Using longitudinal data to define the perimenopause by menstrual cycle characteristics.
Using longitudinal data to define the perimenopause by menstrual cycle characteristics.
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DOI：
10.3109/13697139809080677
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发表时间：
1998-03-01
期刊：
影响因子：
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通讯作者：
Dennerstein, L
中科院分区：
文献类型：
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作者：
Dudley, E C;Hopper, J L;Dennerstein, L
目的：确定月经变化的哪些方面最能预测绝经后时间。方法：总共 250 名年龄在 45-55 岁的澳大利亚出生女性被分为五个月经状态类别：I 组报告月经流量或频率没有变化；第二组报告流量变化；第三组报告频率变化；第四组报告了频率和流量的变化； V 组报告有 3 至 11 个月的闭经。比较月经状态组的年龄、激素水平、潮热和自评更年期状态的基线数据。使用 4 年的随访数据比较随后几年进入绝经后的女性比例。 结果：与过去 3 个月内有月经的女性（第 I-IV 组）相比，第 V 组女性年龄较大，雌二醇和抑制素水平较低，卵泡刺激素水平较高，并且更有可能报告潮热，并自我评估自己已开始绝经过渡。第一组和第二组在年龄和荷尔蒙状态方面相似，第三组和第四组也是如此。在基线后 4 年内进入绝经后状态的女性比例，在 I-V 组中分别为 12%、14%、58%、53% 和 94%。 结论：闭经是未来绝经的最佳预测指标，其次是月经频率的变化。仅流量变化并不能预测未来的更年期。建议采用两阶段分类方案来定义围绝经期。 “早期围绝经期”被定义为自我报告去年月经频率的变化，“晚期围绝经期”被定义为自我报告闭经3-11个月。
OBJECTIVES: To determine which aspects of menstrual change best predict time to postmenopause.METHODS: A total of 250 Australian-born women aged 45-55 years were divided into five menstrual status categories: Group I reported no change in menstrual flow or frequency; Group II reported change in flow; Group III reported change in frequency; Group IV reported change in both frequency and flow; and Group V reported between 3 and 11 months of amenorrhea. Menstrual status groups were compared on baseline data for age, hormone levels, hot flushes and self-rated menopausal status. The proportion of women moving to postmenopause in subsequent years was compared using 4 years of follow-up data.RESULTS: Women in Group V were older, had lower estradiol and inhibin levels, higher follicle stimulating hormone levels, and were more likely to report hot flushes, and to self-rate themselves as having started the menopausal transition, compared with the women who had menstruated in the last 3 months (Groups I-IV). Groups I and II were similar in age and hormonal status, as were Groups III and IV. The proportion of women who had moved to postmenopausal status in the 4 years after baseline were 12%, 14%, 58%, 53% and 94% for Groups I-V, respectively.CONCLUSIONS: Amenorrhea is the best predictor of future menopause followed by changes in menstrual frequency. Change in flow only was not predictive of future menopause. A two-stage classification scheme is suggested for defining the perimenopause. 'Early perimenopause' is defined as the self-reporting of changes in menstrual frequency over the last year, and 'late perimenopause' is defined as the self-report of 3-11 months of amenorrhea.