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Famine as a fetus linked to early menopause

(Reuters Health) – Early menopause is more likely among women who were exposed to famine in the womb, a recent study in China suggests.

Researchers compared the timing of menopause for 751 women born during a famine in China from 1959 to 1961 and for 1,029 women who were young children during the same period. They also looked at a control group of 1,088 women born after the famine ended.

Compared to women born after the famine ended, women exposed to famine in the womb were 59 percent more likely to go through menopause before age 45, which is earlier than normal.

“Our finding underscores the importance of adequate nutrition during early-life stages to avoid adverse effects on reproductive health in adulthood,” said study co-author Dr. Yan Zheng of Fudan University in Shanghai, China.

Women go through menopause when they stop menstruating, typically between ages 45 and 55. As the ovaries curb production of the hormones estrogen and progesterone, women can experience symptoms ranging from vaginal dryness to mood swings, joint pain and insomnia.

Earlier menopause has been linked to an increased risk of heart disease, osteoporosis, diabetes and sleep problems. It can also leave women with fewer reproductive years, particularly when it’s preceded by premature ovarian failure, when the ovaries stop working before age 40.

Women in the current study who were exposed to famine in the womb also appeared more likely than women who didn’t live through the famine to experience premature ovarian failure. But this difference was too small to rule out the possibility that it was due to chance.

While the study wasn’t designed to prove whether or how famine might directly mpact menopause timing, it’s possible that prenatal famine exposure might alter hormone production and gene activity in ways that compromise women’s reproductive health, said Yingli Lu, a researcher at JiaoTong University School of Medicine in Shanghai who wasn’t involved in the study.

Insufficient prenatal nutrition could also mean female babies are born with a smaller reserve of eggs available for release by the ovaries, Lu said by email. Women are typically born with around two million eggs that are released by the ovaries during menstrual cycles in their reproductive years.

“For women undergoing early menopause, hormone therapy at least until the natural age of menopause is recommended,” Lu advised.

When women who go through early menopause don’t take hormones, they may have a higher risk of heart disease, osteoporosis, depression and memory changes, and changes in vaginal and sexual health than their counterparts who do take hormones, said Dr. JoAnn Pinkerton of the University of Virginia Health System in Charlottesville.

While hormone therapy has been linked to an increased risk of blood clots and breast cancer, it is still recommended for many women who are experiencing moderate to severe symptoms of menopause, as well as for women who go through menopause early.

“Women with history of famine exposure or malnutrition while in their mother’s womb should be watched for early menopause with counseling about increased health risks if they develop early menopause,” Pinkerton, executive director of the North American Menopause Society, said by email.

“If no contraindications, hormone therapy given until the average age of menopause will decrease those health risks to those of women going through menopause at a normal age,” Pinkerton said.

SOURCE: Menopause, online December 3, 2018.

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