cancer.Menstrual and reproductive factors are considered to play a role in the development of lung cancer in women. Exposure to passive smoking, COF, and lack of tea intake appeared to significantly modify the relationship.

Exposure to phytoestrogens in utero and age at menarche in a contemporary British cohort.

Phytoestrogens are estrogenic compounds that occur naturally in plants. Phytoestrogens can cross the placenta, and animal studies have found associations between in utero exposure to phytoestrogens and markers of early puberty. We investigated the association between in utero exposure to phytoestrogens and early menarche (defined as <11.5 years of age at onset) using data from a nested case-control study within the Avon Longitudinal Study of Parents and Children, a longitudinal study involving families living in the South West of England. Concentrations of six phytoestrogens were measured in maternal urine samples collected during pregnancy. Logistic regression was used to explore associations between tertiles of phytoestrogen concentrations and menarche status, with adjustment for maternal age at menarche, maternal education, pre-pregnancy body mass index (BMI), child birth order, duration of breastfeeding, and gestational age at sample collection. Among 367 mother-daughter dyads, maternal median (interquartile range) creatinine-corrected concentrations (in µg/g creatinine) were: genistein 62.1 (27.1-160.9), daidzein 184.8 (88.8-383.7), equol 4.3 (2.8-9.0), O-desmethylangolensin (O-DMA) 13.0 (4.4-34.5), enterodiol 76.1 (39.1-135.8), and enterolactone 911.7 (448.1-1558.0). In analyses comparing those in the highest tertile relative to those in the lowest tertile of in utero phytoestrogen exposure, higher enterodiol levels were inversely associated with early menarche (odds ratio (OR)=0.47; 95% confidence interval (CI): 0.26-0.83), while higher O-DMA levels were associated with early menarche (OR=1.89; 95% CI: 1.04-3.42). These findings suggest that in utero exposure to phytoestrogens may be associated with earlier age at menarche, though the direction of association differs across phytoestrogens.

Early Life Residence, Fish Consumption, and Risk of Breast Cancer.

Background: Little is known about fish intake throughout the life course and the risk of breast cancer.Methods: We used data on the first residence of 9,340 women born 1908 to 1935 in the Reykjavik Study as well as food frequency data for different periods of life from a subgroup of the cohort entering the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study (n = 2,882).Results: During a mean follow-up of 27.3 years, 744 women were diagnosed with breast cancer in the Reykjavik Study. An inverse association of breast cancer was observed among women who lived through the puberty period in coastal villages, compared with women residing in the capital area [HR, 0.78; 95% confidence interval (CI), 0.61-0.99]. In the subgroup analysis of this Icelandic population, generally characterized by high fish intake, we found an indication of lower risk of breast cancer among women with high fish consumption (more than 4 portions per week) in adolescence (HR, 0.71; 95% CI, 0.44-1.13) and midlife (HR, 0.46; 95% CI, 0.22-0.97), compared with low consumers (2 portions per week or less). No association was found for fish liver oil consumption in any time period, which could be due to lack of a reference group with low omega-3 fatty acids intake in the study group.Conclusions: Our findings suggest that very high fish consumption in early to midlife may be associated with a reduced risk of breast cancer.Impact: Very high fish consumption in early adulthood to midlife may be associated with decreased risk of breast cancer. Cancer Epidemiol Biomarkers Prev; 26(3); 346-54. ©2016 AACR.

An Overview of Menopausal Symptoms in A District Hospital of Nepal.

INTRODUCTION: Menopause is a universal reproductive phenomenon which confirms the end of fertility of the women. The objectives of this study were to establish the age of natural menopause and to identify the prevalence of menopausal symptoms among the rural women attending district hospital of Nepal. METHODS: This present study is a hospital based, observational cross-sectional study conducted in Outpatient department of Lamjung District Hospital, Lamjung, Nepal. The study was carried out from January 2014 till June 2014. Fifty four menopausal women were included in the study. A structured questionnaire was used and the data were analyzed using statistical package for social sciences. RESULTS: There were 54 participants with menopausal symptoms included in the study. Age ranged from 45 to 60 years with mean 51.2 years. Approximately seventy percentages of women were in age group of above 50 years. About two-third of participants had menarche in at 11 to 13 years of age and 32 (59.5%) of females were married before 15 years of age. In the study total 22 different health problems were reported by menopausal women. The most common symptoms were backache, fatigue/tiredness, numbness and tingling of the extremities, mental exhaustion, depressive mood, bladder problems and sexual symptoms. CONCLUSIONS: The study suggests that rural middle-age and elderly women suffer from variety of health problems related to natural menopause. The health care workers should adopt a holistic approach towards management to improve the quality of life.