title: Thyroid stimulating hormone (TSH) concentrations and menopausal status in women at the mid-life: SWAN.
abstract: OBJECTIVE
  We evaluated menopausal symptoms, menstrual cycle bleeding characteristics and reproductive hormones for their associations with thyroid stimulating hormone (TSH) concentrations in women at the mid-life from five ethnic groups.
  
  
  METHODS
  This report is from the baseline evaluation of the Study of Women's Health Across the Nation (SWAN), a community-based multiethnic study of the natural history of the menopausal transition. Enrollees were 42-52 years old (pre- and early perimenopausal) African American, Caucasian, Chinese, Hispanic and Japanese women (n = 3242). Enrollees were interviewed about self-reported diagnosed hypo- and hyperthyroidism or thyroid treatment, menopausal symptoms and menstrual cycle bleeding characteristics. Serum was assayed for TSH, oestradiol, testosterone, FSH and SHBG.
  
  
  RESULTS
  There were 6.2% of women with TSH > 5.0 mIU/ml and 3.2% with TSH < 0.5 IU/ml, cutpoints that have been used to encompass clinical and subclinical hypo- and hyperthyroidism, respectively. African American women had significantly lower mean TSH concentrations than Caucasian, Hispanic and Chinese women. Of the more than 15 menopause symptoms evaluated, only fearfulness was associated with having a TSH value > 5.0 mIU/ml (P < 0.008) or < 0.5 mIU/ml (P < 0.02). Women with TSH values outside the range of 0.5-5.0 mIU/ml were more likely to report shorter or longer menstrual periods (P = 0.004 for both) than women within that range. FSH, SHBG, dehydroepiandrosterone sulphate (DHEA-S), testosterone, and oestradiol concentrations were not associated with TSH concentrations.
  
  
  CONCLUSIONS
  In mid-aged women, there was a 9.6% prevalence of TSH values outside the euthyroid range of 0.5-5.0 mIU/ml. Although TSH was associated with bleeding length and self-reported fearfulness, it was not associated with indicators of the menopausal transition, including menopausal stage defined by bleeding regularity, menopausal symptoms or reproductive hormone concentrations.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA. mfsowers@umich.edu
authors.forename: MaryFran
authors.initials: M
authors.lastname: Sowers
authors.forename: Judy
authors.initials: J
authors.lastname: Luborsky
authors.forename: Craig
authors.initials: C
authors.lastname: Perdue
authors.forename: Katy L B
authors.initials: KL
authors.lastname: Araujo
authors.forename: Marlene B
authors.initials: MB
authors.lastname: Goldman
authors.forename: Siobán D
authors.initials: SD
authors.lastname: Harlow
mesh_terms: D000328:Adult; D001007:Anxiety / Q000097:blood; D044466:Asian People; D044383:Black People; D002979:Climacteric / Q000097:blood*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006306:Health Surveys; D006801:Humans; D007037:Hypothyroidism / Q000097:blood; D016015:Logistic Models; D008137:Longitudinal Studies; D008599:Menstruation Disturbances / Q000097:blood; D008875:Middle Aged; D011446:Prospective Studies; D044469:Racial Groups; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D013972:Thyrotropin / Q000097:blood*; D014481:United States; D044465:White People; D001741:Black or African American
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D004958:Estradiol; D005640:Follicle Stimulating Hormone; D013972:Thyrotropin