McCoy SS, et al. - Through a case-control study of 2,680 women from the Sjögren's International Collaborative Clinical Alliance registry, the researchers intended to determine whether cumulative estrogen exposure, as defined by age at menarche, age at menopause, female hormone use, hysterectomy, and parity, had an impact on the development of primary Sjögren's syndrome (pSS). A growing opposite trend among pSS and composite estrogen score were noted after adjusting for age, recruitment site, ethnicity, education, employment status, and smoking. A 24% decline was ascertained in cumulative sex hormone exposure at the highest level of cumulative menstrual cycling (CMC) within the postmenopausal group in pSS participants relative to controls. Hence, in comparison to sicca control, pSS women had lower estrogen exposure and CMC. Also, a negative correlation of increasing estrogen exposure with the development of pSS was recognized. In order to confirm these findings, more longitudinal studies of sex hormone exposure in pSS are required.