Climate factors, racial/ethnic disparities, and menstrual cycle health

PROJECT SUMMARY The menstrual cycle is a marker of physiologic and reproductive health and is tightly controlled by hormone signals between the hypothalamus, pituitary, and ovaries. The menstrual cycle can be disrupted by environmental and biological factors that cause hormone dysregulation and ovarian dysfunction. The most common cause of irregular menses in reproductive-age women is polycystic ovary syndrome (PCOS); hallmark features include ovarian dysfunction and androgen excess. Women with PCOS also have an increased risk of developing diabetes, heart disease, obesity, dyslipidemia across their lifespan. Climate factors, such as temperature, have been shown to affect reproductive function in mammals. Air pollution (AP) exposure has been associated with accelerated time to pregnancy loss, arrested embryonic growth in the culture environment, and reduced success of in vitro fertilization. Life course exposures have differing potential biological mechanisms. Gestational AP exposure has been reported to reduce telomere length at birth. Assessment of AP exposures and MCC are limited by studies of heterogenous populations with limited racial/ethnic diversity, incomplete city-level census tract level monitoring, retrospective collection of cycle history, and lack of MCC and PCOS ascertainment11, 12. We will additionally evaluate life course exposure to climate factors including temperature and humidity to understand their contribution to MCC outcomes and risk for PCOS. We will evaluate cumulative lifetime exposure and life course exposure to AP during the sensitive time windows of (1) gestation, (2) childhood/premenarche, and (3) adulthood to determine whether prenatal or adult exposures confer greatest risk. We will additionally evaluate disparities in AP exposures and MCC outcomes in a SafetyNet hospital population.