Bae Jinju, Park Susan, Kwon Jin-Won
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, 80 Daehak-ro, Daegu, 41566, South Korea.
BMC Womens Health. 2018 Feb 6;18(1):36. doi: 10.1186/s12905-018-0528-x.
A regular menstrual cycle is an important indicator of a healthy reproductive system. Previous studies reported obesity, stress, and smoking as the factors that are associated with irregular menstruation and early menopause. However, the integrative effects of these modifiable risk factors have not been fully understood. This study aimed to investigate the modifiable risk factors of menstrual cycle irregularity and premature menopause, as well as their individual and combined effects among adult women in Korea.
This study selected adult women aged 19 years and above who had been included in the 2007-2014 Korean National Health and Nutrition Examination Survey. We used a separate dataset to analyze the risk factors of menstrual cycle irregularity and menopause (pre- and postmenopausal women: n = 4788 and n = 10,697, respectively). Univariate and multiple logistic regression analyses were conducted to evaluate the effects of smoking, drinking, obesity, and perceived level of stress on the menstrual cycle and menopause. Both logit and linear models were used in the analyses of the association between smoking and menopausal age. Equivalized household income, marital status, and educational level were considered as covariates. The modifiable risk factor scores were also calculated to integrate the effect of smoking, drinking, and obesity in the analysis.
Results showed that smoking status, pack-year, obesity, and perceived level of stress were significantly associated with irregular menstruation among premenopausal women. Especially, women demonstrating > 3 modifiable risk factor scores had 1.7 times higher risk of having irregular menstruation than those who had a 0 score. Meanwhile, early initiation of smoking (≤19 years) and high pack-year (≥5) were also significantly associated with premature menopause among postmenopausal women.
This study demonstrated that modifiable risk factors, such as smoking, obesity, and stress, were significantly associated with menstrual cycle irregularity. Lifetime smoking was also correlated with early menopause. Our results suggested that healthier lifestyle practices, including, cessation of smoking, weight control, and stress management, were important factors in improving the reproductive health of women throughout life.
规律的月经周期是生殖系统健康的重要指标。以往研究报告称，肥胖、压力和吸烟是与月经不规律和过早绝经相关的因素。然而，这些可改变的风险因素的综合影响尚未得到充分理解。本研究旨在调查韩国成年女性月经周期不规律和过早绝经的可改变风险因素，以及它们的个体和综合影响。
本研究选取了2007 - 2014年韩国国家健康与营养检查调查中纳入的19岁及以上成年女性。我们使用单独的数据集分析月经周期不规律和绝经（绝经前和绝经后女性：分别为n = 4788和n = 10697）的风险因素。进行单因素和多因素逻辑回归分析，以评估吸烟、饮酒、肥胖和感知压力水平对月经周期和绝经的影响。在分析吸烟与绝经年龄之间的关联时，使用了对数线性模型和线性模型。等效家庭收入、婚姻状况和教育水平被视为协变量。还计算了可改变风险因素得分，以在分析中综合吸烟、饮酒和肥胖的影响。
结果显示，吸烟状况、吸烟包年数、肥胖和感知压力水平与绝经前女性月经不规律显著相关。特别是，显示有超过3个可改变风险因素得分的女性月经不规律的风险是得0分女性的1.7倍。同时，吸烟起始年龄早（≤19岁）和吸烟包年数高（≥5）也与绝经后女性过早绝经显著相关。
本研究表明，吸烟、肥胖和压力等可改变风险因素与月经周期不规律显著相关。终生吸烟也与过早绝经相关。我们的结果表明，更健康的生活方式，包括戒烟、体重控制和压力管理，是改善女性一生生殖健康的重要因素。
