Randolph John F, Crawford Sybil, Dennerstein Lorraine, Cain Kevin, Harlow Siobán D, Little Roderick, Mitchell Ellen S, Nan Bin, Taffe John, Yosef Matheos
L4228 Women's Hospital, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0276, USA.
J Clin Endocrinol Metab. 2006 Aug;91(8):3034-40. doi: 10.1210/jc.2006-0243. Epub 2006 May 23.
The Stages of Reproductive Aging Workshop proposed bleeding and hormonal criteria for the menopausal transition, but operational definitions of hormone parameters were not specified.
This paper investigates the longitudinal relationship of annual serum FSH levels with four proposed bleeding criteria for the late menopausal transition in two cohort studies. The goal is to provide empirically based guidance regarding application of hormonal criteria that may be optimal for widespread application in clinical and research settings for assessing menopausal stage.
DESIGN/SETTING: Prospective menstrual calendar and annual serum FSH data were collected from two population-based cohort studies: the Melbourne Women's Midlife Health Project and the Study of Women's Health Across the Nation.
Participants in the study were 193 Melbourne Women's Midlife Health Project and 2223 Study of Women's Health Across the Nation women aged 42-57 yr at baseline who contributed 10 or more menstrual cycles and at least one annual serum FSH value.
MAIN OUTCOME MEASURE(S): Association between bleeding criteria for the late menopausal transition and FSH was a main outcome measure. Associations of bleeding criteria, FSH, and hot flashes with the final menstrual period were also measured.
A single FSH measure is an independent marker of the late menopausal transition, but FSH concentrations are less predictive of menopausal stage than any of four proposed bleeding criteria. Criterion FSH values for the late transition are similar across both studies. Experience of hot flashes adds no information in the presence of hormonal and bleeding criteria.
An annual serum FSH concentration of 40 IU/liter could be incorporated, in conjunction with bleeding markers, into the Stages of Reproductive Aging Workshop paradigm for markers of the late menopausal transition.
生殖衰老阶段研讨会提出了围绝经期过渡的出血和激素标准，但未明确激素参数的操作定义。
本文在两项队列研究中调查了年度血清促卵泡生成素（FSH）水平与围绝经期晚期四个拟议出血标准之间的纵向关系。目标是为激素标准的应用提供基于实证的指导，这些标准可能最适合在临床和研究环境中广泛应用于评估绝经阶段。
设计/地点：从两项基于人群的队列研究中收集前瞻性月经日历和年度血清FSH数据：墨尔本女性中年健康项目和全国女性健康研究。
研究参与者为193名墨尔本女性中年健康项目的女性和2223名全国女性健康研究的女性，她们在基线时年龄为42 - 57岁，提供了10个或更多月经周期以及至少一个年度血清FSH值。
围绝经期晚期出血标准与FSH之间的关联是主要观察指标。还测量了出血标准、FSH和潮热与末次月经之间的关联。
单次FSH测量是围绝经期晚期的独立标志物，但FSH浓度对绝经阶段的预测性低于四个拟议出血标准中的任何一个。两项研究中围绝经期晚期的FSH标准值相似。在存在激素和出血标准的情况下，潮热经历并未增加额外信息。
每年血清FSH浓度为40 IU/升可与出血标志物一起纳入生殖衰老阶段研讨会的围绝经期晚期标志物范式。
