Implications of Early Menopause in Women Exposed to Perfluorocarbons

Context: Perfluorocarbons (PFC) are man-made chemicals used in numerous household products. They have a long half-life in humans and complex animal toxicity, and accumulating evidence points toward associations with multiple human health endpoints. Objective: Our objective was to investigate whether PFC are associated with endocrine disruption in women. Design: Cross-sectional analyses were made between quintiles of serum PFC, serum estradiol, and menopause onset. Setting: The C8 Health Project, with cohort of 69,030 adults and children, was conducted due to PFC contamination of drinking water from six water districts in two states. Participants: Participants included 25,957 women aged 18-65 yr. Main Outcome Measures: Serum estradiol levels and onset of menopause were assessed. The survey was the result of a class action suit, and survey designers (an independent corporation) had no a priori hypotheses. All hypotheses have been formulated by other investigators after data collection. Results: After excluding women who reported hysterectomy and adjusting for age within the group, smoking, alcohol consumption, body mass index, and exercise, the odds of having experienced menopause were significantly higher in the highest quintile relative to the lowest quintile of perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) in the perimenopausal [PFOS odds = 1.4, confidence interval (CI) = 1.1-1.8; PFOA odds = 1.4, CI = 1.1-1.8] and menopausal age groups (PFOS odds = 2.1, CI = 1.6 -2.8; PFOA odds = 1.7, CI = 1.3-2.3). After appropriate exclusions and adjustment for covariates, there was a significant inverse association between PFOS and estradiol in perimenopausal (beta = -3.65; P < 0.0001) and menopausal age groups (beta = -0.83; P = 0.007) but not between PFOA and estradiol. Conclusions: These data suggest that PFC are associated with endocrine disruption in women and that further research on mechanisms is warranted. (J Clin Endocrinol Metab 96: 1747-1753, 2011)