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Brendan J Nolan Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Aviva S Frydman Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia

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Shalem Y Leemaqz College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia

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Meg Carroll Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Mathis Grossmann Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Jeffrey D Zajac Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Ada S Cheung Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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( 8 ). Pre-clinical data demonstrates modulation of the γ-aminobutyric acid type A (GABA-A) receptor, and micronised progesterone treatment has been found to reduce sleep onset latency and to improve self-reported sleep outcomes in randomised

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Elinor Chelsom Vogt Department of Clinical Science, University of Bergen, Bergen, Norway
K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, Bergen, Norway
Department of Medicine, Haukeland University Hospital, Bergen, Norway

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Francisco Gómez Real Department of Clinical Science, University of Bergen, Bergen, Norway
Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway

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Eystein Sverre Husebye Department of Clinical Science, University of Bergen, Bergen, Norway
K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, Bergen, Norway
Department of Medicine, Haukeland University Hospital, Bergen, Norway

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Sigridur Björnsdottir Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden

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Bryndis Benediktsdottir Medical Faculty, University of Iceland, Reykjavik, Iceland
Department of Sleep, Landspitali University Hospital Reykjavík, Reykjavik, Iceland

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Randi Jacobsen Bertelsen Department of Clinical Science, University of Bergen, Bergen, Norway

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Pascal Demoly University Hospital of Montpellier, IDESP, Univ Montpellier-Inserm, Montpellier, France

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Karl Anders Franklin Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden

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Leire Sainz de Aja Gallastegui Unit of Epidemiology and Public Health, Department of Health, Basque Government, Vitoria-Gasteiz, Spain

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Francisco Javier Callejas González Department of Respiratory Medicine, Albacete University Hospital, Albacete, Spain

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Joachim Heinrich Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia

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Mathias Holm Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Nils Oscar Jogi Department of Clinical Science, University of Bergen, Bergen, Norway

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Benedicte Leynaert Université Paris-Saclay, Inserm U1018, Center for Epidemiology and Population Health, Integrative Respiratory Epidemiology Team, Villejuif, France

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Eva Lindberg Department of Medical Sciences, Respiratory, Allergy and Sleep Medicine, Uppsala University, Uppsala, Sweden

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Andrei Malinovschi Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden

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Jesús Martínez-Moratalla Pneumology Service of the General University Hospital of Albacete, Albacete, Spain
Albacete Faculty of Medicine, Castilla-La Mancha University, Albacete, Spain

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Raúl Godoy Mayoral Department of Respiratory Medicine, Albacete University Hospital, Albacete, Spain

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Anna Oudin Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

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Antonio Pereira-Vega Juan Ramón Jiménez University Hospital in Huelva, Huelva, Spain

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Chantal Raherison Semjen INSERM, EpiCene Team U1219, University of Bordeaux, Talence, France

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Vivi Schlünssen Department of Public Health, Environment, Work and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
The National Research Center for the Working Environment, Copenhagen, Denmark

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Kai Triebner Department of Clinical Science, University of Bergen, Bergen, Norway

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Marianne Øksnes Department of Clinical Science, University of Bergen, Bergen, Norway
K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, Bergen, Norway
Department of Medicine, Haukeland University Hospital, Bergen, Norway

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Objective

To investigate markers of premature menopause (<40 years) and specifically the prevalence of autoimmune primary ovarian insufficiency (POI) in European women.

Design

Postmenopausal women were categorized according to age at menopause and self-reported reason for menopause in a cross-sectional analysis of 6870 women.

Methods

Variables associated with the timing of menopause and hormone measurements of 17β-estradiol and follicle-stimulating hormone were explored using multivariable logistic regression analysis. Specific immunoprecipitating assays of steroidogenic autoantibodies against 21-hydroxylase (21-OH), side-chain cleavage enzyme (anti-SCC) and 17alpha-hydroxylase (17 OH), as well as NACHT leucine-rich-repeat protein 5 were used to identify women with likely autoimmune POI.

