Summary
Tepper PG, Randolph JF, McConnell DS, et al. Trajectory clustering of estradiol and follicle-stimulating hormone during the menopausal transition among women in the Study of Women’s Health across the Nation (SWAN). J Clin Endocrinol Metab 2012 June 1 [Epub ahead of print]. Level of evidence: III.
Are there different patterns of change in estradiol (E2) and follicle-stimulating hormone (FSH) over the menopause transition and are race/ethnicity and body mass index (BMI) related to these different trajectories? This current study from the Study of Women’s Health Across the Nation (SWAN) recruited postmenopausal women ages 42 to 52 whose final menstrual period (FMP) was not due to hysterectomy or oophorectomy. These women had not used hormone therapy (HT). Seven participating sites followed them for 11 annual visits. The women’s annual serum E2 and FSH levels anchored to FMP were measured.
Researchers determined four distinct E2 trajectories: slow decline (26.9%), flat (28.6%), rise/slow decline (13.1%), and rise/steep decline (31.5%). Three distinct FSH trajectories were identified: low (10.6%), medium (48.7%), and high (41.7%) rising patterns. Obese women were more likely to follow a flat E2 and low FSH trajectory for all race/ethnic groups. Normal-weight Caucasian and African-American women were likely to follow the rise/steep decline E2 and high FSH trajectories. Normal-weight Chinese/Japanese women were likely to follow the slow decline E2 and high/medium FSH trajectories.