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Hum. Reprod. Advance Access published online on June 30, 2004
Human Reproduction, doi:10.1093/humrep/deh381
© 2004 by European Society of Human Reproduction and Embryology
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Received October 14, 2003
Accepted May 24, 2004

Article

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

Maria L.C. Hagemans 1, Yvonne T. van der Schouw 2*, Miriam J.J. de Kleijn 2, Wija A. van Staveren 1, Victor J.M. Pop 3, Geraline L. Leusink 4, Diederick E. Grobbee 2

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

* To whom correspondence should be addressed. E-mail: y.t.vanderschouw{at}umcutrecht.nl.


  Abstract

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.

Keywords: bone mineral density; estrogen; premenopausal; postmenopausal; reproductive factors.
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