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Early menopausal changes in bone mass and sex steroids
The Journal of Clinical Endocrinology and Metabolism
|November 1, 1985
Summary
Bone loss, particularly in the spine, can start before menopause ends. This bone loss is linked to lower estrogen levels and increased bone remodeling, highlighting the importance of monitoring bone health during this transition.
Area of Science:
- Reproductive endocrinology
- Bone metabolism
- Menopause research
Background:
- Perimenopause and early postmenopause are characterized by hormonal fluctuations and changes in menstrual patterns.
- Estrogen decline during this phase is a known risk factor for bone loss.
- Understanding the precise timing and hormonal correlates of bone loss is crucial for early intervention.
Purpose of the Study:
- To investigate the relationship between menopausal status, hormonal changes, and bone mineral density in perimenopausal and early postmenopausal women.
- To determine if bone loss begins before the cessation of menses.
- To correlate estrogen levels and bone remodeling markers with bone mass.
Main Methods:
- Eighty-four healthy women were categorized into four groups based on menstrual regularity and follicle-stimulating hormone (FSH) levels.
- Plasma concentrations of estrone, estradiol, androstenedione, testosterone, FSH, and luteinizing hormone (LH) were measured.
- Vertebral and radial bone mass were assessed.
- Serum calcium and bone gla protein levels were analyzed to indicate bone remodeling.
Main Results:
- Estrone and estradiol levels decreased progressively in groups with irregular periods and those further into postmenopause.
- Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels significantly increased with menopausal progression.
- Vertebral bone mass was significantly reduced in groups B, C, and D compared to group A; radial bone mass decreased in group D.
- A positive correlation was observed between plasma estrone/estradiol and bone mass at both the radius and vertebra.
Conclusions:
- Bone loss, especially from the spine, may commence during perimenopause, prior to the final menstrual period.
- Decreased estrogen production and increased bone remodeling are significantly associated with bone loss during this menopausal transition.
- These findings underscore the importance of early assessment of bone health and estrogen status in perimenopausal women.