Perfluorooctanoic acid exposure and natural menopause: A longitudinal study in a community cohort

Environ Res. 2016 Apr:146:323-30. doi: 10.1016/j.envres.2015.12.037. Epub 2016 Jan 21.


Introduction: Perfluorooctanoic acid (PFOA), a suspected endocrine disruptor, is a bio-persistent chemical found at low levels in the serum of nearly all U.S. residents. Early menopause has been positively associated with serum PFOA in prior cross-sectional studies.

Methods: We conducted a longitudinal analysis of age at menopause among women, aged ≥40 years, (N=8759) in a Mid-Ohio Valley community cohort, exposed to high PFOA levels via contaminated drinking water. Using estimated retrospective year-specific serum PFOA concentrations (1951-2011), we examined the associations between PFOA, as cumulative exposure or year-specific serum estimates, and natural menopause using a Cox proportional hazards models. As participants were initially recruited in 2005-2006, we also analyzed the cohort prospectively (i.e., from the time of enrollment), using both modeled cumulative PFOA, and PFOA serum levels measured in 2005-2006. Women with hysterectomy (a competing risk) were either censored or excluded from the analysis.

Results: Neither in the retrospective nor the prospective cohort did we find a significant (at α=0.05) trend between PFOA exposure and natural menopause. The non-significant, hazard ratios by quintile of increasing cumulative serum PFOA were 1.00 (referent), 1.00, 1.09, 1.05 and 1.06 (trend test for log cumulative exposure: p=0.37) with hysterectomies censored, and 1.00 (referent), 1.06, 1.13, 1.09 and 1.11 (trend test for log cumulative exposure: p=0.85) with hysterectomies excluded. Year-specific serum estimates were also not associated with early menopause.

Conclusion: Our data suggest that earlier age at menopause is not associated with PFOA exposure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Caprylates / blood
  • Caprylates / toxicity*
  • Cohort Studies
  • Environmental Exposure*
  • Environmental Pollutants / blood
  • Environmental Pollutants / toxicity*
  • Female
  • Fluorocarbons / blood
  • Fluorocarbons / toxicity*
  • Humans
  • Longitudinal Studies
  • Menopause / drug effects*
  • Middle Aged
  • Models, Biological
  • Ohio
  • Proportional Hazards Models
  • Prospective Studies
  • Retrospective Studies
  • West Virginia


  • Caprylates
  • Environmental Pollutants
  • Fluorocarbons
  • perfluorooctanoic acid