Results

Premature menopause was identified in 2.8% of women, and these women had higher frequencies of nulliparity (37.4% vs 19.7%), obesity (28.7% vs 21.4%), osteoporosis (17.1% vs 11.6%), hormone replacement therapy (59.1% vs 36.9%) and never smokers (60.1% vs 50.9%) (P < 0.05), compared to women with menopause ≥40 years. Iatrogenic causes were found in 91 (47%) and non-ovarian causes in 27 (14%) women, while 77 (39%) women were classified as POI of unknown cause, resulting in a 1.1% prevalence of idiopathic POI. After adjustments nulliparity was the only variable significantly associated with POI (odds ratio 2.46; 95% CI 1.63–3.42). Based on the presence of autoantibodies against 21 OH and SCC, 4.5% of POI cases were of likely autoimmune origin.

Conclusion

Idiopathic POI affects 1.1% of all women and almost half of the women with premature menopause. Autoimmunity explains 4.5% of these cases judged by positive steroidogenic autoantibodies.

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Meghnaa Hebbar College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Halimah Khalil College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Nawal Zia College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Jameela Sheikh College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Eka Melson University of Leicester, Leicester, United Kingdom

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Meri Davitadze Clinic NeoLab, Tbilisi, Georgia

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Helena Gleeson Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom

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Tejal Lathia Apollo Hospitals, Mumbai, India

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Chitra Selvan Department of Endocrinology, M S Ramaiah Medical College, Bengaluru, India

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Punith Kempegowda Clinic NeoLab, Tbilisi, Georgia
Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom

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PCOS SEva Working Group
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PCOS SEva Working Group

attending the clinic. Women attending these clinics are screened, managed, and referred for type 2 diabetes mellitus, hypertension, coronary heart disease, lipid disorders, dermatological issues, non-alcoholic fatty liver disease, and obstructive sleep

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Małgorzata Kałużna Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Pola Kompf Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Katarzyna Wachowiak-Ochmańska Heliodor Święcicki Clinical Hospital, Poznan, Poland

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Jerzy Moczko Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland

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Aleksandra Królczyk Chair and Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Adam Janicki Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Karol Szapel Department of Physiotherapy, Poznan University of Medical Sciences, Poznan, Poland

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Marian Grzymisławski Chair and Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Marek Ruchała Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Katarzyna Ziemnicka Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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, which consists of 15 different dimensions – mobility, vision, hearing, breathing, sleeping, eating, speech, excretion, usual activities, mental function, discomfort and symptoms, depression, distress, vitality and sexual activity, each to be estimated on

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Yan-yu Zhang Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Xian Zhang Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Shao-yang Bu Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Wei-wei Zhang Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Tian-xiu Li Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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De-cai Zheng Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Ze-xiang Huang Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Qian Wang Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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has more excess expression in the POA than kiss1 ( 36 ). The hypothalamus is considered a region of upstream regulation of the reproductive axis. The habenula, involved in behavioral responses related to pain, stress, anxiety and sleep, has the most

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Xinyuan Zhang Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
School of Life Science and Engineering, Southwest Jiaotong University, Chengdu, Sichuan, China

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Suiyan Li School of Life Science and Engineering, Southwest Jiaotong University, Chengdu, Sichuan, China

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Hongwei Liu Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Huai Bai Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Qingqing Liu Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Chunyi Yang Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Ping Fan Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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resistance, heightened oxidative stress, low-grade chronic inflammation, dyslipidemia, increased risks of complications during pregnancy, type 2 diabetes, cardiocerebrovascular disease, anxiety and depression, obstructive sleep apnea, and endometrial cancer

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Milou Cecilia Madsen Department of Internal Medicine and Center of Expertise on Gender Dysphoria, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

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Martin den Heijer Department of Internal Medicine and Center of Expertise on Gender Dysphoria, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

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Claudia Pees Walaeus Library, Leiden University Medical Center, Leiden, the Netherlands

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Nienke R Biermasz Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands

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Leontine E H Bakker Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands

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countries TU/ none 1438 men with hypogonadism 5 injections (1 year) Improvement of concentration and sleep quality. Stability in mood, less hot flushes, and sweating. Lower blood pressure and better lipid profile Studies on transgender

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