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Hormonal changes in the menopause transition.

Henry G Burger1, Emma C Dudley, David M Robertson

  • 1Prince Henry's Institute of Medical Research at Monash Medical Centre, Clayton, Victoria, Australia. henry.burger@med.monash.edu.au

Recent Progress in Hormone Research
|May 23, 2002
PubMed
Summary
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Menopause transition involves hormonal shifts, including rising follicle-stimulating hormone (FSH) and declining inhibin B, years before final menstruation. These changes, primarily driven by falling estradiol, contribute to menopausal symptoms and bone density loss.

Area of Science:

  • Reproductive Endocrinology
  • Gynecology
  • Menopause Research

Background:

  • Menopause is defined as the permanent cessation of menstruation due to loss of ovarian follicular activity.
  • The menopausal transition is characterized by endocrine, biological, and clinical changes, often starting with menstrual irregularity.
  • Key biological changes include neuroendocrine shifts and a significant decline in ovarian follicle numbers.

Purpose of the Study:

  • To elucidate the hormonal dynamics during the menopausal transition.
  • To identify reliable markers for predicting menopause onset and understanding associated physiological changes.
  • To correlate hormonal fluctuations with the onset of menopausal symptoms and bone mineral density loss.

Main Methods:

  • Analysis of hormonal profiles, including follicle-stimulating hormone (FSH), inhibin B (INH-B), estradiol, testosterone, dehydroepiandrosterone (DHEA), and DHEAS.

Related Experiment Videos

  • Correlation of hormonal changes with the stages of the menopausal transition and clinical indicators.
  • Investigation of the relationship between hormonal decline and bone mineral density changes.

    • Main Results:

    • Follicle-stimulating hormone (FSH) levels begin to rise years before clinical menopause, reflecting declining ovarian follicle numbers and decreased inhibin B (INH-B) production.
    • Estradiol levels remain stable or rise until the late perimenopause, potentially in response to elevated FSH, but fluctuate significantly during the transition.
    • Testosterone levels show little change during transition, while DHEA/DHEAS decline with age, independent of menopause. The sharp drop in estradiol around final menses is linked to bone mineral density loss.

    Conclusions:

    • Rising FSH and falling INH-B are early indicators of the menopausal transition, preceding clinical signs.
    • Hormonal fluctuations during the transition make FSH and estradiol unreliable for precise menopausal status determination.
    • The decline in estradiol during late perimenopause is a primary driver of menopausal symptoms and contributes to bone mineral density loss.