Evaluation of four proposed bleeding criteria for the onset of late menopausal transition.

Full Abstract

CONTEXT:
The current criterion for onset of late menopausal transition is amenorrhea of 90 d or more. The Stages of Reproductive Aging Workshop proposed alternative criteria based on a shorter period of amenorrhea. Empirical data comparing proposed criteria are not available.

OBJECTIVE:
This paper evaluates the several bleeding criteria that served as the basis of these recommendations. The goal was to provide empirically based guidance regarding which bleeding criterion may be optimal for widespread application in clinical and research settings.

DESIGN/SETTING:
The study used prospective menstrual calendar data from four community and population-based cohort studies:
TREMIN, Melbourne Women's Midlife Health Project, Seattle Midlife Women's Health Study, and Study of Women's Health Across the Nation.

PARTICIPANTS:
The study included 735 TREMIN, 279 Seattle Midlife Women's Health Study, 216 Melbourne Women's Midlife Health Project, and 2270 Study of Women's Health Across the Nation women aged 35-57 yr at baseline who contributed 10 menstrual cycles or more. MAIN OUTCOME MEASURE(S):
The main measures were the frequency of and median age at occurrence and time from occurrence to final menstrual period (FMP) for four criteria:
skipped segment, 10-segment running range, 60- and 90-d amenorrhea.

RESULTS:
A skipped segment, 10-segment running range greater than 42 d and 60-d amenorrhea identify a similar time in women's reproductive lives. The latter two identify the exact same date in two thirds of women. All three criteria occur in a greater proportion of women than the 90-d criterion and are equally predictive of the FMP, although they occur 1-2 yr earlier.

CONCLUSIONS:
These findings support the recommendation of the Stages of Reproductive Aging Workshop that 60 d of amenorrhea be used to define onset of the late menopausal transition.

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Author information

Author/s: Harlow, Siobán D (SD); Cain, Kevin (K); Crawford, Sybil (S); Dennerstein, Lorraine (L); Little, Roderick (R); Mitchell, Ellen S (ES); Nan, Bin (B); Randolph, John F (JF); Taffe, John (J); Yosef, Matheos (M);

Affiliation: Department of Epidemiology, University of Michigan, 611 Church Street, Room 350, Ann Arbor, Michigan 48104, USA. harlow(-atsign-)umich.edu

Grants: AG 021543 (Agency:NIA NIH HHS) ; AG012495 (Agency:NIA NIH HHS) ; AG012505 (Agency:NIA NIH HHS) ; AG012531 (Agency:NIA NIH HHS) ; AG012535 (Agency:NIA NIH HHS) ; AG012539 (Agency:NIA NIH HHS) ; AG012546 (Agency:NIA NIH HHS) ; AG012553 (Agency:NIA NIH HHS) ; AG012554 (Agency:NIA NIH HHS) ; NR004061 (Agency:NINR NIH HHS) ; NR004141 (Agency:NINR NIH HHS) ; NR04001 (Agency:NINR NIH HHS) ; R01 AG021543-01A1 (Agency:NIA NIH HHS) ; R01 AG021543-02 (Agency:NIA NIH HHS)

Journal and publication information

Publication Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab), published in United States. (Language: eng)

Reference: 2006-Sep; vol 91 (issue 9) : pp 3432-8

Dates: Created 2006/09/08; Completed 2006/10/12; Revised 2008/11/20;

PMID: 16772350, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Amenorrhea - etiology
Cohort Studies
Female

Humans
Middle Aged
Perimenopause - physiology
Prospective Studies

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