Circulating sex hormones and risk of uterine fibroids: Study of women's health across the nation (swan)

Jason Y Y Wong, Ellen B Gold, Wesley O. Johnson, Jennifer S. Lee

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Context: Estrogen has been implicated in the development of uterine fibroids. However, the contribution of androgen in women is unknown. Objective: Our objective was to assess the longitudinal relations of circulating androgens and estradiol (E2) and their joint effects to the risk of developing fibroids. Design: This is a 13-year longitudinal study in the Study of Women's Health Across the Nation. Setting: This study was conducted in seven sites across the United States (1997â€"2013). Participants: At baseline, 3240 pre- or early peri-menopausal women with an intact uterus, ages 45â€"52 years were included; 43.6% completed the follow-up. There were 512 incident and 478 recurrent fibroid cases. Exposures: We measured near-annual time-varying serum levels of bioavailable E2 and bioavailable T, dichotomized at the median (high vs low). Main Outcomes and Measures: We estimated the conditional odds ratio (OR) of fibroids in the ensuing year using discrete-time proportional odds models adjusted for race/ethnicity/site, age, body mass index, menopausal stage, reproductive factors, smoking, timing of blood draw, and FSH. Results: Women with high T had a statistically significant increased risk of incident fibroids (OR, 1.33; 95% confidence interval [CI], 1.01â€"1.76; P = .04), but not recurrent fibroids. This risk was further elevated in those with high T and E2 (OR, 1.52; 95% CI, 1.07â€"2.17; P = .02). High E2 and T was associated with lower risk of recurrent fibroids (OR, 0.50; 95% CI, 0.26â€"0.96; P = .04). Conclusions: High T with high E2 was associated with an elevated risk of incident fibroids in midlife women who never reported fibroids before baseline. Conversely, the risk of recurrent fibroids was mitigated in women with high E2 and high T.

Original languageEnglish (US)
Pages (from-to)123-130
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume101
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Gonadal Steroid Hormones
Leiomyoma
Women's Health
Androgens
Odds Ratio
Confidence Intervals
Estradiol
Estrogens
Blood
Uterus
Longitudinal Studies
Body Mass Index
Smoking
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Circulating sex hormones and risk of uterine fibroids : Study of women's health across the nation (swan). / Wong, Jason Y Y; Gold, Ellen B; Johnson, Wesley O.; Lee, Jennifer S.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 101, No. 1, 01.01.2016, p. 123-130.

Research output: Contribution to journalArticle

@article{bc9e1b486d5441939abe1916bf2fa2fb,
title = "Circulating sex hormones and risk of uterine fibroids: Study of women's health across the nation (swan)",
abstract = "Context: Estrogen has been implicated in the development of uterine fibroids. However, the contribution of androgen in women is unknown. Objective: Our objective was to assess the longitudinal relations of circulating androgens and estradiol (E2) and their joint effects to the risk of developing fibroids. Design: This is a 13-year longitudinal study in the Study of Women's Health Across the Nation. Setting: This study was conducted in seven sites across the United States (1997{\^a}€{"}2013). Participants: At baseline, 3240 pre- or early peri-menopausal women with an intact uterus, ages 45{\^a}€{"}52 years were included; 43.6{\%} completed the follow-up. There were 512 incident and 478 recurrent fibroid cases. Exposures: We measured near-annual time-varying serum levels of bioavailable E2 and bioavailable T, dichotomized at the median (high vs low). Main Outcomes and Measures: We estimated the conditional odds ratio (OR) of fibroids in the ensuing year using discrete-time proportional odds models adjusted for race/ethnicity/site, age, body mass index, menopausal stage, reproductive factors, smoking, timing of blood draw, and FSH. Results: Women with high T had a statistically significant increased risk of incident fibroids (OR, 1.33; 95{\%} confidence interval [CI], 1.01{\^a}€{"}1.76; P = .04), but not recurrent fibroids. This risk was further elevated in those with high T and E2 (OR, 1.52; 95{\%} CI, 1.07{\^a}€{"}2.17; P = .02). High E2 and T was associated with lower risk of recurrent fibroids (OR, 0.50; 95{\%} CI, 0.26{\^a}€{"}0.96; P = .04). Conclusions: High T with high E2 was associated with an elevated risk of incident fibroids in midlife women who never reported fibroids before baseline. Conversely, the risk of recurrent fibroids was mitigated in women with high E2 and high T.",
author = "Wong, {Jason Y Y} and Gold, {Ellen B} and Johnson, {Wesley O.} and Lee, {Jennifer S.}",
year = "2016",
month = "1",
day = "1",
doi = "10.1210/jc.2015-2935",
language = "English (US)",
volume = "101",
pages = "123--130",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "1",

}

TY - JOUR

T1 - Circulating sex hormones and risk of uterine fibroids

T2 - Study of women's health across the nation (swan)

AU - Wong, Jason Y Y

AU - Gold, Ellen B

AU - Johnson, Wesley O.

