EPIDEMIOLOGY STUDY OF THE LATE REPRODUCTIVE YEARS

这是一项对非裔美国人和高加索女性晚育年龄段的激素和症状的纵向研究。其具体目的是：1)描述选定的激素：卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇、睾酮和脱氢表雄酮硫酸盐(DHEAS)的波动和变化率；评估通常与生殖衰老有关的心理和身体症状；3)将激素变化与症状的严重程度相关联；4)比较非裔美国人和高加索女性的结果。广泛的假设是：a)与生殖衰老有关的心理和身体症状与荷尔蒙变化的波动或速率有关；b)DHEAS，一种肾上腺激素衰老的标记物，可能对心理症状有直接影响；c)心理症状与血管运动症状无关，并且发生在血管舒缩症状之前；d)在控制了已发现区分这些群体的变量，如教育、收入、婚姻状况和体重后，非裔美国人和高加索女性之间在症状和激素方面的任何差异可以忽略不计。以人口为基础的400名妇女(200名非裔美国人，200名高加索人)将通过随机数字拨号进行识别。这些女性的年龄在35岁到47岁之间，注册时有规律的月经周期。每隔7-9个月进行一次的六个评估期将随着时间推移对研究变量进行评估。超过80%的美国女性在生育年龄逐渐减少时会出现心理或身体症状，并有不同程度的严重程度和正常功能障碍。这项前瞻性研究将填补关于激素变化与生育后期症状之间关系的一个重要知识空白，并提供有关非裔美国女性这些因素的第一个信息。此外，这些发现将对临床医生解决妇女晚年生育问题具有重要意义，并将加深我们对生殖老龄化在绝经后妇女发病率和死亡率上升中的作用的理解。

This is a longitudinal study of hormones and symptoms of African American and Caucasian women in their late reproductive years. The specific aims are to: 1) characterize the fluctuations and rates of changes of selected hormones: follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone and dehydroepiandrosterone sulfate (DHEAS); evaluate psychological and physical symptoms commonly associated with reproductive aging; 3) correlate hormone changes with the severity of symptoms; 4) compare the results between African American and Caucasian women. The broad hypotheses are that: a) psychological and physical symptoms which occur with reproductive aging are associated with the fluctuations or rates of hormonal changes; b) DHEAS, an adrenal hormone marker of aging, may have a direct effect on psychological symptoms; c) psychological symptoms are not correlated with and occur prior to vasomotor symptoms; and d) any difference in symptoms and hormones compared between African American and Caucasian women is negligible after controlling for variables that have been found to differentiate these groups, such as education, income, marital status and body mass. A population-based sample of 400 women (200 African American, 200 Caucasian) will be identified through random digit dialing. The women will be ages 35-47 with regular menstrual cycles at enrollment. Six assessment periods, conducted at 7-9 month intervals will evaluate the study variables over time. More than 80% of U.S. women experience psychological or physical symptoms in the waning reproductive years, with varying degrees of severity and disruption of normal functioning. This prospective study will fill an important gap in the knowledge of relationships between hormone changes and symptoms in the late reproductive years and provide the first information on these factors in African American women. In addition, the findings will be important for clinicians addressing fertility problems of women in their late reproductive years and will increase our understanding of the role of reproductive aging in the increased morbidity and mortality of postmenopausal women.