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Fertil Steril. 2008 Jan;89(1):129-40. Epub 2007 Aug 6.

The ReSTAGE Collaboration: defining optimal bleeding criteria for onset of early menopausal transition.

Author information

  • 1Epidemiology, University of Michigan, Ann Arbor, Michigan 48104, USA. harlow@umich.edu

Abstract

OBJECTIVE:

Criteria for staging the menopausal transition are not established. This article evaluates five bleeding criteria for defining early transition and provides empirically based guidance regarding optimal criteria.

DESIGN/SETTING:

Prospective menstrual calendar data from four population-based cohorts: TREMIN, Melbourne Women's Midlife Health Project (MWMHP), Seattle Midlife Women's Health Study (SMWHS), and Study of Women's Health Across the Nation (SWAN) with annual serum FSH from MWMHP and SWAN.

PARTICIPANTS:

735 TREMIN, 279 SMWHS, 216 MWMHP, and 2270 SWAN women aged 35-57 at baseline who maintained menstrual calendars.

MAIN OUTCOME MEASURE(S):

Age at and time to menopause for: standard deviation >6 and >8 days, persistent difference in consecutive segments >6 days, irregularity, and >or=45 day segment. Serum FSH concentration.

RESULT(S):

Most women experienced each of the bleeding criteria. Except for a persistent >6 day difference that occurs earlier, the criteria occur at a similar age and at approximately the same age as late transition in a large proportion of women. FSH was associated with all proposed markers.

CONCLUSION(S):

The early transition may be best described by ovarian activity consistent with the persistent >6 day difference, but further study is needed, as other proposed criterion are consistent with later menstrual changes.

PMID:
17681300
[PubMed - indexed for MEDLINE]
PMCID:
PMC2225986
Free PMC Article
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