Menstruation during and after caloric restriction: The 1944-1945 Dutch famine

Objective: To investigate the relation between exposure to the 1944-45 Dutch famine and concurrent and subsequent menstrual disturbances. Design: Cohort study. Setting: Doorlopend Onderzoek Mammacarcinoom, breast cancer screening project, Utrecht, the Netherlands. Patient(s): Between 1983 and 1986, approximately 12,500 women (born 1911-41) reported their individual famine experiences. Main Outcome Measure(s): irregular menstruation during the famine; time to regular menses after menarche, and menstrual patterns in adulthood after childhood famine. Result(s): The famine had a direct impact on menstruation. The odds ratio (OR) of concurrent irregular menses in severely versus unexposed women was 8.85 (95% confidence interval [0], 7.31-10.70). Women exposed to severe famine before menarche were 1.51 (95% Cl, 1. 15-1.98) times more likely to experience irregular menses for a prolonged time after menarche compared with the unexposed. This association was stronger in women with an early menarche. When the menstrual pattern was assessed in adulthood by menstrual diaries, a nonsignificant tendency of increased irregularity (OR, 1. 13; 95% Cl, 0.82-1.54) and regular but long menstrual cycles (OR, 1.41; 95% CI, 0.89-2.23) was observed in women exposed to severe famine. Conclusion(S): Famine relates to concurrent menstrual irregularity, and exposure in childhood seems to affect the subsequent menstrual pattern. (Fertil Steril (R) 2007;88(Suppl 2):1101-7. (C)2007 by American Society for Reproductive Medicine.)