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PubMed2002

Female mate value at a glance: relationship of waist-to-hip ratio to health, fecundity and attractiveness.

A fundamental assumption of adaptive explanations of female attractiveness is that bodily features that males judge as attractive reliably signal youthfulness, healthiness, and fertility or female mate value. One of the bodily features, waist-to-hip ratio (WHR), is a reliable indicator of a female's reproductive age, sex hormone profile, parity and risk for various diseases. Systematic variation in the size of WHR also systematically affects the judgment of female attractiveness, healthiness, and youthfulness. This article summarizes recent findings about the relationship between female's WHR and various factors affecting reproductive capability and risk for diseases. Research on the relationship between attractiveness and WHR is discussed in light of some methodological objections to previous research. Finally, cross-cultural and historical data are presented that suggest that the relationship between WHR and female attractiveness is not culture-specific and not inculcated by modern Western fashion dictates or media.

Body Mass Index↗
PubMed2002

Anaemia in women of reproductive age in Dar-es-Salaam, Tanzania.

BACKGROUND: Anaemia is among the greatest health problems in reproductive age women in developing countries. OBJECTIVES: To estimate the prevalence of anaemia among non-pregnant parous women, and to investigate the main underlying cause for the anaemia. SETTING: A sub-urban Maternal and Child Health Clinic (MCH) in Dar es Salaam. DESIGN: Cross-sectional. METHODS: Consecutive parous non-pregnant women who had brought their children for vaccination and/or had come for family planning to Mbagala MCH clinic were invited to participate in the study. Obstetric and social history was recorded, and their height and weight were checked. Haemoglobin was measured using HemoCue hemoglobinometer. Anaemic women were further investigated to determine the cause of anaemia by haematological and biochemical tests. RESULTS: Five hundred and four parous non-pregnant women were screened, 49% were anaemic (Hb <12 g/dl) and 1.6% severely anaemic (Hb <7 g/dl). Anaemia was not related to socio-demographic and obstetric history characteristics, but decreased significantly with increasing Body Mass Index (BMI) (p=0.042). The prevalence of anaemia was significantly lower in women using hormonal contraceptives, compared to non-users (36% vs 54%) (p=0.04). Eighty-seven percent of the anaemic women were iron deficient and 8.7% had elevated serum C-reactive protein indicating undiagnosed infections. CONCLUSION: Nutritional deficiencies in women have to be corrected before and between pregnancies and all contacts women have with the health system should be utilised for anaemia control interventions, in addition to long-term community approaches. To improve maternal health calls for a broader agenda and a change of approach in the MCH-clinics.

Adolescent↗
PubMed1990

Host heterogeneity in female breast cancer: possible significance for pathophysiology, therapy, and prevention.

Longitudinal studies on human growth have revealed seasonal patterns in the gain of height in 1/3 of the population. Seasonal sensitivity of growth velocity is apparently linked with a lean body structure. This being so, a subgroup with specific biological features could be isolated, including specific endocrine mechanisms (e.g. shorter interval between menarche and menopause, higher incidence of irregular early postmenstrual cycles, and higher concentration of growth hormone secretion) and specific metabolic pathways (more frequent drinking, smoking, and use of the contraceptive pill). This biological specificity may be responsible for behavioral heterogeneity in cancer in general and in breast malignancies in particular. One third of the breast cancer patient population is hormone responsive. The response to all the methods of cancer adjuvant therapy (including ablation of hormone producing organs, chemotherapy, and immunologic manipulation) used up till now does not surpass 33% in the long run. Breast cancer risk reduction by 1/3 due to full-term teenage pregnancies suggests that this may be a consequence of the interruption of a premalignant process initiated in women of the aforementioned subgroup. Simulation of early pregnancy might therefore lead to prevention of breast cancer in women who had seasonal growth patterns as children.

Adult↗
PubMed2006

Several anthropometric measurements and breast cancer risk: results of the E3N cohort study.

