Urinary oestrogen patterns in long follicular phases

Long menstrual cycles have been associated with reduced risk of breast cancer and increased risk of osteoporosis. These observations have led to assumptions about the endogenous oestrogen exposure of women with long cycles. However, daily oestrogen profiles in long menstrual cycles have not been described. This paper examines daily urinary oestrogen profiles during the follicular phases of 416 conception and non-conception cycles. Women were aged 21-42 years, had no history of infertility and were not under treatment. Twenty-eight cycles were defined as long, with a follicular phase that lasted 24 days or more. Five patterns were observed among these long cycles, the most common being a pattern consistent with delayed emergence of a dominant follicle. Other patterns were a pattern consistent with demise and replacement of a dominant follicle, one consistent with delayed follicular recruitment, one showing a prolonged initial drop in oestrogen and one with an extended oestrogen peak. Average follicular phase oestrogen concentrations were highest in cycles with short follicular phases (7-11 days). Oestrogen concentrations from long follicular phases (24-59 days) did not differ substantially from follicular phases of usual length (12-17 days). The oestrogen profiles in long follicular phases are heterogeneous and not necessarily hypo-oestrogenic.