军事暴露和早期绝经：来自海湾战争时期队列研究（GWECS）的发现。

IF 2.5 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Womens Health Issues Pub Date : 2025-07-01 DOI:10.1016/j.whi.2025.05.001

Carolyn J. Gibson PhD, MPH , Guichan Cao MS , Sabra Inslicht PhD , Allison D. Altman PhD , Caitlin E. Haas BS, BA , Aaron Schneiderman PhD, MPH, RN , Erin Dursa PhD, MPH

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引用次数: 0

摘要

目的：服役期间的创伤和环境暴露可能影响生殖健康和卵巢老化，使女性退伍军人面临提前绝经的风险。我们研究了1990-1991年海湾战争女性退伍军人的军事暴露与可能的提前绝经之间的关系。方法：这是对海湾战争时期队列研究数据的纵向分析。女性海湾战争退伍军人完成基线（1995年）和随访评估（2012年），随访时年龄≤45岁。军事暴露（海湾战争部署、军事环境暴露[MEEs]、海湾战争疾病、军事性创伤[MST]）和创伤后应激障碍（PTSD）在基线时进行评估。如果参与者在回答关于月经的后续调查问题时表示更年期或1年内没有月经，他们就被归类为可能提前绝经。用logistic回归模型检验了军事暴露、创伤后应激障碍和可能的早期绝经之间的关系。结果：分析样本包括668名女性退伍军人。在海湾战争中服役的退伍军人（n = 384）中，63%报告了MEEs， 26%报告了MST。在总样本中，57%符合海湾战争疾病的标准，23%符合可能的创伤后应激障碍的标准。在随访中，15%的人可能提前绝经。在校正分析中，海湾战争病(优势比[OR] 1.83；95%可信区间[CI][1.14, 2.95])和可能的PTSD (OR 2.45；95% CI[1.54, 3.90])与可能的提前绝经显著相关。结论：45岁以下的女性退伍军人可能容易出现提前绝经，这需要在健康促进和症状管理方面进行额外的护理。退伍军人事务部的更年期护理应包括考虑创伤后应激障碍和合并症慢性疾病，如海湾战争病，这些以退伍军人为中心的关键临床相关因素可能会影响更年期的发生和经历。

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Military Exposures and Early Menopause: Findings From the Gulf War Era Cohort Study (GWECS)

Objective

Traumatic and environmental exposures during military service may affect reproductive health and ovarian aging, putting women veterans at risk for early menopause. We examined relationships between military exposures and possible early menopause among women 1990–1991 Gulf War veterans.

Methods

This is a longitudinal analysis of data from the Gulf War Era Cohort Study. Women Gulf War veterans who completed baseline (1995) and follow-up assessments (2012) and were aged ≤45 at follow-up were included. Military exposures (Gulf War deployment, military environmental exposures [MEEs], Gulf War Illness, military sexual trauma [MST]) and posttraumatic stress disorder (PTSD) were assessed at baseline. Participants were categorized as having possible early menopause if in response to follow-up survey questions about menstruation they indicated menopause or having no periods for 1 year. Associations among military exposures, PTSD, and possible early menopause were examined with logistic regression models.

Results

The analytic sample included 668 women veterans. Among Gulf War–deployed veterans (n = 384), 63% reported MEEs and 26% reported MST during deployment. Within the total sample, 57% met criteria for Gulf War Illness, and 23% met criteria for probable PTSD. At follow-up, 15% had possible early menopause. In adjusted analyses, Gulf War Illness (odds ratio [OR] 1.83; 95% confidence interval [CI] [1.14, 2.95]) and probable PTSD (OR 2.45; 95% CI [1.54, 3.90]) were significantly associated with possible early menopause.

Conclusion

Women veterans may be vulnerable to early menopause (under age 45), which brings additional care considerations for health promotion and symptom management. Menopause care in the Department of Veterans Affairs should include consideration of PTSD and comorbid chronic conditions such as Gulf War Illness, key veteran-centric clinical correlates that may influence the onset and experience of menopause.

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来源期刊

Womens Health Issues Multiple-

CiteScore

4.50

自引率

6.20%

发文量

审稿时长

32 days

期刊介绍： Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.