OBJECTIVE: To investigate the association between various anthropometric characteristics and breast cancer. DESIGN: Longitudinal prospective cohort study. Follow-up between 1995 and 2000. SUBJECTS: In total, 69 116 women (age: 45-70 years; mean follow-up: 3.6 years), 275 premenopausal and 860 postmenopausal incident invasive breast cancers. MEASUREMENTS: Self-reported height, weight, breast, thorax, waist and hip circumferences and calculated body mass index (BMI) and waist-to-hip ratio (WHR) at baseline. RESULTS: A slight increase in risk with increasing height was found. Weight, BMI, thorax and waist circumferences and WHR were negatively related to breast cancer risk among premenopausal women. The relationships became non significant after additional adjustment for BMI. An increased risk of premenopausal breast cancer with an android body shape (WHR>0.87) might possibly be confined to obese women. Among postmenopausal women, all anthropometric measurements of corpulence were positively associated with breast cancer risk but became non significant after additional adjustment for BMI. No difference in risk of postmenopausal breast cancer according to HRT use was observed. CONCLUSION: The study confirmed that adiposity was negatively associated to premenopausal breast cancer risk and positively associated to postmenopausal breast cancer risk. Further studies will be needed to specify clearly the association between WHR and breast cancer risk, particularly before menopause.

Adiposity↗
PubMed1993

Reproductive axis suppression in acute illness is related to disease severity.

Changes in the adrenal and thyroid axes in critically ill patients are accentuated by increasing disease severity. However, the relationship of gonadal axis suppression to severity of illness is not well defined. We evaluated serial serum levels of LH, FSH, and testosterone (T) in 59 men and 42 postmenopausal women admitted to critical care units with a spectrum of disease severity. Patients were grouped according to severity of illness by the Acute Physiologic and Chronic Health Evaluation II (APACHE II) scores and by survival. Patients with surgery, renal or hepatic failure, alcohol abuse, endocrine disease, or head trauma were excluded to avoid these confounding factors. In men, mean admission serum T levels in all groups were lower than in healthy controls (P < 0.005). In addition, T levels in men with severe illness (APACHE > 15) were lower than in men with relatively mild (APACHE < 10; P < 0.01) or moderate illness (APACHE 10-15; P < 0.05). These differences were accentuated as hospitalization progressed. In postmenopausal women and men, nadir serum FSH but not LH levels during hospitalization were lower in patients with APACHE greater than 15 than in patients with APACHE scores of 10-15 or less than 15 (P < 0.05). Grouping patients by survival yielded similar results. Analysis of drug effects, age, and PRL did not explain these relationships. We conclude that the degree of both central and peripheral suppression of the reproductive axis in acute illness is related to disease severity. This suppression could not be attributed to other factors known to alter the reproductive axis independently from critical illness (e.g. age, drugs, head trauma, hepatic failure, etc.). These findings further document a general endocrine response to acute illness involving several axes which is graded according to disease severity.

Acute Disease↗
PubMedDate not supplied

Sperm-peritoneal fluid incubation test: influence of a GnRH agonist treatment.

Objectives of our work were to determine whether the presence of endometriosis, stage and the activity of the disease influence the sperm-peritoneal fluid (PF) incubation test and, possibly, whether a GnRH agonist (GnRHa) treatment in these patients can reduce the PF toxicity toward sperms. Preovulatory PFs from 18 patients with endometriosis (11 stage I-II rAFS and/stage III-IV; 10 with active lesions and 8 with inactive disease), and from 15 women with unexplained infertility were collected and frozen at the time of diagnostic laparoscopy. The ten patients with active endometriosis were treated by 3 months ovarian desensitization by a GnRH a (Decapeptyl 3.75 mg, Ipsen, Milan Italy) followed by a controlled ovarian hyperstimulation with a purified FSH (Metrodin, Serono, Rome, Italy) and HCG 10.000 UI (Profasi, Serono) when appropriate. In these patients, immediately before performing intrauterine and/or intraperitoneal insemination, a small aliquot of PF was collected transvaginally checking the absence of oocytes. Five hundreds suspension for one hour. PFs inducing a decrease in sperm motility greater than 20% were defined "toxic". The prevalence of toxic PF was not statistically greater in endometriosis (8/18) than in unexplained infertility (3/15) and was not dependent upon the stage of the disease, while it was significantly (rho = 0.01) more frequent in patients with active endometriosis (7/10) than other women (4/23). After a three months GnRHa treatment of these patients the rate of toxic PFs was significantly (p = 0.02) decreased (1 out of 10 treated cases).(ABSTRACT TRUNCATED AT 250 WORDS)

Ascitic Fluid↗
PubMed1995

Relation of body fat distribution to reproductive factors in pre- and postmenopausal women.

