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Purpose: To compare sexual functioning from diagnosis to 5 years post diagnosis among breast cancer survivors (BCS) and women without cancer (controls). Patients and Methods: Analyses included 118 BCS and 1765 controls from 20 years of the longitudinal Study of Women's Health Across the Nation (SWAN), a multiracial/ethnic cohort of mid‐life women assessed approximately annually from 1995 to 2015. Pink SWAN participants reported no cancer at SWAN enrollment and developed (BCS) or did not develop (controls) incident breast cancer after enrollment. Outcomes included: being sexually active or not, intercourse frequency, sexual desire, vaginal dryness, and pain with intercourse. Using longitudinal logistic regression, we compared BCS and controls on prevalence of sexual functioning outcomes with respect to years since diagnosis. In addition, we examined whether menopause transition stage, depressive symptoms, relationship satisfaction, vaginal dryness, or pain with intercourse modified the relation between breast cancer and sexual functioning outcomes. Results: Adjusting for partner status, both BCS and controls reported similar declines over time in being sexually active, sexual intercourse frequency, and sexual desire. Among sexually active women, more BCS than controls consistently reported vaginal dryness with significant differences between 2 and 4 years post‐diagnosis, and pain with intercourse, with statistically significant differences between 0.5 years post‐diagnosis to 2 years post‐diagnosis. Being post‐menopausal and reporting depressive symptoms were significant effect modifiers for pain with intercourse with both variables having positive and stronger associations with pain among the controls than among BCS. Conclusion: Except for more reporting of vaginal dryness and pain with intercourse among BCS, negative changes in sexual function during mid‐life were similar in those with and without breast cancer. [ABSTRACT FROM AUTHOR]

BACKGROUND: Germline mutations in BRCA1 and BRCA2 ( BRCA1/2) are related to an increased lifetime risk of developing breast and ovarian cancer. Although risk-reducing salpingo-oophorectomy reduces the risk of both cancers, loss of fertility is a major concern. A recent study suggested an association between BRCA1 mutation and occult primary ovarian insufficiency. The objective of the current study was to determine whether BRCA1/2 mutation carriers have an earlier onset of natural menopause compared with unaffected women. METHODS: White carriers of the BRCA1/2 gene (n = 382) were identified within the Breast Cancer Risk Program Registry at the University of California at San Francisco and compared with non-clinic-based white women in northern California (n = 765). The 2 groups were compared with regard to median age at the time of natural menopause before and after adjustment for known risk factors, and the role of smoking within each group was examined using the Kaplan-Meier approach for unadjusted analyses and Cox proportional hazards regression analyses for adjusted analyses. RESULTS: The median age at the time of natural menopause in the BRCA1/2 carriers was significantly younger than among the unaffected sample (50 years vs 53 years; P < .001). The unadjusted hazard ratio for natural menopause when comparing BRCA1/2 carriers with unaffected women was 4.06 (95% confidence interval, 3.03-5.45) and was 3.98 (95% confidence interval, 2.87-5.53) after adjusting for smoking, parity, and oral contraceptive use. For BRCA1/2 carriers who were current heavy smokers (smoking ≥ 20 cigarettes/day), the median age at natural menopause was 46 years versus 49 years for nonsmokers ( P = .027). CONCLUSIONS: The BRCA1/ 2 mutation was associated with a significantly earlier age at natural menopause, and heavy smoking compounded this risk. Because the relationship between menopause and the end of natural fertility is considered to be fixed, these findings suggest the risk of earlier infertility among BRCA1/ 2 carriers. Cancer 2013. © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

Objective: Short sleep duration has been associated with higher current BMI and subsequent weight gain. However, most prior longitudinal studies are limited by reliance on self-reported sleep duration, and none accounted for the potential confounding effect of sleep-disordered breathing. The associations of sleep duration with current BMI and BMI change were examined among 310 midlife women in the Study of Women's Health Across the Nation (SWAN) Sleep Study (2003-2005). Methods: Sleep duration was assessed for approximately one month with concurrent wrist actigraphy and sleep diaries. The presence and severity of sleep-disordered breathing was quantified using the apnea-hypopnea index (AHI) based on in-home polysomnography. BMI was assessed annually through core SWAN visit 10 (2006 and 2008). Results: Mean BMI increased from 29.6 (SD = 7.8) kg/m2 to 30.0 (SD = 8.0) kg/m2 over an average of 4.6 years (SD = 1.0) of follow-up. In cross-sectional analyses controlling for AHI, demographic variables, and several potential confounding variables, actigraphy (estimate = -1.22, 95% confidence interval (CI): -2.03, -0.42) and diary (estimate = -0.86, 95% CI -1.62, -0.09) measures of sleep duration were inversely associated with BMI. Each hour of less sleep was associated with 1.22 kg/m2 greater BMI for actigraphy sleep duration, and a 0.86 kg/m2 greater BMI for diary sleep duration. Longitudinal associations between sleep duration and annual BMI change were nonsignificant in unadjusted and fully adjusted models. Conclusion: In this cohort of midlife women, cross-sectional associations between sleep duration and current BMI were independent of sleep-disordered breathing, but sleep duration was not prospectively associated with weight change. [ABSTRACT FROM AUTHOR]

