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Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have been associated with earlier natural menopause; however, the underlying mechanisms are not well understood, particularly the extent to which this relationship is mediated by sex hormones. We analyzed data (1999–2017) on 1,120 premenopausal women from the Study of Women's Health Across the Nation (SWAN). Causal mediation analysis was applied to quantify the degree to which follicle-stimulating hormone (FSH) and estradiol levels could mediate the associations between PFAS and incident natural menopause. Participants with higher PFAS concentrations had shorter times to natural menopause, with a relative survival of 0.82 (95% confidence interval (CI): 0.69, 0.96) for linear perfluorooctane sulfonate (n-PFOS), 0.84 (95% CI: 0.69, 1.00) for sum of branched-chain perfluorooctane sulfonate (Sm-PFOS), 0.79 (95% CI: 0.66, 0.93) for linear-chain perfluorooctanoate (n-PFOA), and 0.84 (95% CI: 0.71, 0.97) for perfluorononanoate (PFNA), comparing the highest tertile of PFAS concentrations with the lowest. The proportion of the effect mediated through FSH was 8.5% (95% CI: −11.7, 24.0) for n-PFOS, 13.2% (95% CI: 0.0, 24.5) for Sm-PFOS, 26.9% (95% CI: 15.6, 38.4) for n-PFOA, and 21.7% (6.8, 37.0) for PFNA. No significant mediation by estradiol was observed. The effect of PFAS on natural menopause may be partially explained by variations in FSH concentrations. [ABSTRACT FROM AUTHOR]

Objective. To estimate the relationship between obesity (defined by both BMI and SAD) and various levels of depressive symptoms in women in the United States. Methods. This is a cross-sectional design. All data were collected from NHANES 2011-2012 and 2013-2014. The Patient Health Questionnaire (PHQ-9) was the primary variable used to index depressive symptoms. SAD was assessed using an abdominal caliper. We stratified participates into three groups according to SAD (trisection): T1: low (11.8-18.4 cm), T2: middle (18.5-22.8 cm), and T3: high (22.9-40.1 cm). Other data were collected following the NHANES protocols. We aimed to investigate the effects of obesity on the depression in the NHANES populations. Results. A total of 4477 women were enrolled in the final study population. Participants with a high SAD had the highest risk of clinical depression symptoms (OR = 1.2 , 95% CI: 1.1-1.4), which was, in particular, the case for moderate-severe depression (OR = 1.4 , 95% CI: 1.1-1.7) and severe depression (OR = 1.4 , 95% CI: 1.0-1.9). We also found a significant relationship between SAD and BMI (r = 0.836). We did, however, not find a significant relationship between BMI and severe depression. Conclusions. SAD had a better correlation with clinical depression symptoms than BMI, especially regarding severe depression symptoms. [ABSTRACT FROM AUTHOR]

Context: Previous epidemiologic studies of per- and polyfluoroalkyl substances (PFASs) and menopausal timing conducted in cross-sectional settings were limited by reverse causation because PFAS serum concentrations increase after menopause.Objectives: To investigate associations between perfluoroalkyl substances and incident natural menopause.Design and Setting: A prospective cohort of midlife women, the Study of Women's Health Across the Nation, 1999-2017.Participants: 1120 multiracial/ethnic premenopausal women aged 45-56 years.Methods: Serum concentrations of perfluoroalkyls were quantified by high-performance liquid chromatography isotope dilution tandem mass spectrometry. Natural menopause was defined as the bleeding episode prior to at least 12 months of amenorrhea not due to surgery or hormone use. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).Results: Participants contributed 5466 person-years of follow-up, and 578 had incident natural menopause. Compared with the lowest tertile, women at the highest tertile of baseline serum concentrations had adjusted HR for natural menopause of 1.26 (95% CI: 1.02-1.57) for n-perfluorooctane sulfonic acid (n-PFOS) (Ptrend = .03), 1.27 (95% CI: 1.01-1.59) for branched-PFOS (Ptrend = .03), and 1.31 (95% CI: 1.04-1.65) for n-perfluorooctanoic acid (Ptrend = .01). Women were classified into four clusters based on their overall PFAS concentrations as mixtures: low, low-medium, medium-high, and high. Compared with the low cluster, the high cluster had a HR of 1.63 (95% CI: 1.08-2.45), which is equivalent to 2.0 years earlier median time to natural menopause.Conclusion: This study suggests that select PFAS serum concentrations are associated with earlier natural menopause, a risk factor for adverse health outcomes in later life. [ABSTRACT FROM AUTHOR]

Background: Feminine hygiene products (FHPs) are personal care products widely used by women. A few studies have detected some volatile organic compounds (VOCs) in FHPs, but no previous epidemiological studies have linked use of these products to human exposure to VOCs using biomarkers. Therefore, we evaluated whether the use of FHPs was associated with VOC exposures among reproductive-aged women in the United States. Materials and Methods: Data on 2432 women aged 20–49 years from National Health and Nutrition Examination Survey 2001–2004 were utilized. Self-reported use of feminine products (tampons, sanitary napkins, vaginal douches, sprays, powders, wipes/towelettes, and other products) was obtained from questionnaires. Survey-weighted linear regression models were used to estimate percent changes in VOC whole blood concentrations and 95% confidence intervals (CIs). Results: Black women had significantly more use of vaginal douching and significantly higher whole blood concentrations of 1,4-dichlorobenzene (DCB) (p < 0.0001). After adjusting for confounders, we observed a dose–response relationship between the frequency of vaginal douching in the past 6 months and 1,4-DCB concentrations. Compared with never users, women with occasional use (≤1 time/month) of vaginal douching had 18% (95% CI: −12% to 59%) higher concentrations, and those with frequent use (≥2 time/month) had 81% (95% CI: 2% to 221%) higher concentrations of 1,4-DCB (p for trend = 0.04). Use of feminine powder in the past month was significantly associated with 36% (95% CI: 0.4% to 83%) higher concentrations of ethylbenzene. Conclusions: Our findings suggest that differences in whole blood VOC concentrations might be explained by feminine hygiene practices. The presence of environmental chemicals in FHPs warrants further examination. [ABSTRACT FROM AUTHOR]