Conference Report From the 10th World Congress on the Menopause

Professor Lorraine Dennerstein, AO MBBS, PHD, DPM, FRANZCP

Disclosures

July 03, 2002

In This Article

The Endocrinology of Menopause

The endocrinologic changes underlying the menopausal transition have been reported by Professor Henry Burger and colleagues. Professor Burger,[7] of Prince Henry's Medical Research Institute, Monash Medical Centre, Australia, spoke in the seminar on gender-related aging and endocrine deficiencies. Using annually collected hormone measures from participants in the Melbourne Women's Midlife Health Project, Burger and colleagues[8] have shown that FSH begins to rise during the early menopausal transition with steepest rise occurring about 1 year before FMP during the late menopausal transition. The rise in FSH seems to be driven by a fall in the level of inhibin B[9] and to some extent estradiol,[8] with which FSH has an inverse correlation. FSH levels stabilize at an elevated level during the early postmenopause, while estradiol levels stabilize at low levels during the same phase. Burger and coworkers[10] have also shown that total testosterone levels did not change with the menopausal transition or with the 8 years of follow-up. However the amount of bioavailable testosterone (free testosterone index [FTI]) increased as a result of a corresponding fall in sex hormone binding globulin (SHBG). Dehydroepiandrosterone sulfate (DHEAS) was not affected by the menopausal transition but showed a steady decline with age.

In a new analysis of the Melbourne data presented at the Congress,[11] we showed that there is extremely strong tracking or autocorrelation for each of FSH, estradiol, inhibin, testosterone, and DHEAS. Thus, any analysis of longitudinal hormone data must take into account the level of each hormone in the prior year. A geometric model was devised by Lehert, which could be fitted to the hormones using structural equation modeling and then be used to analyze the effect of hormones on different aspects of health (see below).

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