Epidemiologic Study of the Late Reproductive Years

描述（由申请人提供）：这是卵巢衰老前瞻性队列研究的延续。这项研究的重点是在绝经前妇女进入并经历更年期过渡阶段时的激素动态和相关症状。具体目的是：1)比较非裔美国妇女和白种人妇女的激素水平和纵向趋势；2)确定女性体内研究激素（雌二醇、卵泡刺激素、黄体生成素、抑制素B、DHEAS和睾酮）的趋势和辅助因素（如BMI、种族、年龄、症状等）如何预测过渡期的进展；3)确定激素动态与卵巢衰老时出现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绝经期症状的关联。每年在连续两个月经周期的第1-6天或非月经周期女性间隔1个月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态及其在完全绝经过渡期间对更年期症状影响的新信息。超过80%的美国女性在更年期前后经历了身体或行为上的症状，这些症状的严重程度和功能紊乱程度各不相同，其中许多女性寻求医学治疗来缓解这些令人痛苦的症状。缺乏对这些症状的原因及其与卵巢衰老的激素因素的关系的了解是一个重大的卫生保健问题。进一步了解与生殖衰老相关的变化以及这些变化是否存在种族差异，将有助于制定更好的预防和治疗策略，以减少妇女在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.