Reproductive factors and lower extremity arterial occlusive disease in women

Background: Reproductive variables affecting sexual hormone levels seem to be significant for atherosclerosis, a major cause of morbidity of the vessels of the lower extremities such as lower extremity arterial occlusive disease (LEAOD). We quantify a direct relationship between reproductive variables including age at regular and premature menopause and the incidence of severe LEAOD among post-menopausal women. Methods and results: Questionnaires were administered to 269 female amputees with LEAOD, 224 patients who underwent total joint replacement due to osteoarthritis and 88 healthy women. Respondents provided information on: age at menarche, age at the onset of menopause, number of births, number of abortions, lifetime oral contraceptive use, hysterectomy, oophorectomy, and medical consultation and treatment for post-menopausal symptoms. The in-sample log-odds ratio of LEAOD incidence was modeled as a function of the reproductive variables. An increase in the risk of LEAOD was associated with a reduction in the length of the fertile period, an increase in the number of births, and lifetime oral contraceptive use of 10 years or longer; a decrease in the risk of LEAOD was associated with an increase in the number of abortions. Conclusion: We established a distinct relationship between reproductive variables, such as length of fertile period and age at menopause, and the development of severe LEAOD. The relations that we found are, by and large, consistent with other findings on similar ailments.