AU - Lee, Jennifer S.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Context: Estrogen has been implicated in the development of uterine fibroids. However, the contribution of androgen in women is unknown. Objective: Our objective was to assess the longitudinal relations of circulating androgens and estradiol (E2) and their joint effects to the risk of developing fibroids. Design: This is a 13-year longitudinal study in the Study of Women's Health Across the Nation. Setting: This study was conducted in seven sites across the United States (1997â€"2013). Participants: At baseline, 3240 pre- or early peri-menopausal women with an intact uterus, ages 45â€"52 years were included; 43.6% completed the follow-up. There were 512 incident and 478 recurrent fibroid cases. Exposures: We measured near-annual time-varying serum levels of bioavailable E2 and bioavailable T, dichotomized at the median (high vs low). Main Outcomes and Measures: We estimated the conditional odds ratio (OR) of fibroids in the ensuing year using discrete-time proportional odds models adjusted for race/ethnicity/site, age, body mass index, menopausal stage, reproductive factors, smoking, timing of blood draw, and FSH. Results: Women with high T had a statistically significant increased risk of incident fibroids (OR, 1.33; 95% confidence interval [CI], 1.01â€"1.76; P = .04), but not recurrent fibroids. This risk was further elevated in those with high T and E2 (OR, 1.52; 95% CI, 1.07â€"2.17; P = .02). High E2 and T was associated with lower risk of recurrent fibroids (OR, 0.50; 95% CI, 0.26â€"0.96; P = .04). Conclusions: High T with high E2 was associated with an elevated risk of incident fibroids in midlife women who never reported fibroids before baseline. Conversely, the risk of recurrent fibroids was mitigated in women with high E2 and high T.

AB - Context: Estrogen has been implicated in the development of uterine fibroids. However, the contribution of androgen in women is unknown. Objective: Our objective was to assess the longitudinal relations of circulating androgens and estradiol (E2) and their joint effects to the risk of developing fibroids. Design: This is a 13-year longitudinal study in the Study of Women's Health Across the Nation. Setting: This study was conducted in seven sites across the United States (1997â€"2013). Participants: At baseline, 3240 pre- or early peri-menopausal women with an intact uterus, ages 45â€"52 years were included; 43.6% completed the follow-up. There were 512 incident and 478 recurrent fibroid cases. Exposures: We measured near-annual time-varying serum levels of bioavailable E2 and bioavailable T, dichotomized at the median (high vs low). Main Outcomes and Measures: We estimated the conditional odds ratio (OR) of fibroids in the ensuing year using discrete-time proportional odds models adjusted for race/ethnicity/site, age, body mass index, menopausal stage, reproductive factors, smoking, timing of blood draw, and FSH. Results: Women with high T had a statistically significant increased risk of incident fibroids (OR, 1.33; 95% confidence interval [CI], 1.01â€"1.76; P = .04), but not recurrent fibroids. This risk was further elevated in those with high T and E2 (OR, 1.52; 95% CI, 1.07â€"2.17; P = .02). High E2 and T was associated with lower risk of recurrent fibroids (OR, 0.50; 95% CI, 0.26â€"0.96; P = .04). Conclusions: High T with high E2 was associated with an elevated risk of incident fibroids in midlife women who never reported fibroids before baseline. Conversely, the risk of recurrent fibroids was mitigated in women with high E2 and high T.

UR - http://www.scopus.com/inward/record.url?scp=84954486955&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84954486955&partnerID=8YFLogxK

U2 - 10.1210/jc.2015-2935

DO - 10.1210/jc.2015-2935

M3 - Article

C2 - 26670127

AN - SCOPUS:84954486955

VL - 101

SP - 123

EP - 130

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 1

ER -