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.