Perimenopausal patterns of gonadotrophins, immunoreactive inhibin, oestradiol and progesterone

Hee, Jennifer; MacNaughton, J.; Bangah, Mohan; Burger, Henry G.

doi:10.1016/0378-5122(93)90026-e

Cited by 86 publications

(38 citation statements)

References 23 publications

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“…Our study did, indeed, show that serum concentrations of activin A in men and women are not related to FSH concentration throughout adult life; furthermore, no differences exist between fertile and postmenopausal women. It has been proven that serum inhibin concentrations become undetectable in postmenopausal women (22). These findings clearly suggest that gonads are therefore not the major source of circulating activin A in both sexes.…”

Section: Discussionsupporting

confidence: 53%

Influence of age and sex on serum concentrations of total dimeric activin A

Loria¹,

Petraglia²,

Concari³

et al. 1998

European Journal of Endocrinology

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Several studies have shown that activin A is secreted in substantial amounts into the systemic circulation. The changes that occur during menstrual cycle and pregnancy suggest a correlation with reproductive function. At present, however, no definitive evidence has confirmed this pattern throughout adult life; moreover, neither the origin nor the physiological implications of this circulating growth factor have been clearly defined. The aim of the present study was to evaluate whether circulating concentrations of activin A change in adult men and women according to age and sex, and to examine the possible correlation with serum concentrations of FSH. Total dimeric activin A was measured using a specific two-site enzyme immunoassay in serum specimens collected from a cohort of normal individuals enrolled in an epidemiological survey. A group of men (n ¼ 106) and one of women (n ¼ 151) were subdivided into six age groups (20-30, 30-40, 40-50, 50-60, 60-70 and 70-90 years). In a small group of 8 men and 11 women, serum concentrations of activin A were evaluated twice, in specimens collected at an interval of 10 years. Serum FSH concentrations were also measured in all specimens.Serum concentrations of activin A were not significantly different in men and women and showed an age-related progressive increase between 20 and 50 years of age (P < 0.01, those aged 40-50 compared with those aged 20-30 years). After the age of 50 years, activin A concentrations remained in the same range of values in women, whereas they increased significantly in men, reaching peak values between 70 and 90 years (P < 0.01 compared with the group aged between 20 and 50 years). From the age of 50 years, activin A concentrations were significantly greater in men compared with those in women in the corresponding age groups (P < 0.001). Activin A concentrations correlated with age in men, but not in women. No significant correlation between concentrations of activin A and FSH was found in either sex. Activin A concentrations in specimens collected 10 years apart showed an increase in seven of eight men, but not in women. Finally, no significant variations of activin A concentrations were observed when fertile and postmenopausal women were compared.The present data indicate that circulating concentrations of activin A vary according to age; furthermore, men older than 50 years have greater concentrations than women. These changes, which occur irrespectively of FSH concentrations, indicate that circulating activin A is not a hormone of the reproductive axis.

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Section: Discussionsupporting

confidence: 53%

Influence of age and sex on serum concentrations of total dimeric activin A

Loria¹,

Petraglia²,

Concari³

et al. 1998

European Journal of Endocrinology

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“…Metcalf (1988) subsequently concluded that "in older women, a good menstrual history is probably the single most useful measure of ovarian status." Hee et al (1993) confirmed the variability of perimenopausal E 2 concentrations and added data on immunoreactive INH in a small longitudinal study of three volunteer women who had developed irregular cycles at age 45 to 46. Abrupt decreases in E 2 and INH into the postmenopausal range were followed by values characteristic of reproductive-aged women.…”