The cross-sectional relations of several reproductive characteristics with self-reported waist-to-hip circumference ratio were evaluated in 44,487 pre- and postmenopausal women 40 to 65 years of age who were free of cancer, cardiovascular disease, and diabetes. All results were adjusted for age, body mass index, cigarette smoking, physical activity, and alcohol intake. Current use of postmenopausal hormones was associated with a significantly lower waist-to-hip ratio than either past or never use independent of type of menopause (0.778 versus 0.784, p = 0.0001 and 0.787, p = 0.0001, respectively), although associations with type (unopposed estrogens versus combined estrogen and progesterone) and duration of hormone therapy were not noted. Waist-to-hip ratio did not differ between pre- and postmenopausal women, but demonstrated weak positive associations with age at menarche, parity, and age at first birth, and a weak inverse association with past duration of breast-feeding. These data confirm relations of several reproductive factors and use of hormone replacement therapy with body fat distribution. Epidemiologic studies relating body fat distribution to disease outcomes in women should consider these factors as potential confounders.

Adipose Tissue↗
PubMed2005

Cutaneous malignant melanoma in women. Phenotypic characteristics, sun exposure, and hormonal factors: a case-control study from Italy.

PURPOSE: We examined the role of personal host characteristics in relation to cutaneous malignant melanoma (CMM) among women, with a particular focus on hormonal and reproductive factors. METHODS: A case-control study conducted in Italy between 1992 and 1994, including 316 women with incident, histologically confirmed CMM and 308 controls, admitted to the same network of hospitals as cases for acute, non-dermatological, and non-neoplastic conditions. RESULTS: CMM was significantly associated with body mass index (kg/m(2)) (odds ratio [OR]=1.96 for > or =27 compared with < 23) and body surface area (m(2)) (OR=1.68 for > or =1.71 compared with < 1.59), eye color (OR=1.74 for green/hazel compared with brown), solar lentigines (OR=1.47), and number of melanocytic nevi (OR=3.39 for total number of nevi > or =16 compared with < 5). Age at first (OR=2.69 for > or =27 compared with < 23 years) and last birth (OR=2.13 for > or =31 compared with < 27 years) were associated with the risk of CMM, whereas other reproductive, menstrual, and hormonal factors, including menopause, number of live-births and abortions, use of oral contraceptives, and hormone replacement therapy were not significantly associated. CONCLUSIONS: Our results confirm findings from previous studies on the role of major recognized risk factors for CMM, and add further evidence of an absence of a consistent association between hormonal and reproductive factors and CMM risk.

Adult↗
PubMed2003

Leptin and soluble leptin receptor in follicular fluid.

PURPOSE: Previous studies suggest that follicular fluid leptin levels predict successful assisted reproduction. The relationship between intrafollicular leptin and the soluble leptin receptor, ovarian hormones, and oocyte quality was examined to determine potential factors contributing to this finding. METHODS: Follicular fluid leptin, soluble leptin receptor, hormones, and oocyte quality were examined in 84 individual follicles from 30 women undergoing in vitro fertilization. RESULTS: Follicular fluid leptin and soluble leptin receptor levels correlated inversely with each other (r = -0.354; p = 0.001). Follicular fluid leptin levels correlated with intrafollicular estradiol (r = 0.42; p < 0.001), progesterone (r = 0.48; p < 0.001), and androstenedione (r = 0.49; p < 0.001), whereas soluble leptin receptor levels correlated with activin (r = 0.38; p < 0.001) and follistatin (r = 0.35; p < 0.002). There was no relationship between follicular fluid leptin or soluble leptin receptor levels and pretreatment serum hormone levels, stimulated serum estradiol, follicle number, oocyte quality, fertilization, or embryo grade. CONCLUSION: The data demonstrate that leptin and the soluble leptin receptor are highly interrelated with each other and with other intrafollicular hormones, but not with markers of oocyte quality, fertilization, or embryo grade.