The metabolic syndrome (MetS) is associated with an increase in breast cancer risk. In our study, we evaluated whether the MetS was associated with an increase in percent mammographic density (MD), a breast cancer risk factor. We used linear regression and mixed models to examine the cross-sectional and longitudinal associations of the MetS and components of the MetS to percent MD in 790 premenopausal and early perimenopausal women enrolled in the Study of Women's Health Across the Nation (SWAN). In cross-sectional analyses adjusted for body mass index (BMI), modest inverse associations were observed between percent MD and the MetS [β = −2.5, standard error (SE) = 1.9, p = 0.19], abdominal adiposity (β = −4.8, SE = 1.9, p = 0.01) and raised glucose (β = −3.7, SE = 2.4, p = 0.12). In longitudinal models adjusted for covariates including age and BMI, abdominal adiposity (β = 0.34, SE = 0.17, p = 0.05) was significantly positively associated with slower annual decline in percent MD with time. In conclusion, our results do not support the hypothesis that the MetS increases breast cancer risk via a mechanism reflected by an increase in percent MD. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the longitudinal association between menopausal vasomotor symptoms (VMS) and urinary N-telopeptide level (NTX) according to menopausal stage. We analyzed data from 2283 participants of the Study of Women's Health Across the Nation, a longitudinal community-based cohort study of women aged 42 to 52 years at baseline. At baseline and annually through follow-up visit 8, participants provided questionnaire data, urine samples, serum samples, and anthropometric measurements. Using multivariable repeated-measures mixed models, we examined associations between annually assessed VMS frequency and annual NTX measurements. Our results show that mean adjusted NTX was 1.94 nM of bone collagen equivalents (BCE)/mM of creatinine higher among early perimenopausal women with any VMS than among early perimenopausal women with no VMS ( p < .0001). Mean adjusted NTX was 2.44 nM BCE/mM of creatinine higher among late perimenopausal women with any VMS than among late perimenopausal women with no VMS ( p = .03). Among premenopausal women, VMS frequency was not significantly associated with NTX level. When NTX values among women with frequent VMS (≥6 days in past 2 weeks) were expressed as percentages of NTX values among women without frequent VMS, the differences were 3% for premenopausal women, 9% for early perimenopausal women, 7% for late perimenopausal women, and 4% for postmenopausal women. Adjustment for serum follicle-stimulating hormone (FSH) level greatly reduced the magnitudes of associations between VMS and NTX level. We conclude that among early perimenopausal and late perimenopausal women, those with VMS had higher bone turnover than those without VMS. Prior to the final menstrual period, VMS may be a marker for risk of adverse bone health. © 2011 American Society for Bone and Mineral Research. [ABSTRACT FROM AUTHOR]