Section: A Fsh and Estradiolmentioning

confidence: 51%

Hormonal Changes in the Menopause Transition

Burger

Dudley²,

Robertson³

et al. 2002

Recent Progress in Hormone Research

407

232

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The menopause is the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. It is heralded by the menopausal transition, a period when the endocrine, biological, and clinical features of approaching menopause begin. A common initial marker is the onset of menstrual irregularity. The biology underlying the transition to menopause includes central neuroendocrine changes as well as changes within the ovary, the most striking of which is a profound decline in follicle numbers. Follicle-stimulating hormone (FSH) is an established indirect marker of follicular activity. In studies of groups of women, its concentration, particularly in the early follicular phase of the menstrual cycle, begins to increase some years before there are any clinical indications of approaching menopause. The rise in FSH is the result of declining levels of inhibin B (INH-B), a dimeric protein that reflects the fall in ovarian follicle numbers, with or without any change in the ability of the lining granulosa cells to secrete INH-B. Estradiol levels remain relatively unchanged or tend to rise with age until the onset of the transition and are usually well preserved until the late perimenopause, presumably in response to the elevated FSH levels. During the transition, hormone levels frequently vary markedly -hence, measures of FSH and estradiol are unreliable guides to menopausal status. Concentrations of testosterone have been reported to fall by about 50% during reproductive life, between the ages of 20 and 40. They change little during the transition and, after menopause, may even rise. Dehydroepiandrosterone (DHEA) and DHEAS, its sulphate, on the other hand, decline with age, without any specific influence of the menopause. Symptoms of the menopause can be interpreted as resulting primarily from the profound fall in estradiol, occurring over a 3-to 4-year period around final menses, a fall that presumably contributes importantly to the beginning, in the late perimenopause, of loss of bone mineral density.

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“…The months before and after the final menstrual period are characterized by significant ovarian and gonadotrophin hormonal variability and change [18,[29][30][31]. In one longitudinal study, a marked decrease in oestradiol levels occurred during the 6-month period around the menopause [31].…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Bone Loss in Menopausal Australian-Born Women

Guthrie¹,

Ebeling

Hopper

et al. 1998

Osteoporosis International

113

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Two hundred and twenty-four women (74 pre-, 90 peri-, 60 post-menopausal), aged 46-59 years, from a population-based cohort participated in a longitudinal study of bone mineral density (BMD). BMD was measured by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and femoral neck and the time between bone scans was on average 25 (range 14-41) months. The aim of the study was to assess changes in BMD in relation to changes in normal menopausal status. During the study period women who were between 3 and 12 months past their last menstrual period (n = 22, late perimenopausal) at the time of the second bone scan had a mean (SE) annual change in BMD of -0.9% (0.4%) at the lumbar spine and -0.7% (0.6%) at the femoral neck (both p < 0.05 compared with women who remained premenopausal). In the women who became postmenopausal (n = 42) the mean annual changes in BMD were -2.5% (0.2%) at the lumbar spine and -1.7% (0.2%) at the femoral neck (both p < 0.0005), and in the women who remained post-menopausal (n = 60) they were -0.7% (0.2%) per year and -0.5% (0.3%) per year respectively (both p < 0.05), compared with women who remained premenopausal. In the 1-3 years after the final menstrual period (FMP) there was greater bone loss from the lumbar spine than the femoral neck (p < 0.05). In women who were menstruating at the time of the second bone scan and whose FMP could be dated prospectively (n = 35), higher baseline oestradiol levels were associated with less lumbar spine bone loss (p < 0.005). In the women who remained postmenopausal there was an association between baseline body mass index (BMI) and percentage change per year in femoral neck BMD (p < 0.05), such that women with higher BMI had less bone loss. In conclusion, during the time of transition from peri- to post-menopause, women had accelerated BMD loss at both the hip and spine.

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Perimenopausal patterns of gonadotrophins, immunoreactive inhibin, oestradiol and progesterone

Cited by 86 publications

References 23 publications

Influence of age and sex on serum concentrations of total dimeric activin A

Influence of age and sex on serum concentrations of total dimeric activin A

Hormonal Changes in the Menopause Transition

A Prospective Study of Bone Loss in Menopausal Australian-Born Women

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