Body Mass Index↗
PubMed1994

Correlation of cervical cancer mortality with reproductive and dietary factors, and serum markers in China.

BACKGROUND: Cervical cancer is the second leading cause of cancer death among Chinese women. Within China, a considerable geographical variation in mortality rates has been observed, but the reasons are not well understood. METHODS: Cervical cancer rates were examined in relation to indices of reproductive factors, dietary habits, and selected serum biomedical markers in 65 rural Chinese counties. RESULTS: Cervical cancer mortality rates correlated positively and significantly with antibodies to herpes simplex virus type 2 (HSV-2) (r = 0.40, P < 0.01), serum levels of ferritin (r = 0.33, P < 0.01), body mass index (BMI) (r = 0.42, P < 0.01) and cigarette smoking (r = 0.51, P < 0.05) and negatively and significantly with age at first birth (r = -0.51, P < 0.01), consumption of green vegetables (r = -0.40, P < 0.01) and animal foods (r = -0.40, P < 0.01), and serum levels of selenium (r = -0.26, P < 0.05). When these variables were considered in the multiple regression analysis, early age at first birth and higher BMI were positively associated with cervical cancer mortality, while consumption of green vegetables and animal foods were negatively correlated. In the serum model, infection with HSV-2 and low levels of sex hormone binding globulin (SHBG) were positively related to cervical cancer mortality. No relation was found for consumption of fruits. CONCLUSIONS: Although limitations of these ecologic data preclude causal inferences, findings in this study, including associations with HSV-2 infection, early age at first birth, consumption of green vegetables and animal foods, may provide clues to cervical cancer aetiology.

Adult↗
PubMed2001

Risk factors for uterine leiomyoma: a practice-based case-control study. I. African-American heritage, reproductive history, body size, and smoking.

The authors conducted a case-control study among premenopausal women in the Baltimore, Maryland, area to examine the associations of uterine leiomyoma with ethnicity and hormone-related characteristics. Cases of uterine leiomyoma (n = 318) were surgically or sonographically first confirmed between January 1990 and June 1993. A total of 394 controls were selected from women who were visiting their gynecologist for a routine checkup. Data were collected through telephone interviews and abstraction of medical records; 77.8% of eligible cases and 78.0% of eligible controls were interviewed. Positive adjusted associations were observed between risk of uterine leiomyoma and self-described African-American ethnicity (vs. Whites: odds ratio (OR) = 9.4; 95% confidence interval (CI): 5.7, 15.7), early menarche (<11 years vs. >13 years: OR = 2.4; 95% CI: 1.1, 5.6), and high body mass index (upper quartile vs. lower quartile: OR = 2.3; 95% CI: 1.4, 3.8). Inverse associations were observed with use of oral contraceptives (current use vs. never use: OR = 0.2, 95% CI: 0.1, 0.6) and duration of smoking (> or =19 years vs. never: OR = 0.6; 95% CI: 0.4, 1.1). Younger ages at infertility diagnosis and at first and last childbirth were more common among cases; however, analyses of data on tumor location suggested that these associations represent predominantly consequences of uterine leiomyoma. These results suggest that development of uterine leiomyoma is associated with increased exposure to ovarian hormones. Possible reasons for the very elevated risk among African-American women need further investigation.

Adolescent↗
PubMed2000

Rapid maturation of the reproductive axis during perimenarche independent of body composition.

