title: Endocrine features of menstrual cycles in middle and late reproductive age and the menopausal transition classified according to the Staging of Reproductive Aging Workshop (STRAW) staging system.
abstract: BACKGROUND
  Female reproductive aging based on changes in menstrual cycle length and frequency progresses through a number of stages as defined by the Stages of Reproductive Aging Workshop (STRAW) staging criteria.
  
  
  OBJECTIVE
  This paper provides a comprehensive description of the endocrine features associated with the STRAW stages.
  
  
  METHODS
  Healthy women aged 21-35 and 45-55 yr submitted three blood samples a week over a single menstrual cycle. They were classified as mid-reproductive age (n = 21), late-reproductive age (n = 16), early menopause transition (n = 16), and late menopause transition (n = 23).
  
  
  RESULTS
  There were nine, one, zero, and two anovulatory cycles identified in the late menopause transition, early menopause transition, late-reproductive age, and mid-reproductive age groups, respectively. Ovulatory cycle FSH, LH, and estradiol levels increased with progression of STRAW stage (P = 0.001, P < 0.01, and P < 0.05, respectively), and mean luteal phase serum progesterone decreased (P < 0.01). Early cycle (ovulatory and anovulatory) inhibin B decreased steadily across the STRAW stages (P < 0.01) and was largely undetectable during elongated ovulatory and anovulatory cycles in the menopause transition. Anti-Mullerian hormone decreased markedly (10- to 15-fold) and progressively across the STRAW stages (P < 0.01 and P < 0.001, respectively).
  
  
  CONCLUSIONS
  Progression through the STRAW stages is associated with elevations in serum FSH, LH, and estradiol and decreases in luteal phase progesterone. The marked fall in inhibin B and particularly anti-Mullerian hormone indicate that they may be useful in predicting STRAW stage but future analyses of early cycle measurements on larger cohorts are needed to draw predictive conclusions.
authors.affiliation: Department of Obstetrics and Gynecology, University of Sydney, New South Wales, Australia 2006. ghale@med.usyd.edu.au
authors.forename: Georgina E
authors.initials: GE
authors.lastname: Hale
authors.forename: Xue
authors.initials: X
authors.lastname: Zhao
authors.forename: Claude L
authors.initials: CL
authors.lastname: Hughes
authors.forename: Henry G
authors.initials: HG
authors.lastname: Burger
authors.forename: David M
authors.initials: DM
authors.lastname: Robertson
authors.forename: Ian S
authors.initials: IS
authors.lastname: Fraser
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology*; D054304:Anti-Mullerian Hormone; D004702:Endocrine Glands / Q000502:physiology*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase / Q000097:blood; D006023:Glycoproteins / Q000097:blood; D006801:Humans; D007265:Inhibins / Q000097:blood; D008183:Luteal Phase / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D008593:Menopause / Q000502:physiology*; D008597:Menstrual Cycle / Q000502:physiology*; D008875:Middle Aged; D011374:Progesterone / Q000097:blood; D012098:Reproduction / Q000502:physiology*; D009626:Terminology as Topic; D013735:Testicular Hormones / Q000097:blood
chemical_list: D006023:Glycoproteins; D013735:Testicular Hormones; C422362:inhibin A; C422364:inhibin B; D011374:Progesterone; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone