Association between perfluoroalkyl and polyfluoroalkyl substances exposure and reproductive longevity for female in the United States: A population-based study

Wide exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS) poses a great risk to human reproductive health. Reproductive longevity is a major factor influencing the female reproductive cycle and affects women's healthy ageing. However, few studies have comprehensively evaluated the correlation between serum PFAS concentrations and female reproductive age, including menarche, reproductive longevity, and menopause. The purpose of this research is to investigate the correlation between serum PFAS levels and female reproductive age using linear regression models based on the National Health and Nutrition Examination Survey (NHANES) database. A total of 4743 participants were included in this analysis, and the results showed that age at menopause was inversely associated with perfluorooctanoic acid (PFOA) (β = -0.77, 95 % CI = -1.36, -0.18, P = 0.01), perfluorohexane sulfonic acid (PFHxS) (β = -1.07, 95 % CI = -1.53, -0.60, P < 0.001) and perfluorooctane sulfonic acid (PFOS) (β = -0.84, 95 % CI = -1.30, -0.38, P < 0.001). Moreover, the results showed that PFOS (β = -0.89, 95 % CI = -1.36, -0.42, P < 0.001), PFHxS (β = -1.08, 95 % CI = -1.55, -0.60, P < 0.001), and PFOA (β = -0.68, 95 % CI = -1.28, -0.08, P = 0.03) exposure were inversely related to reproductive longevity in women, exhibiting a strong dose-response trend. Evidence from the study indicates that exposure to PFAS may raise the risk of shortened reproductive longevity in women.