Reproductive Hormones and the Menopause Transition

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Staging the MT

The MT is preceded by approximately 35 years of regular, predictable menstrual cycles. During this time, women have a well-defined intermenstrual interval of 25 to 35 days. These cycles consist of a 14-day luteal phase, and a follicular phase of at least 10 to 11 days. Before the appearance of a break in this characteristic menstrual rhythm, the oocyte supply has been dwindling, but has not yet reached a critical level. Nonetheless, although no signs are detectable to a woman, some subtle

Menstrual Cycle Hormone Changes Across the MT

Although numerous worldwide studies have reported findings on annual or semiannual changes in serum hormones across the MT,12, 26, 27 which are usually measured in the early follicular phase of the cycle, day-to-day hormone levels across a menstrual cycle have been less well characterized.

The first studies of menstrual cycle dynamics across the MT were performed by Metcalf, from New Zealand. To characterize hormone patterns over time, these investigators developed methods suitable for the

Clinical Implications

With the maturation of SWAN and the transition to postmenopause by the vast majority of participants, both observed and obscured by hormone use or surgery, it has become possible to disentangle many of the coincident effects of both ovarian and chronologic aging on the health of women at midlife. Moreover, the complex patterns of change throughout the MT in both the cyclic and longitudinal hormone profiles are now in sharper focus and will help to direct clinical care as well as guide future

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      Therefore, the results of this study should not be compared with studies that examined hormonal concentrations longitudinally over time (e.g., [12]). This is important because early in the menopausal transition, serum E2 concentrations fluctuate and can be intermittently elevated [26]. Moreover, VMS are experienced well before the increasing variability in cycle length of the late menopausal transition (cessation of menses for at least 60 days), highlighting the complexity of associations between serum estrogen concentrations and menopausal symptoms.

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    Funded by AG-12535 and NR-04061.

    Dr Nanette Santoro is a consultant to Menogenix.

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