Epidemiologic Study of the Late Reproductive Years

描述（由申请人提供）：这是卵巢老化前瞻性队列研究的延续。这项研究的重点是激素动力学和相关症状，因为绝经前妇女进入并通过过渡到绝经期的阶段。具体目标是：1））比较非裔美国人和高加索妇女之间的激素水平和纵向趋势; 2）确定研究激素的妇女内趋势如何（雌二醇、FSH、LH、抑制素B、DHEAS和睾酮）和辅助因子如BMI、种族、年龄、症状等预测过渡期的进展; 3）确定激素动力学与卵巢老化发生的身体和行为症状的关联，并确定这些因素的种族差异; 4）确定遗传多态性与水平和纵向趋势以及与更年期症状的关联。每年在连续两个月经周期的第1-6天或间隔1个月的非周期性女性中收集激素评估和一系列身体和行为评估。这项队列研究的继续将提供有关激素动力学及其对整个绝经过渡期绝经症状影响的新信息。超过80%的美国女性在更年期前后会出现身体或行为症状，其严重程度和功能中断程度各不相同，其中许多女性会寻求药物缓解痛苦症状。缺乏对这些症状的贡献者及其与卵巢老化的激素因素的关联的理解是一个重要的卫生保健问题。增加对与生殖老化相关的变化以及这些变化中是否存在种族差异的理解，将导致更好的预防和治疗策略，以减少妇女中年和绝经后的短期和长期发病率。

DESCRIPTION (provided by applicant): This is a continuation of a prospective cohort study of ovarian aging. The study focuses on hormone dynamics and associated symptoms as premenopausal women enter and move through stages in the transition to menopause. The specific aims are to: 1)) Compare hormone levels and longitudinal trends between African American and Caucasian women; 2) Identify how within-woman trends of the study hormones (estradiol, FSH, LH, Inhibin B, DHEAS, and testosterone) and cofactors such as BMI, race, age, symptoms, et al predict the progression through the transition; 3) Identify associations of hormone dynamics with physical and behavioral symptoms that occur with ovarian aging and identify racial differences in these factors; 4) Identify associations of genetic polymorphisms with levels and longitudinal trends and with menopausal symptoms. Hormone evaluations and a battery of physical and behavioral assessments are collected annually on days 1-6 of two consecutive menstrual cycles or 1 month apart in non-cycling women. Continuation of this cohort study will provide new information on hormone dynamics and their influences on menopausal symptoms through the full menopausal transition. More than 80% of U.S. women experience physical or behavioral symptoms around menopause, with varying degrees of severity and disruption in their functioning, and many of these women seek medical relief for distressing symptoms. The lack of understanding of the contributors to these symptoms and their associations with hormonal factors of ovarian aging is a significant health care problem. Increased understanding of the changes associated with reproductive aging and whether there are racial differences in these changes will lead to better preventive and therapeutic strategies to reduce the short and long term morbidity of women's mid-life and postmenopausal years.