ArticleEnvironment international2021
Urinary metals and metal mixtures and timing of natural menopause in midlife women: The Study of Women's Health Across the Nation.
Article in Environment international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Associations between pollutants, the regularity of daily sex hormone patterns, and hormone profiles over a complete menstrual cycle.Reproductive toxicology (Elmsford, N.Y.) · 2026Article
- Body mass index and sleep duration may regulate the effect of heavy metals on age at menopause.BMC public health · 2025Article
- Associations Between Blood Metal Exposure and Hypertriglyceridemia Among Adults in NHANES, 2011-2018.Food science & nutrition · 2025Article
- The risk factors, pathogenesis and treatment of premature ovarian insufficiency.Journal of ovarian research · 2025Review
- Heavy Metals and Trajectories of Anti-Müllerian Hormone During the Menopausal Transition.The Journal of clinical endocrinology and metabolism · 2024Article
- Update of the risk assessment of inorganic arsenic in food.EFSA journal. European Food Safety Authority · 2024Article
- Review
- Exposure to heavy metals and hormone levels in midlife women: The Study of Women's Health Across the Nation (SWAN).Environmental pollution (Barking, Essex : 1987) · 2023Article
- Metals and risk of incident metabolic syndrome in a prospective cohort of midlife women in the United States.Environmental research · 2022Article
- Perfluoroalkyl Substances and Incident Natural Menopause in Midlife Women: The Mediating Role of Sex Hormones.American journal of epidemiology · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundExposure to metals and metal mixtures may influence ovarian aging. However, epidemiologic evidence of their potential impact is lacking.
objectiveWe prospectively examined the associations of 15 urinary metal concentrations and their mixtures with natural menopause in the Study of Women's Health Across the Nation Multi-Pollutant Study.
methodsThe study population consisted of 1082 premenopausal women from multiple racial/ethnic groups, aged 45-56 years at baseline (1999-2000), with the median follow-up of 4.1 years. Urinary concentrations of 15 metals, including arsenic, barium, cadmium, cobalt, cesium, copper, mercury, manganese, molybdenum, nickel, lead, antimony, tin, thallium, and zinc, were measured at baseline. Natural menopause was defined as the final bleeding episode prior to at least 12 months of amenorrhea, not due to surgery or hormone therapy. Cox proportional hazards models were used to examine associations between individual metal concentrations and timing of natural menopause. The associations between metal mixtures and natural menopause were evaluated using elastic net penalized Cox regression, and an environmental risk score (ERS) was computed to represent individual risks of natural menopause related to metal mixtures.
resultsThe median age at natural menopause was 53.2 years. Using the Cox proportional hazards models, the adjusted hazard ratio (HR) (and its 95% confidence interval (CI)) for natural menopause was 1.32 (1.03, 1.67) for arsenic and 1.36 (1.05, 1.76) for lead, comparing the highest with the lowest quartiles of metal concentrations. The predicted ages at natural menopause in the highest and lowest quartiles were 52.7 and 53.5 years for arsenic; and 52.9 and 53.8 years for lead. A significant association between ERS and menopause was also observed. Women in the highest vs. the lowest quartiles of ERS had an HR of 1.71 (1.36, 2.15), equivalent to a 1.6 year earlier median time to natural menopause.
conclusionThis study suggests that arsenic, lead, and metal mixtures are associated with earlier natural menopause, a risk factor for adverse health outcomes in later life.
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