Longitudinal changes in hypothalamic and ovarian function in perimenopausal women with anovulatory cycles: relationship with vasomotor symptoms
Received 7 December 2007; received in revised form 7 January 2008; accepted 7 January 2008. published online 21 May 2008.
Objective
To determine whether the transition to menopausal status is unidirectional and predictable with aging.
Design
Longitudinal evaluation of the menstrual cycle hormone patterns and experience of vasomotor symptoms in an anovulatory, perimenopausal cohort, during cycles that occurred 1 and 2 years after an anovulatory cycle.
Setting
Academic center.
Patient(s)
One hundred fifty-nine of 840 women in the Daily Hormone Study, a substudy of the Study of Women's Health across the Nation (SWAN), had anovulatory cycles. Their menstrual cycle patterns were previously described. This report describes their cycle patterns and vasomotor symptoms in the subsequent 2 years.
Intervention(s)
None.
Main Outcome Measure(s)
Daily urinary hormone levels of FSH, LH, and estrogen and P metabolites and reports of daily occurrence of vasomotor symptoms.
Result(s)
While a tendency to develop cycles having a loss of negative feedback of estrogen on LH secretion was seen before menopause, there is no clear progression of cycle patterns in anovulatory women. Anovulation did not predict menopause within 2 years. Vasomotor symptoms occur before menopause, as experienced by 73% of the women. Vasomotor symptoms were not related to cycle pattern.
Conclusion(s)
Any cycle pattern may be related to vasomotor symptoms. The best predictor of vasomotor symptoms is a prior history of vasomotor symptoms.
aDepartment of Preventive Medicine and Community Health, New Jersey Medical School of UMDNJ, Newark, New Jersey
bDepartment of Obstetrics, Gynecology and Women's Health, New Jersey Medical School of UMDNJ, Newark, New Jersey
cDepartment of Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine, New York, New York
dDivision of Preventive and Behavioral Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts
Reprint requests: Laura T. Goldsmith, Ph.D., Department of Obstetrics, Gynecology and Women's Health, New Jersey Medical School of UMDNJ, 185 South Orange Avenue, Newark, New Jersey 07103 (FAX: 973-972-4574).
J.H.S. has nothing to disclose. G.W. has nothing to disclose. L.T.G. has nothing to disclose. N.S. has nothing to disclose. S.C. has nothing to disclose.
The Study of Women's Health across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), Department of Health and Human Services, through the National Institute on Aging, the National Institute of Nursing Research, and the NIH Office of Research on Women's Health (grant nos. NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, and AG012495).
ABSTRACT