Body size and ethnicity are associated with menstrual cycle alterations in women in the early menopausal transition: The Study of Women's Health across the Nation (SWAN) Daily Hormone Study
Authors
Santoro, NanetteLasley, William L.
McConnell, Dan
Allsworth, Jenifer E.
Crawford, Sybil L.
Gold, Ellen B.
Finkelstein, Joel S.
Greendale, Gail A.
Kelsey, Jenny
Korenman, Stan
Luborsky, Judith L.
Matthews, Karen A.
Midgley, Rees
Powell, Lynda
Sabatine, Janice
Schocken, Miriam
Sowers, Mary Fran
Weiss, Gerson
UMass Chan Affiliations
Department of Medicine, Division of Preventive and Behavioral MedicineDocument Type
Journal ArticlePublication Date
2004-06-08Keywords
AdultAfrican Continental Ancestry Group
Age Distribution
Asian Continental Ancestry Group
Body Constitution
Cohort Studies
Corpus Luteum
Estrone
European Continental Ancestry Group
Female
Follicle Stimulating Hormone
Humans
Longitudinal Studies
Luteinizing Hormone
Menopause
Menstrual Cycle
Middle Aged
Pregnanediol
United States
Women's Health
Life Sciences
Medicine and Health Sciences
Women's Studies
Metadata
Show full item recordAbstract
The dynamics of reproductive hormones that characterize the menopausal transition (perimenopause) are incompletely understood, particularly in non-Caucasian women. The Study of Women's Health across the Nation (SWAN) is a multiethnic cohort study of 3302 women at seven sites who were aged 42-52 yr at baseline. All participants are seen annually to assess a variety of endpoints. A subcohort of 848 women undergoes further investigation of their daily patterns of reproductive hormones in the Daily Hormone Study (DHS). DHS enrollees annually complete a daily collection of first morning voided urine for an entire menstrual cycle or up to 50 d (whichever comes first). Chemiluminescent assays measured urinary LH and FSH, as well as metabolites of estradiol [estrone conjugates (E1c)] and progesterone [pregnanediol glucuronide (Pdg)]. Cycles were assessed for evidence of luteal activity and day of luteal transition using previously developed algorithms. Midreproductive-aged women who underwent similar daily urinary analyses served as historical controls. Correlates of cycle features were identified. Eight hundred thirty-three cycles were evaluable and had complete data on covariates. Six hundred seventy-four (80.9%) cycles had evidence of luteal activity, and 159 (19.1%) did not. Women who were at least 49 yr old were less likely to have cycles with luteal activity and had more variable cycle length, higher total-cycle FSH, and lower total-cycle Pdg. Compared with heavier women, those with body mass index less than 25 kg/m2 had shorter cycles and higher total-cycle LH, FSH, and Pdg but not E1c. Chinese- and Japanese-American women had overall lower adjusted total-cycle E1c excretion. Smoking was not significantly associated with cycle length or hormones. When compared with cycles of younger control women, the cycles of the SWAN DHS participants had higher gonadotropins, lower total integrated Pdg, and E1c levels that were not different, which suggests that the ovary retains sensitivity to elevated FSH in the early menopausal transition. In this cross-sectional study of women over age 42 who are premenopausal or in the early menopausal transition, there were important differences in the characteristics of cycles related to age, body mass index, and ethnicity. Comparisons to younger women indirectly support the inhibin hypothesis, which proposes that the initiating event in the menopausal transition is the loss of inhibin negative feedback on FSH secondary to a diminished follicular reserve.Source
J Clin Endocrinol Metab. 2004 Jun;89(6):2622-31.Link to article on publisher's siteDOI
10.1210/jc.2003-031578Permanent Link to this Item
http://hdl.handle.net/20.500.14038/50802PubMed ID
15181033Related Resources
Link to article in PubMedae974a485f413a2113503eed53cd6c53
10.1210/jc.2003-031578
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