EPIDEMIOLOGY STUDY OF THE LATE REPRODUCTIVE YEARS

这是一项关于非裔美国人和白种人妇女在生育年龄后期的激素和症状的纵向研究。具体目的是：1)表征选定激素的波动和变化率：卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇、睾酮和硫酸脱氢表雄酮（DHEAS）；评估通常与生殖衰老相关的心理和生理症状；3)将激素变化与症状的严重程度联系起来；4)比较非裔美国人和白种人妇女的结果。广泛的假设是：a)与生殖衰老有关的心理和生理症状与激素变化的波动或速率有关；b)脱氢表雄素（DHEAS）是衰老的肾上腺激素标志物，可能对心理症状有直接影响；C)心理症状与血管舒缩症状无关，且发生在血管舒缩症状之前；d)在控制了教育、收入、婚姻状况和体重等已发现的区分这些群体的变量后，非洲裔美国妇女和高加索妇女之间在症状和激素方面的任何差异都可以忽略不计。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确定。参与研究的女性年龄在35-47岁之间，月经周期正常。六个评估期，每隔7-9个月进行一次，评估研究变量随时间的变化。超过80%的美国女性在生育年龄下降时出现心理或身体症状，严重程度不同，正常功能受到干扰。这项前瞻性研究将填补关于生育后期激素变化与症状之间关系的重要知识空白，并首次提供有关非裔美国妇女这些因素的信息。此外，这些发现对于临床医生解决生育年龄后期妇女的生育问题将是重要的，并将增加我们对生殖衰老在绝经后妇女发病率和死亡率增加中的作用的理解。

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.