Environmental risk factors for early menopause among Black women

Boston University Medical Campus, Boston MA

Investigators

Abstract

Menopause is the cessation of spontaneous menstruation for 12 months, a normal part of aging that marks the end of reproductive life. After the onset of menopause, women are expected to live an average of 30 additional years; therefore, optimizing health before, during, and after menopause is critically important. Age at menopause and time since menopause are markers of not only reproductive aging, but somatic aging and general health. Relative to White women, Black women enter menopause earlier and consistently report longer-lasting, more intense symptoms (e.g., hot flashes, night sweats, vaginal discomfort). Much of our current understanding of menopause, its determinants, and devastating consequences within western societies are derived from studies of White women. Historical and contemporary neighborhood conditions have recently been proposed to play a significant role in early onset of menopause between Black and White women, contributing to increased exposure of social and physical environmental hazards that shape the lived experience of Black individuals (e.g., chemical hair straighteners, neighborhood disadvantage, evictions). However, few existing studies have identified downstream effects of neighborhood conditions that could influence the timing of menopause in high-risk populations. With the NIH F32 Award, Dr. Sharonda Lovett will launch the largest investigation of environmental determinants in relation to early menopause among Black women. This proposal leverages prospective cohort data from the Black Women’s Health Study (BWHS), the largest study in existence focused on the health of Black women (n>59,000 U.S. participants followed biennially for >25 years). We aim to estimate the effect of 1) chemical hair straighteners, 2) features of the neighborhood social and physical environment (e.g., neighborhood socioeconomic status, evictions, air pollution, residential green space), and 3) environmental mixtures, on age at natural menopause. Neighborhood-level exposures will be derived by linking residential addresses to geospatial data. Outcome information will be based on permanent cessation of menstrual periods, including the reason for the participants’ stopped menstrual periods. This proposal will also support Dr. Lovett’s training in menopause, selected environmental exposures (e.g., air pollution, residential green space), and mixture modelling approaches (e.g., Bayesian kernel machine regression) to better understand how the individual and joint (“mixture”) effects of these hazards are uniquely associated with early menopause. Overseen by an interdisciplinary team with a history of successful collaboration, Dr. Lovett’s training plan outlines a robust curriculum of planned tutorials in environmental mixtures and geospatial exposure assessment, intensive workshops, and a clinical rotation on factors that influence menopause-related care.