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Menstrual bleeding, hormones, and the menopausal transition.
1New England Research Institutes, Watertown, MA 02472, USA.
Seminars in Reproductive Endocrinology
|June 14, 2000
Summary
Perimenopause involves significant hormonal and menstrual cycle changes, with increasing variability as menopause approaches. Understanding these patterns helps differentiate normal transitions from potential health issues.
Area of Science:
- Reproductive endocrinology
- Gynecology
- Menopause research
Background:
- Reproductive aging begins before perimenopause with rising FSH, shorter cycles, and declining follicles.
- Perimenopause onset is marked by the first irregular menstrual cycle.
- Hormonal changes during perimenopause are characterized by increased variability and unpredictability.
Purpose of the Study:
- To review research on reproductive hormone and menstrual bleeding patterns during the menopausal transition.
- To improve the distinction between normal perimenopausal events and significant pathology.
Main Methods:
- Review of existing research on reproductive hormones (FSH, gonadotropins, estradiol, inhibin) and menstrual bleeding.
- Analysis of hormonal dynamics and cycle characteristics during the menopausal transition.
Main Results:
- Perimenopause exhibits significant variability in reproductive hormone levels and menstrual cycle characteristics.
- Hormonal fluctuations, including abrupt spikes in gonadotropins and estradiol, are characteristic of this phase.
- No single endocrine marker adequately indicates menopausal status.
Conclusions:
- Variability is a hallmark of perimenopause, driven by hormonal fluctuations.
- Understanding these transitional patterns is crucial for clinical assessment.
- Distinguishing normal changes from pathology requires comprehensive knowledge of perimenopausal endocrinology.