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Using longitudinal data to define the perimenopause by menstrual cycle characteristics.

E C Dudley1, J L Hopper, J Taffe

  • 1Office for Gender and Health, Department of Psychiatry, University of Melbourne, 211 Grattan Street, Carlton, Victoria, 3053, Australia.

Climacteric : the Journal of the International Menopause Society
|March 23, 2002
PubMed
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Amenorrhea (3-11 months of no periods) is the strongest predictor of postmenopause. Changes in menstrual frequency also predict menopause, but changes in flow alone do not. This research defines early and late perimenopause stages.

Area of Science:

  • Reproductive endocrinology
  • Women's health
  • Menopause research

Background:

  • The menopausal transition is a complex process with varying individual timelines.
  • Predicting the onset of postmenopause is crucial for women's health management.
  • Menstrual cycle changes are key indicators of reproductive aging.

Purpose of the Study:

  • To identify which menstrual changes most accurately predict the time to postmenopause.
  • To establish reliable markers for defining perimenopausal stages.
  • To enhance understanding of the menopausal transition in women aged 45-55.

Main Methods:

  • 250 Australian women (45-55 years) categorized by menstrual status (no change, flow change, frequency change, both, or amenorrhea).
  • Comparison of baseline demographics, hormone levels (estradiol, inhibin, FSH), and self-rated menopausal status.

Related Experiment Videos

  • Follow-up for 4 years to track progression to postmenopause.

    • Main Results:

    • Women with amenorrhea (Group V) were older, had lower estradiol/inhibin, higher FSH, and more menopausal symptoms.
    • Progression to postmenopause after 4 years: 12% (Group I), 14% (Group II), 58% (Group III), 53% (Group IV), and 94% (Group V).
    • Amenorrhea and changes in menstrual frequency were significant predictors; changes in flow alone were not.

    Conclusions:

    • Amenorrhea is the most significant predictor of future menopause, followed by changes in menstrual frequency.
    • A two-stage perimenopause classification is proposed: 'early' (frequency change) and 'late' (amenorrhea).
    • This study provides a clearer framework for understanding and classifying perimenopausal stages based on menstrual patterns.