Objective To summarize recommended updates to the 2001 Stages of Reproductive Aging Workshop (STRAW) criteria. The 2011 STRAW+10 workshop reviewed advances in understanding of the critical changes in hypothalamic-pituitary-ovarian function that occur before and after the final menstrual period (FMP). Methods Scientists from five countries and multiple disciplines evaluated data from cohort studies of midlife women and in the context of chronic illness and endocrine disorders, on change in menstrual, endocrine and ovarian markers of reproductive aging including anti-mullerian hormone (AMH), inhibin B, follicle-stimulating hormone (FSH), and antral follicle count (AFC). Modifications were adopted by consensus. Results STRAW+10 simplified bleeding criteria for the early and late menopausal transition, recommended modifications to criteria for the late reproductive stage (Stage − 3) and the early post-menopause stage (Stage +1), provided information on the duration of the late transition (Stage −1) and early post-menopause (Stage +1) and recommended application regardless of women’s age, ethnicity, body size or lifestyle characteristics. Conclusion STRAW+10 provides a more comprehensive basis for assessing reproductive aging in research and clinical contexts. Application of the STRAW+10 staging system should improve comparability of studies of midlife women and facilitate clinical decision-making. Nonetheless, important knowledge gaps persist and seven research priorities are identified.

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STRAW + 10 provides a more comprehensive basis for assessing reproductive aging in research and clinical contexts. Application of the STRAW + 10 staging system should improve comparability of studies of midlife women and facilitate clinical decision making. Nonetheless, important knowledge gaps persist, and seven research priorities are identified.

A select group of investigators attended a structured workshop, the Stages of Reproductive Aging Workshop (STRAW), at Park City, Utah, USA, in July 2001, which addressed the need in women for a staging system as well as the confusing nomenclature for the reproductive years.