Age at Menarche and Risk of Respiratory Diseases

The Relationship of Estrogen Changes With Sinonasal Symptoms and Disease in Women: A Scoping Review

OBJECTIVE

Rhinitis and chronic rhinosinusitis (CRS) are inflammatory-driven processes. Previous research has shown an influence of sex hormones on inflammatory processes, including asthma. The purpose of this scoping review was to assess the existing epidemiologic literature looking at the relationship of estrogen to sinonasal symptoms in women.

DATA SOURCES

PubMed and Embase were searched with "estrogen," "rhinitis," and "female," along with related terms.

METHODS

All English language articles examining the relationship between estrogen changes and sinonasal symptoms in women were included; case reports were excluded. Data collected included hormonal exposure, presence of sinonasal symptoms, and the influence of hormonal exposure on symptoms.

RESULTS

57 studies were included. The literature suggests worsening of sinonasal outcomes with and throughout pregnancy. Early menarche (higher lifetime estrogen) may be associated with a higher rhinitis likelihood, which may also suggest a pro-inflammatory estrogen effect. The literature, however, also suggests menopause (low estrogen state) is associated with worse sinonasal outcomes. The literature examining oral contraceptives and hormone replacement therapy is overall too conflicting and limited to suggest any directionality. There are few studies on CRS or its outcomes.

CONCLUSION

The studies included in this review suggest a potential relationship between biological sex, sex hormones, and sinonasal outcomes, but the validity of the findings is limited due to the lack of rigorous and standardized study design. Given the growing evidence of the inflammatory-modulating effects of sex hormones, which form a pathophysiologic basis for this relationship, further research on the impact of sex hormones on sinonasal disease is required.

Age at menarche is inversely related to the prevalence of uterine cancer

OBJECTIVES

The objective of this study was to investigate the relationship between the age of menarche and the prevalence of malignancies of the uterus and ovaries.

METHODS

A total of 5540 women were screened from those who participated in the National Health And Nutrition Examination Survey (NHANES) questionnaire from 2007 to 2020, and their variable factors of age, race, education level, Poverty Impact Ratio (PIR), marital status, Body Mass Index (BMI), waist circumference, duration of moderate exercise, smoking habits, hypertension status, energy intake, diabetes and alcohol consumption habits were analysed statistically and by logistic regression.

RESULTS

Univariate and multivariate logistic regression analysis of the relationship between age at menarche and gynaecological cancer (uterus/cervix/ovary cancer, the following gynecologic cancers in the article refer to having at least one of these three cancers) prevalence showed a negative association between age at menarche and malignancies of the uterus and ovaries prevalence (OR: 0.82, 95% CI 0.69-0.97), with a statistically significant difference (p = 0.02). Regression results of the association between age at menarche and different types of malignancies of the uterus and ovaries found a negative association between age at menarche and prevalence in uterine cancers (P = 0.03) and no association between age at menarche and prevalence in cervical and ovarian cancers (P = 0.17, P = 0.29). Those with a younger age at menarche were more likely to develop uterine cancer (OR: 0.72, 95% CI 0.54-0.98).

CONCLUSIONS

There was a correlation between age at menarche and malignancies of the uterus and ovaries, with those who had menarche at an earlier age being at a higher risk of uterine cancer.

Outdoor air pollution and hormone-assessed pubertal development in children: Results from the GINIplus and LISA birth cohorts

BACKGROUND

Air pollution is hypothesized to affect pubertal development. However, the few studies on this topic yielded overall mixed results. These studies did not consider important pollutants like ozone, and none of them involved pubertal development assessed by estradiol and testosterone measurements. We aimed to analyze associations between long-term exposure to four pollutants and pubertal development based on sex hormone concentrations among 10-year-old children.

METHODS

These cross-sectional analyses were based on the 10-year follow-up medical examinations of 1945 children from the Munich and Wesel centers of the GINIplus and LISA German birth cohorts. Female and male pubertal development was assessed by dichotomizing the concentration of hormones in serum at 18.4 pmol/L and 0.087 nmol/L using the lower limits of quantification for estradiol and testosterone, respectively. Land-use regression models derived annual average concentrations of particulate matter with an aerodynamic diameter < 2.5 and 10 µm (PM_2.5 and PM₁₀), as well as spatial models assessed yearly average concentrations of nitrogen dioxide (NO₂) and ozone, were calculated at the 10-year residential addresses. To evaluate associations, we utilized logistic regressions adjusted for potential covariates. The analyses were stratified by area and sex.

RESULTS

Around 73% of the 943 females and 25% of the 1002 males had a high level of hormones and had already started puberty at the age of 10. Overall, we found no statistically significant associations between exposure to particles (PM_2.5 or PM₁₀) and pubertal development. Results on NO₂ and ozone were not significant as well; for instance, per 10 µg/m³ increase in ozone concentration, odds ratios and 95% confidence intervals were 0.900 (0.605, 1.339) and 0.830 (0.573, 1.203) for females and males, respectively. Stratified by area, the aforementioned results did not reveal any associations either.

CONCLUSIONS

Our study did not observe the associations between ambient air pollutants and pubertal development determined by estradiol and testosterone levels in children. However, due to the current limited number of studies on this topic, our results should be cautiously interpreted. Future longitudinal studies are needed to assess the association.