Age at natural menopause in women exposed to diethylstilbestrol in utero.
A recent analysis of data from questionnaires returned by the participants in the DES Follow-up Study suggests that exposed daughters tend to have a slightly earlier age at natural menopause than unexposed daughters (Hatch EE et al, Age at Natural Menopause in Women Exposed to Diethylstilbestrol in Utero, American Journal of Epidemiology, October 1, 2006). The researchers analyzed data on over 4210 exposed daughters and 1829 unexposed daughters, and accounted for other factors that could be related to the age at natural menopause, such as cigarette smoking, hormone use, pregnancy history, and the age of the mother’s menopause. The average age at menopause was 52.2 years in unexposed women and 51.5 years in DES-exposed women, equivalent to about a nine month earlier menopause. Women who had been exposed to higher cumulative doses of DES tended to have menopause even earlier than those who had lower doses. Although this relatively small difference in age at menopause should not be related to any major health problems among the DES daughters, it does highlight the fact that DES seems to have health effects across the lifespan, especially in the reproductive tract. In general, menopause is thought to occur when the number of ovarian follicles left in the ovaries reaches a ‘critical’ level, therefore it is possible that DES daughters may have been born with a smaller reserve of follicles than unexposed women.