Diagnostic role of follicle-stimulating hormone (FSH) measurements during the menopausal transition—an analysis of FSH, oestradiol and inhibin
Diagnostic role of follicle-stimulating hormone (FSH) measurements during the menopausal transition—an analysis of FSH, oestradiol and inhibin
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绝经过渡期间促卵泡激素 (FSH) 测量的诊断作用——FSH、雌二醇和抑制素的分析
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发表时间：
1994
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通讯作者：
H. Burger
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作者：
H. Burger
本文综述了卵泡刺激素（FSH）测量在评估绝经过渡期症状的意义和可能的持续生育能力方面的作用。促卵泡激素测量经常被认为是围绝经期患者的一种有用的诊断工具。一些研究者已经表明，在40岁以上的女性中，如果继续经历规律的月经周期，血清FSH水平在卵泡早期-中期和排卵后早期增加。血清雌二醇水平可能下降（尽管这是有争议的），免疫反应性FSH水平福尔斯下降，与FSH水平上升呈负相关。当月经周期或流量开始改变时，标志着绝经过渡期的开始，FSH水平可能会突然改变，上升到正常绝经后范围，并再次下降到年轻育龄妇女的正常范围。雌二醇和卵泡刺激素通常彼此平行波动，但与FSH相反，尽管有时雌二醇可能特别显著增加。绝经后FSH水平可能伴随着与正常排卵相符的内分泌证据。绝经后，FSH水平上升10-15倍，雌二醇水平低，检测不到雌二醇水平。它的结论是，FSH测量是没有价值的，如果有在评估妇女在绝经过渡期，因为它不能被可靠地解释，因为，显然，排卵（和，据推测，潜在的生育）周期可能会发生在观察绝经后FSH水平。雌二醇和雌二醇都是循环FSH的重要负反馈调节剂。
This review examines the role of follicle-stimulating hormone (FSH) measurement in assessing the significance of symptoms and possible continuing fertility during the menopausal transition. Follicle-stimulating hormone measurement is advocated frequently as a useful diagnostic tool in perimenopausal patients. Several investigators have shown that the serum FSH level increases in the early--mid-follicular and early postovulatory phases in women over the age of 40 years who continue to experience regular menstrual cycles. The serum oestradiol level may fall (although this is controversial) and the immunoreactive inhibin level falls, being inversely correlated with the rising FSH level. When alterations in menstrual cyclicity or flow commence, signalling the onset of the menopausal transition, FSH levels may change abruptly, rising into the normal postmenopausal range and falling again into the range normally seen in young fertile women. Oestradiol and inhibin generally fluctuate in parallel with each other but inversely to FSH, although at times oestradiol in particular may be increased markedly. Postmenopausal FSH levels may be followed by endocrine evidence compatible with normal ovulation. After the menopause, FSH levels rise 10-15-fold, with low oestradiol and undetectable inhibin levels. It is concluded that FSH measurement is of little value, if any in the assessment of women during the menopausal transition because it cannot be interpreted reliably and because, apparently, ovulatory (and, presumably, potentially fertile) cycles may occur subsequent to the observation of postmenopausal FSH levels. Both oestradiol and inhibin are important negative feedback regulators of circulating FSH.