A new UCLA-led study suggests a way to predict when a woman will have her final menstrual period. The findings, published in the April issue of the peer-reviewed Journal of Clinical Endocrinology and Metabolism, could help women and physicians gauge the onset of menopause-related bone loss, which generally begins a year prior to the last period.
The researchers used women's ages, menstrual bleeding patterns and measurements of hormone levels to estimate the amount of time until they were likely to reach menopause, said the study's lead author, Dr. Gail Greendale, professor of medicine in the division of geriatrics at the David Geffen School of Medicine at UCLA.
Greendale said women who are approaching menopause often ask their health care providers when they will be done with their periods, but the information is sometimes more telling than women realize.
"Being able to estimate when the final menstrual period will take place has taken on importance beyond just helping women gauge when they will stop having periods," she said. "We know that potentially deleterious physiological developments, such as the onset of bone loss and an increase in cardiovascular risk factors, precede the final menses by at least a year."
The researchers used data collected annually for up to 11 years on 554 women, including Caucasians, African Americans, Hispanics and those of Chinese and Japanese descent, participating in the multi-site, multi-ethnic Study of Women's Health Across the Nation. At enrollment, the women were between the ages of 42 to 53, had an intact uterus and at least one ovary, were not using medications affecting ovarian function and had experienced at least one menstrual period in the prior three months.
The researchers measured levels of estradiol (E2), a hormone produced by the ovaries, and follicle stimulating hormone (FSH), which comes from the pituitary gland and triggers the production of eggs. FSH starts increasing and E2 starts decreasing about two years prior to the final menstrual period, or about a year before bone loss and cardiovascular risk factors rise.
The study found that the levels of the two hormones could be used to estimate whether women were within two years of beginning their final menstrual period, within one year or beyond their final period.
The study had some limitations, including its modest sample size. In addition, hormone levels were sampled once a year and more frequent sampling might have allowed the researchers to more precisely estimate the woman's place on the timeline.
Study co-authors were Mei-Hua Huang and Dr. Arun Karlamangla of UCLA and Dr. Shinya Ishii of the University of Tokyo.
The Study of Women's Health Across the Nation was funded by the National Institutes of Health through the National Institute on Aging, the National Institute of Nursing Research, and the NIH Office of Research on Women's Health (NR004061, NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554 and AG012495).
The UCLA Division of Geriatrics within the department of medicine at the David Geffen School of Medicine at UCLA offers comprehensive outpatient and inpatient services at several convenient locations and works closely with other UCLA programs that strive to improve and maintain the quality of life of seniors. UCLA geriatricians are specialists in managing the overall health of people age 65 and older and treating medical disorders that frequently affect the elderly, including memory loss and dementia, falls and immobility, urinary incontinence, arthritis, arthritis, high blood pressure, heart disease, osteoporosis and diabetes. As a result of their specialized training, UCLA geriatricians can knowledgably consider and address a broad spectrum of health-related factors — including medical, psychological and social — when treating patients.
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