The “Quiet Revolution” and the cesarean section in the United States

This paper estimates how changes in family structure and women’s labor market attachment during the last fifty years have affected the incidence of cesarean delivery in the United States. Both sets of factors are strongly related to cesarean utilization, and have generally changed so as to increase the rate of cesarean delivery over time. Altogether, changes in these factors, complemented by demographic changes, raised the U.S. cesarean section rate by eleven percentage points since the late 1970s, nearly two-thirds of the increase over that period. Today’s elevated cesarean section rate is in part a social phenomenon.     

Reproductive factors,exogenous hormone use,and risk of pancreatic cancer in postmenopausal women

IntroductionThe epidemiologic literature on menstrual and reproductive factors associated with pancreatic cancer has yielded weak and inconsistent evidence of an association. Furthermore, few cohort studies have examined the association of exogenous hormone use, including type and duration, with this disease. The aim of this study was to assess the association of these exposures with risk of pancreatic cancer in a large cohort of postmenopausal women.MethodsWe used data from the Women’s Health Initiative on 1003 cases of pancreatic cancer diagnosed among 158,298 participants over 14.3 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the associations of interest.ResultsBeing parous vs. nulliparous was associated with reduced risk (HR = 0.84, 95% CI 0.70–1.00), and women who had 1–2 and 3–4 births were at decreased risk compared to nulliparous women, whereas women who had >5 births showed no decrease in risk. Compared to women who gave birth between the ages of 20–29, women who gave birth at age 30 or above were at increased risk (HR 1.23, 95% CI 1.00–1.53, p for trend 0.003). Other reproductive factors and exogenous hormone use were not associated with risk.ConclusionsTogether with the existing literature on this topic, our results suggest that reproductive and hormonal exposures are unlikely to play an important role in the etiology of pancreatic cancer.     

Sexual identity differences in biomarkers of tobacco exposure among women in a national sample

BackgroundSexual minority women are consistently at increased risk for tobacco use compared to heterosexual women. Neither biomarkers of nicotine exposure nor biomarkers of tobacco toxicant exposure have been examined by sexual identity.MethodsThis study used interview and biomarker data from women in the biomarker core sample of Wave 1 of the Population Assessment of Tobacco and Health (PATH) study (2013–2014; n = 4930). We examined associations of sexual identity with nicotine exposure (measured with urinary cotinine and TNE-2) and with tobacco-specific nitrosamines (measured with urinary NNAL). Multivariable regression modeling was used to examine these associations among the full biomarker core sample, among past 30-day tobacco users, and among exclusive established cigarette users before and after controlling for tobacco use quantity and intensity.ResultsIn the full biomarker sample of women, prior to adjusting for tobacco use quantity and intensity, bisexual women had significantly higher cotinine, TNE-2, and NNAL levels compared to heterosexual women. Among exclusive established cigarette users, gay/lesbian women had significantly higher NNAL compared to heterosexual women prior to adjusting for tobacco quantity and intensity. No differences by sexual identity were found after adjusting for tobacco use quantity and intensity.ConclusionsThis is the first study to demonstrate differences in biological markers of tobacco exposure by sexual identity among women in the U.S. This has important public health implications as greater exposure to both nicotine and to tobacco-specific nitrosamines are strongly linked to cancer risk.     

Body dimensions and thyroid hormone levels in premenopausal and postmenopausal women from Austria

Correlations between thyroid hormone levels and body dimensions were investigated in a group of 124 premenopausal (ages 16–40 years) and 142 postmenopausal (ages 38–61 years) women from Vienna, Austria. Twenty-nine absolute body dimensions and thirteen anthropometric indices were correlated with the serum levels of thyroxine, triiodothyronine, thyroid-stimulating hormone, and thyroid-hormone-binding globulin as well as three hormone ratios (T3/T4, T4/TSH, T3/TSH). All hormones exhibited statistically significant correlations with 24 anthropometric variables and 11 indices. The correlations between thyroxine and triiodothyronine levels and the body measurements were predominantly positive in both proband groups. Higher thyroid hormone levels were associated positively with body dimensions, especially with the amount of subcutaneous fat tissue, in adult females independently of their menstrual status. The direction of the correlations between thyroid-stimulating hormone and body measures as well as anthropometric indices differed between the premenopausal and the postmenopausal women. While in premenopausal women mainly positive correlations between anthropometric characters and the level of thyroid stimulating hormone occur, in postmenopausal women most of these correlations are negative. This is probably due to the decrease of thyroid-stimulating hormone levels with increasing age, as well as with changes in body shape during the climacteric and after the menopause. © 1994 Wiley-Liss, Inc.     

Attractive men induce testosterone and cortisol release in women

Recently, Roney et al. (Roney, J.R., Lukaszewski, A.W., Simmons, Z.L., 2007. Rapid endocrine responses of young men to social interactions with young women. Horm. Behav. 52, 326-33; Roney, J.R., Mahler, S.V., Maestripieri, D., 2003. Behavioral and hormonal responses of men to brief interactions with women. Evol. Hum. Behav. 24, 365-375) demonstrated that men release testosterone and cortisol in response to brief social interactions with young women. The current experiment examined whether women show a similar endocrine response to physically and behaviorally attractive men. 120 women (70 naturally-cycling and 50 using hormonal contraceptives) were shown one of four 20-minute video montages extracted from popular films, depicting the following scenarios: 1) an attractive man courting a young woman (experimental stimulus), 2) a nature documentary (video clip control), 3) an unattractive older man courting a woman (male control), and 4) an attractive woman with no men present (female control). Saliva samples were taken before and after presentation of the stimulus, and were later analyzed for testosterone and cortisol content via enzyme immunoassay. Naturally-cycling women experienced a significant increase in both testosterone and cortisol in response to the experimental stimulus but to none of the control stimuli. Participants taking hormonal contraceptives also showed a significant cortisol response to the attractive man. Women may release adrenal steroid hormones to facilitate courtship interactions with high mate-value men.     

Minimizing Venous Thromboembolism in Feminizing Hormone Therapy: Applying Lessons From Cisgender Women and Previous Data

ObjectiveTo review he impact of estrogen-containing feminizing hormone regimens on transgender individuals’ risk for VTE.MethodsWe evaluated VTE risk by screening 1170 relevant studies published from 1994 to 2020, focusing on meta-analysis data.ResultsThe type of oral estrogen, route of administration, patient demographics, and comorbidities may affect the risk of VTE. Venous thrombosis is the most common vascular complication associated with HT.ConclusionConjugated equine estrogens and 17-β estradiol appear to be safer than oral ethinyl estradiol. Transdermal estrogen formulations appear to be the least thrombogenic estrogens. Estrogens used concomitantly with progestins increase the risk of VTE compared to estrogens alone.To date, there are no data to demonstrate the benefit of holding HT prior to vaginoplasty or other gender affirming surgeries. For most young, healthy transgender women, there is little risk of VTE with HT, while older patients with risk factors should be discussed case by case.