Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor MI 48109, USA.
J Clin Endocrinol Metab. 2012 Apr;97(4):1159-68. doi: 10.1210/jc.2011-3362. Epub 2012 Feb 16.
The aim of this article is to summarize the recommended updates to the 2001 Stages of Reproductive Aging Workshop (STRAW) criteria. The 2011 STRAW + 10 reviewed advances in understanding of the critical changes in hypothalamic-pituitary-ovarian function that occur before and after the final menstrual period.
Scientists from five countries and multiple disciplines evaluated data from cohort studies of midlife women and in the context of chronic illness and endocrine disorders on change in menstrual, endocrine, and ovarian markers of reproductive aging including antimüllerian hormone, inhibin-B, follicle-stimulating hormone, and antral follicle count. Modifications were adopted by consensus.
STRAW + 10 simplified bleeding criteria for the early and late menopausal transition, recommended modifications to criteria for the late reproductive stage (Stage -3) and the early postmenopause stage (Stage +1), provided information on the duration of the late transition (Stage -1) and early postmenopause (Stage +1), and recommended application regardless of women's age, ethnicity, body size, or lifestyle characteristics.
STRAW + 10 provides a more comprehensive basis for assessing reproductive aging in research and clinical contexts. Application of the STRAW + 10 staging system should improve comparability of studies of midlife women and facilitate clinical decision making. Nonetheless, important knowledge gaps persist, and seven research priorities are identified.
本文旨在总结 2001 年生殖衰老工作坊（STRAW）标准的推荐更新内容。2011 年 STRAW + 10 回顾了对下丘脑-垂体-卵巢功能关键变化的理解进展，这些变化发生在末次月经前后。
来自五个国家和多个学科的科学家评估了中年女性队列研究的数据，并结合慢性疾病和内分泌紊乱，评估了生殖衰老的月经、内分泌和卵巢标志物的变化，包括抗缪勒管激素、抑制素 B、卵泡刺激素和窦卵泡计数。通过共识采纳了修改意见。
STRAW + 10 简化了绝经前期和晚期的出血标准，推荐了晚期生殖阶段（阶段-3）和早期绝经后阶段（阶段+1）标准的修改，提供了晚期过渡期（阶段-1）和早期绝经后（阶段+1）持续时间的信息，并建议无论女性的年龄、种族、体型或生活方式特征如何，都应应用该标准。
STRAW + 10 为研究和临床环境中评估生殖衰老提供了更全面的基础。STRAW + 10 分期系统的应用应提高中年女性研究的可比性，并有助于临床决策。然而，仍然存在重要的知识空白，并确定了七个研究重点。
