EPIDEMIOLOGY STUDY OF THE LATE REPRODUCTIVE YEARS

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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.