Predicting Menopause Will Soon Be Possible

For many women, including the growing number who choose later-in-life pregnancy, predicting their biological clock's relation to the timing of their menopause and infertility is critically important.

Researchers at the University of Michigan have found some new information about hormonal biomarkers that address the beginning of menopause transition.

"In the end, this information can change the way we do business," said MaryFran Sowers, professor in the University of Michigan, School of Public Health Department of Epidemiology. "The information provides a roadmap as to how fast women are progressing through the different elements of their reproductive life."

The team examined changes in hormones follicle-stimulating hormone (FSH), anti-Mullerian hormone (AMH) and inhibin B, in more than 600 women over 14 years. They discovered that the biomarker AMH declined to a very low or non-measurable level five years prior to the final menstrual period, a decline which signals a critical stage in which a woman probably has so few follicles (eggs) that her fertility becomes increasingly questionable.

Based on a woman's age and the level of FSH in the blood, the researchers were able to describe four different stages that occur for women from their late reproductive period to the time of their final menstrual period. While it is now possible for doctors to measure hormones, information about AMH, inhibin B or FSH collected on a large group of women over time has not been available in order to relate changes in the levels to fertility or to a menopause endpoint.

Professor Sowers says people want information about how long they will remain fertile and when they are likely to have their final menstrual period. "Now we are beginning to say, 'If you have a specific FSH level combined with your age, this is the likelihood that you are in this reproductive stage."

Although the technique has been around for some time she said, now there are numbers, from enough women, evaluated over a long time period, to describe the reproductive aging process which will give women and clinicians an expanded way to look at menses and endocrine events in terms of reproductive progression. Additional study results have been submitted to describe the amount of bone loss that occurs at the different FSH stages, so if women and clinicians know where women are in the various reproductive stages, it will further their understanding of the likely health implications associated with each stage.