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Hum. Reprod. Advance Access originally published online on June 30, 2004
Human Reproduction 2004 19(9):2163-2169; doi:10.1093/humrep/deh381
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Human Reproduction vol. 19 no. 9 © European Society of Human Reproduction and Embryology 2004; all rights reserved

Indicators for the total duration of premenopausal endogenous estrogen exposure in relation to BMD

Maria L.C. Hagemans1,2, Yvonne T. van der Schouw1,5, Miriam J.J. de Kleijn1, Wija A. van Staveren1,2, Victor J.M. Pop3, Geraline L. Leusink4 and Diederick E. Grobbee1

1 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Room D 01.335, PO Box 85500, 3508 GA Utrecht, The Netherlands, 2 Division of Human Nutrition and Epidemiology, Wageningen University, PO Box 8129, 6700 EV Wageningen, The Netherlands, 3 Department of Clinical Health Psychology, University of Tilburg, PO Box 90153, 5000 LE Tilburg, The Netherlands and 4 Diagnostic Centre Eindhoven, Stratumse Dijk 28a, 5611 NE Eindhoven, The Netherlands

5 To whom correspondence should be addressed at: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, HP D01.335, PO Box 85500, 3508 GA Utrecht, The Netherlands. Tel: +31 30 250 9360; Fax: +31 30 250 5485; Email: y.t.vanderschouw{at}umcutrecht.nl

BACKGROUND: Previous studies have shown that age at menopause is an important indicator of duration of endogenous estrogen exposure. The present study investigates whether combining more information on reproductive factors is useful in estimating individual total duration of exposure to endogenous estrogens. METHODS: Bone mineral density (BMD) was used as operational outcome. The study population consisted of 3476 white women living in Eindhoven, The Netherlands, aged 46–57 years, either pre- (n=2420) or postmenopausal (n=1056). BMD of the lumbar spine was measured by dual X-ray absorptiometry. Information on reproductive factors was obtained with questionnaires. RESULTS: The number of reproductive years explained 4.8% of the variance in BMD, while age at menopause alone accounted for 3.6%. Duration of lactation or oral contraceptive use did not add to the proportion of variance explained. The effect of reproductive years on BMD was stronger in older women. No significant associations with BMD were found for other reproductive variables. The number of miscarriages in premenopausal women ({beta}=0.00760, SE = 0.00357, P=0.03) explained only 0.16% of the variance in BMD. CONCLUSIONS: We conclude that it is not necessary to use more reproductive factors besides age at menopause and menarche in determining total duration of endogenous estrogen exposure.

Key words: bone mineral density/estrogen/premenopausal/postmenopausal/reproductive factors


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