Background: Health-related quality of life has been hypothesized to predict time to additional breast cancer events and all-cause mortality in breast cancer survivors. Methods: Women with early-stage breast cancer ( n=2967) completed the SF-36 (mental and physical health-related quality of life) and standardized psychosocial questionnaires to assess social support, optimism, hostility, and depression prior to randomization into a dietary trial. Cox regression was performed to assess whether these measures of quality of life and psychosocial functioning predicted time to additional breast cancer events and all-cause mortality; hazard ratios were the measure of association. Results: There were 492 additional breast cancer events and 301 deaths occurred over a median 7.3 years (range: 0.01-10.8 years) of follow-up. In multivariate models, poorer physical health was associated with both decreased time to additional breast cancer events and all-cause mortality ( p trend=0.005 and 0.004, respectively), while greater hostility predicted additional breast cancer events only ( p trend=0.03). None of the other psychosocial variables predicted either outcome. The hazard ratios comparing persons with poor (bottom two quintiles) to better (top three quintiles) physical health were 1.42 (95% CI: 1.16, 1.75) for decreased time to additional breast cancer events and 1.37 (95% CI: 1.08, 1.74) for all-cause mortality. Potentially modifiable factors associated with poor physical health included higher body mass index, lower physical activity, lower alcohol consumption, and more insomnia ( p<0.05 for all). Conclusion: Interventions to improve physical health should be tested as a means to increase time to additional breast cancer events and mortality among breast cancer survivors. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective Oestradiol (E2) and its metabolites 2-hydroxyoestrone (2-OHE1) and 16α-hydroxyoestrone (16α-OHE1) are thought to curtail the greater oxidative stress found in the development and progression of disease conditions including atherosclerosis. We related oestrogen levels to F2a-isoprostane levels, a biomarker of oxidative stress. Design and participants Data were obtained from 1647 women, aged 47–57 years, participating in the fifth annual follow-up of the Study of Women's Health Across the Nation (SWAN), a study of the menopausal transition. Measurements Serum E2 and urinary 2-OHE1 and 16α-OHE1 concentrations were determined by enzyme-linked immunosorbent assay (ELISA) and urinary F2a-isoprostanes were measured by enzyme immunoassay (EIA). Results F2a-isoprostane concentrations were elevated in women who smoked, a behaviour associated with increased oxidative stress, but not in stages of the natural menopause. Mean F2a-isoprostane concentrations among pre- and postmenopausal women who smoked were 1082 and 1064 pg/ml, respectively, values double those in pre- (343 pg/ml) and postmenopausal (379 pg/ml) nonsmoking women. 2-OHE1 and F2a-isoprostane concentrations were positively and highly correlated (partial correlations ρY|X = 0·44 and ρY|X = 0·43 in pre- and postmenopausal women, respectively). Similarly, 16α-OHE1 concentrations were positively and highly correlated with F2a-isoprostane concentrations (ρY|X = 0·52 and ρY|X = 0·59 in pre- and postmenopausal women, respectively). E2 was significantly correlated with F2a-isoprostanes only in postmenopausal women (ρY|X = 0·20). Associations were adjusted for age, body mass index (BMI), race/ethnicity, lipids, physical activity level and alcohol consumption. Conclusions This study does not support the commonly held hypothesis that levels of endogenous E2 or its oestrone metabolites favourably modify oxidative stress by decreasing F2a-isoprostane levels. [ABSTRACT FROM AUTHOR]

Two algorithms for assessing ovulatory status using daily urinary levels of oestrogen and progesterone metabolites have been applied to non-clinic-based, free-living populations of women. These relatively new methods for assessing ovarian function have been used to assess the potential adverse effects of occupational and environmental exposures, such as smoking, on the reproductive health of women. One algorithm has been validated against serum hormone measurements and gives good sensitivity and specificity for anovulation. However, a gold standard is generally not available in epidemiologic field studies in which these daily urine samples are collected. In this paper, we used Bayesian methods to estimate: (i) the probability of occurrence of anovulation, (ii) the sensitivity and specificity of the two algorithms, and (iii) the association between anovulation and smoking and other risk factors in the absence of a perfect test. We evaluated the two published algorithms for assessing ovulatory status, based on their cross-classified results applied to one randomly selected cycle from each woman in a sample of 338 employed women. We first assumed that the algorithms were independent, conditional on ovulatory status. Then, we used a dependence model to allow for correlation between the results of the two algorithms. We implemented a Bayesian logistic regression analysis that allowed the outcome measurement to be partially imperfect. We incorporated the posterior distributions for algorithm accuracy obtained from the dependence model as prior distributions for this logistic regression model. Then, we compared the results with those obtained from a standard multiple logistic approach using the algorithm determination of ovulatory status as if it were perfect. Our results indicated that increasing physical activity was associated with a significantly increased risk of anovulation; and smokers had a potentially, but not statistically significant, increased occurrence of anovulation. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Drawing from women's testimonials in The Guardian and from contributions of feminist writers, Virginia Woolf, Julia Kristeva, and Margaret Mead, we start a conversation on the positive and energizing aspects of menopause in the workplace. We propose a social interpretation of menopause that challenges a pervasive perspective of medical decline: A theorization of "the dialectic of zest," as inspired by the writings of Margaret Mead. By problematizing the experiences of women going through this transition in the workplace, we reveal how well‐intentioned awareness campaigns can lead to further stigmatization. We thus encourage organizations to not only favor an approach of "education for all" but also extend their social imaginaries beyond medicalized perspectives and coping views. Organizations can then embrace the potential of "zest," a positive side of menopause that remains largely unknown. We argue that organizations, inspired by a holistic view of menopause in the workplace, can creatively support the professional progressions and ambitions of not only women but also all employees. [ABSTRACT FROM AUTHOR]

The article presents a list of about Consultants for the Journal of Obstetrics and Gynaecology Research 2021, which include Ahmed Abbas, Sharmin Abbasi; and Ibrahim Abdelazim.

Acknowledges various people who have contributed their expertise in compiling the journal 'Paediatric and Perinatal Epidemiology' during January-June 2002.

Expresses appreciation to a list of referees to issues of the 'Paediatric and Perinatal Epidemiology' published between June 2001 and June 2002. Melissa Adams; Jennifer Parker; Jose Villar.