Relationship between arsenic skin lesions and the age of natural menopause.

Fakir Md Yunus,Samar Kumar Hore,Musarrat Jabeen Rahman,Mahfuzar Rahman,Md Zahidul Alam

doi:10.1186/1471-2458-14-419

Abstract

BackgroundChronic exposure to arsenic is associated with neoplastic, cardiovascular, endocrine, neuro-developmental disorders and can have an adverse effect on women’s reproductive health outcomes. This study examined the relationship between arsenic skin lesions (a hallmark sign of chronic arsenic poisoning) and age of natural menopause (final menopausal period) in populations with high levels of arsenic exposure in Bangladesh.MethodsWe compared menopausal age in two groups of women – with and without arsenic skin lesions; and presence of arsenic skin lesions was used as an indicator for chronic arsenic exposure. In a cross-sectional study, a total of 210 participants were randomly identified from two ongoing studies— participants with arsenic skin lesions were identified from an ongoing clinical trial and participants with no arsenic skin lesions were identified from an ongoing cohort study. Mean age of menopause between these two groups were calculated and compared. Multivariable linear regression was used to estimate the relationship between the status of the arsenic skin lesions and age of natural menopause in women.ResultsWomen with arsenic skin lesions were 1.5 years younger (p <0.001) at the time of menopause compared to those without arsenic skin lesions. After adjusting with contraceptive use, body mass index, urinary arsenic level and family history of premature menopause, the difference between the groups’ age at menopause was 2.1 years earlier (p <0.001) for respondents with arsenic skin lesions.ConclusionsThe study showed a statistically significant association between chronic exposure to arsenic and age at menopause. Heavily exposed women experienced menopause two years earlier than those with lower or no exposure.

Highlights

Chronic exposure to arsenic is associated with neoplastic, cardiovascular, endocrine, neuro-developmental disorders and can have an adverse effect on women’s reproductive health outcomes
Previous studies reported the effect of chronic arsenic exposure on reproductive health outcomes in women and noted significant association with adverse pregnancy outcomes such as spontaneous abortion, stillbirth and preterm births
We assessed the relationship of chronic arsenic exposure and the natural menopausal age in rural Bangladesh

Summary

Introduction

Chronic exposure to arsenic is associated with neoplastic, cardiovascular, endocrine, neuro-developmental disorders and can have an adverse effect on women’s reproductive health outcomes. Previous studies reported the effect of chronic arsenic exposure on reproductive health outcomes in women and noted significant association with adverse pregnancy outcomes such as spontaneous abortion, stillbirth and preterm births. Other study identified chronic arsenic exposure a female reproductive toxicant, and as an endocrine disruptor, considered as a major threat for female reproductive health. In animal (rat) experiments, arsenic toxicity deprives oestrogen receptors [15] resulting in interrupted normal activity of organs such as uterine lining, skin, breast tissue, etc. Oestrogen is responsible for the onset of menstruation in adolescents; gradual deprivation of receptor eventually results early menopause [16]. Another study suggested that arsenic causes delayed menarche [17]

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Conclusion