The development of the reproductive axis is thought to be a gradual process, but our understanding of the complex endocrine changes that accompany the transition from premenarche to reproductive life in women has been hampered by the paucity of longitudinal studies. We studied 112 premenarchal Caucasian females at 6-month intervals over 4 yr and obtained a detailed reproductive and dietary history. We quantified reproductive hormones in 24-h urine collections as a measure of daily output and measured body composition biometrically and with the use of dual energy x-ray absortiometry scans. The percent body fat did not change appreciably in the study period (range, 21-24%) and was unrelated to menarche. Sex steroid and gonadotropin levels changed exponentially in the year approaching menarche. FSH levels peaked at menarche and then progressively declined thereafter. Estradiol output increased rapidly in the year approaching menarche and then plateaued thereafter. The frequency of menstrual bleeding increased rapidly and plateaued at 1 yr postmenarche. At 1 yr, 65% of these adolescent women had established a pattern of 10 or more menstrual episodes/yr, and by 3 yr postmenarche this figure exceeded 90%. There were no significant changes in dietary intake of protein, carbohydrate, or fat in the same period. Menarche occurs as a result of rapid maturation of the reproductive axis and heralds the reestablishment of a negative sex steroid feedback loop that parallels the adult threshold. These events appear to develop independent of changes in body composition and diet, but may reflect the improved nutrition and socioeconomic status of the late 20th century.

Adipose Tissue↗
PubMedDate not supplied

Reproductive life of Bhoksa women.

The paper discusses the reproductive life of 111 ever-married Bhoksa women. The mean age at marriage for women of all ages among Bhoksas, like other tribal populations, is high, unlike the caste populations. The mean ages at first birth of the pooled sample and of the completed fertility cases suggest late and early marriages of the older and younger generations. The maximum number of marriages occur between 15 and 19 years and of first births between 16 and 20 years. Percentage of reproductive wastage is high in both the lower and higher age groups. Young mothers with low birth orders and older mothers with high birth orders display a high frequency of reproductive wastage. Evidently, both birth order and the age of the mother have effects on reproductive wastage. Average number of children ever born (including stillbirth but not abortion or miscarriage) per mother of all ages is the highest among Bhoksas of all the studied ethnic groups of India. The Bhoksa, like caste populations, show a high number of children ever born per mother of completed fertility. Quite a high masculinity in the secondary sex ratio, like other mongoloid population is noticed. The contribution of mortality component to the Total Index of Opportunity for Selection is more than that of the fertility component. Bhoksas conform to the general low range of net reproductive index, which is however greater than unity, suggesting that they are in a growth stage.

Age Factors↗
PubMed2006

High tea consumption diminishes salivary 17beta-estradiol concentration in Polish women.

We hypothesized that among reproductive-age women consuming large quantities of tea, the production of estradiol would be suppressed. It has been shown that catechins and theaflavines, the major constituents of tea, inhibit aromatase, an enzyme which catalyses the conversion of androgens to oestrogens. Our study included Polish women living in urban (n 61) and rural (n 48) areas. Women collected daily saliva samples for one complete menstrual cycle and filled out dietary questionnaires. Saliva samples were analysed by RIA for concentration of 17beta-estradiol (E2). Women with high (above the median) average daily consumption of black tea had reduced levels of salivary E2 in comparison with women who drank less black tea (below the median). This effect was observed within the whole study group, as well as separately within urban (P=0.0006) and rural (P=0.013) groups. High intake of the sum of subclasses of tea catechins and epigallocatechin gallate, assessed using the United States Department of Agriculture database (http://www.nal.usda.gov), was also associated with lower concentrations of E2 within all women (P=0.01 and P=0.0001, respectively) and within the urban group (P=0.0001 and P=0.004, respectively). Similar relationships were observed between the sum of subclasses of theaflavines and thearubigines and E2 levels for the whole group (P=0.002) and for urban women (P=0.02). Women with high consumption of tea had lower levels of E2 concentration throughout the entire menstrual cycle. These results may have implications for reducing hormone-related cancer risk by a relatively easy dietary intervention.

Adult↗
PubMed2002

Long term follow-up of patients with polycystic ovarian syndrome after laparoscopic ovarian drilling: clinical outcome.

