Epidemiologic Study of the Late Reproductive Years

描述(由申请人提供)：这是一项关于卵巢老化的前瞻性队列研究的延续。这项研究的重点是绝经前妇女进入和经历绝经过渡阶段时的激素动态和相关症状。其具体目标是：1)比较非裔美国人和高加索女性之间的激素水平和纵向趋势；2)确定研究对象女性内部激素(雌二醇、FSH、黄体生成素、抑制素B、DHEAS和睾酮)以及辅助因素(如BMI、种族、年龄、症状等)如何预测过渡期间的进展；3)确定激素动态与卵巢老化引起的身体和行为症状的关联，并确定这些因素中的种族差异；4)确定基因多态与水平和纵向趋势以及与更年期症状的关联。荷尔蒙评估和一系列身体和行为评估每年在连续两个月经周期的第1-6天收集，对于不骑自行车的女性则在间隔1个月收集。这项队列研究的继续将提供有关激素动态及其在整个更年期过渡过程中对更年期症状的影响的新信息。超过80%的美国女性在更年期前后出现身体或行为症状，并有不同程度的严重程度和功能障碍，其中许多女性为痛苦的症状寻求医疗缓解。缺乏对导致这些症状的因素及其与卵巢老化的激素因素的关系的了解是一个重大的卫生保健问题。更多地了解与生殖老龄化有关的变化以及这些变化是否存在种族差异，将导致制定更好的预防和治疗战略，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.