The menopausal transition - Endocrinology
The menopausal transition - Endocrinology
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DOI：
10.1111/j.1743-6109.2008.00921.x
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发表时间：
2008-10-01
影响因子：
3.5
通讯作者：
Burger, Henry
中科院分区：
文献类型：
--
作者：
Burger, Henry
导论.墨尔本妇女的中年健康项目（MWMHP）和相关的研究已经取得了宝贵的信息，关于绝经过渡期的内分泌变化，这是总结在此reviewsAim。16描述了绝经过渡期的内分泌学。主要结果测量。包括在定期骑自行车的志愿者中横断面和通过绝经过渡期的妇女中纵向（包括睾酮）的β-受体A和B、促卵泡激素（FSH）和雌二醇的变化。在年龄20-50岁的正常志愿者中，以及在最初招募的438名年龄在45 - 55岁之间的受试者中，通过充分表征的免疫测定法测量了早期卵泡期激素浓度，用于绝经过渡的纵向研究，MWMHP，其中每年采集血液样本。此处列出的数据包括前6年的随访。这些志愿者还记录了月经周期数据，并对详细的年度报告做出了回应。在40岁以上的定期骑自行车的女性志愿者中，确定了卵泡刺激素B是循环FSH水平的重要决定因素。根据MWMHP，标记月经不规则发作的中枢内分泌事件显示为卵泡期FSH B浓度下降，FSH无显著性升高，雌二醇或FSH A无变化。对MWMHP早期妇女数据的横断面分析显示，无论绝经状态如何，循环FSH水平变化很大，表明单次FSH测量提供的绝经状态信息很少。基于对末次月经日期（FMP）的前瞻性测定，结果表明，在FMP前约2年，雌二醇水平开始下降，FSH水平上升。在FMP时，FSH水平约为绝经后最终达到的水平的50%，而雌二醇水平较育龄水平下降约50%。尽管随着女性进入绝经期，性功能会出现明显下降，但循环中的睾酮水平并没有明显下降，性功能的下降与雌二醇的下降有关，而与睾酮无关。对相关研究资料的分析表明，在已经经历过周期不规则，甚至闭经超过3个月的妇女中可以观察到内分泌正常的排卵周期，并且可以在接近或在FMR时发生。一个广泛的数据库内分泌，更年期过渡，包括横截面和纵向信息，已获得。
Introduction. The Melbourne Women's MidLife Health Project (MWMHP) and related studies have yielded valuable information regarding the endocrine changes of the menopausal transition, which are summarized in this reviewsAim. 16 describe the endocrinology of the menopause transition.Main Outcome Measures. Includes changes in inhibins A and B, follicle stimulating hormone (FSH), and estradiol, cross-sectionally in regularly cycling volunteers, and longitudinally (including testosterone) in women passing through the menopause transition.Methods. Early follicular phase hormone concentrations were measured by well-characterized immunoassays in normal volunteers aged 20-50 years, and in 438 subjects initially recruited between ages 45 and 55 for a longitudinal study of the menopause transition, the MWMHP, in which annual blood samples were obtained. The data surninarized here includes the first 6 years of follow-up. These Volunteers also recorded menstrual cycle data and responded to detailed annual questionnaires.Results. In regularly cycling female volunteers aged more than 40 years, it was established that inhibin B is a significant determinant of circulating FSH levels. From the MWMHP, the central endocrine event marking the onset of menstrual irregularity was shown to be a fall in follicular phase inhibin B concentrations, with a nonsignificant rise in FSH and no change in estradiol or inhibin A. Cross-sectional analysis of data from women in the early stages of the MWMHP showed a wide variation in circulating FSH levels, irrespective of menopausal status, indicating that single FSH measurements provide little useful information regarding menopausal status. Based on the prospective determination of the date of final menses (FMP), it was shown that estradiol levels begin to fall and FSH levels to rise about 2 years before FMP. At the time of FMP, FSH levels were approximately 50% of those Ultimately reached postmenopausally, while estradiol had fallen by approximately 50% from reproductive age levels. Despite a major decline in sexual function, as women transited the menopause, there was no significant decline In circulating testosterone levels, the decline in sexual function being correlated with the decline in estradiol, not testosterone. Analysis of data from related studies showed that endocrinologically normal ovulatory cycles Could be observed in women who had already experienced cycle irregularity, even more than 3 months of amenorrhea, and could occur close to or at the time of FMRConclusions. An extensive database on the endocrinolop, of the menopause transition, including both crosssectional and longitudinal information, has been obtained.