BACKGROUND: Currently, there is an uncertainty about the impact of laparoscopic ovarian drilling (LOD) on the natural history of polycystic ovarian syndrome (PCOS). This longitudinal follow-up study was undertaken to investigate the long-term effects of LOD. METHODS: The study included 116 anovulatory PCOS women who underwent LOD between 1991 and 1999 (study group) and 34 anovulatory PCOS women diagnosed during the same period but who had not undergone LOD (comparison group). The hospital records were reviewed and questionnaires were sent to all the women. In addition, most women attended a follow-up interview. Clinical data recorded at different intervals of follow-up (short-term, <1 year; medium-term, 1-3 years; and long-term, 4-9 years) included: the menstrual pattern, symptoms relating to hyperandrogenaemia and reproductive history. RESULTS: The proportion of women with regular menstrual cycles increased significantly [relative risk (RR) = 1.6, 95% confidence interval (CI) = 1.4-1.9, P < 0.05] from 8% before LOD to 67% post-operatively. The proportion dropped to 37% (RR = 2.6, 95% CI = 1.8-3.8, P < 0.01) at medium-term follow-up and then increased again to 55% (RR = 2.2, 95% CI = 1.7-2.8, P < 0.01) at long-term follow-up. After LOD, 54/110 women (49%) conceived spontaneously during the first year and 42 (38%) during medium- and long-term follow-up. Among women with hirsutism (n = 43) and acne (n = 25), 10 (23%) and 10 (40%) respectively experienced long-term improvement after LOD. CONCLUSION: LOD produces long-term improvement in menstrual regularity and reproductive performance in about one-third of cases. A modest and sustained improvement in acne and hirsutism can be expected in approximately 40 and approximately 25% of patients respectively.

Acne Vulgaris↗
PubMed1996

Reproductive history in relation to relative weight and fat distribution.

OBJECTIVE: To investigate the relationship between reproductive history and body composition. DESIGN: Prospective population study in Sweden. SUBJECTS: 1462 randomly selected women representing five separate age cohorts (38, 46, 50, 54 and 60 at the 1968-1969 baseline examination) have been followed longitudinally. MEASUREMENTS: Relative weight, fat distribution, and fat cellularity were related to menarche, parity, lactation, menopause and oestrogen medication. RESULTS: Age of menarche did not show any association with subsequent fat distribution, nor did length of lactation time. On the other hand parity was positively associated to total as well as central obesity, and lactation time was positively associated to abdominal fat cell diameter. Premenopausal women showed higher mean body weight and hip circumference than postmenopausal women of the same age. Change from pre- to postmenopausal status was associated with increase of waist circumference as well as reduction of hip circumference, resulting in an increased waist-hip ratio (WHR). Oestrogen replacement suggested some postponement of this increase. CONCLUSION: Parity and menopause are the reproductive factors most associated with gradual changes in body fat distribution. Oestrogen medication seems to play an additional role in diminishing waist circumference increase and could thus contribute to decreased cardiovascular morbidity in women.

Adipose Tissue↗
PubMed2006

Longitudinal follow-up of reproductive and metabolic features of valproate-associated polycystic ovarian syndrome features: A preliminary report.

BACKGROUND: In the Systematic Treatment Enhancement Program for Bipolar Disorder, we showed that valproate is associated with new-onset menstrual-cycle irregularities and hyperandrogenism in 10.5% of 86 women. We now determine whether polycystic ovarian syndrome (PCOS) features reverse on valproate discontinutation. METHODS: Women with valproate-associated PCOS and those at risk for PCOS (valproate use < or =6 months) were re-evaluated for PCOS. RESULTS: Follow-up (mean 17 months) assessments were completed in 14 women (5 with treatment-emergent PCOS, 9 on valproate < or =6-month). Of seven women who developed valproate-associated PCOS, PCOS reproductive features remitted in three of four discontinuing valproate and persisted in all 3 continuing valproate. Menstrual-cycle irregularities improved among valproate-discontinuers whose PCOS features remitted (p = 0.01). There was a trend toward lower serum testosterone (p = 0.06). Body-weight and polycystic ovarian morphology did not change. CONCLUSIONS: In the first longitudinal bipolar-disorder study of valproate-associated PCOS, most valproate-discontinuers had improved reproductive features of PCOS despite static body-weight.

Adolescent↗