Usefulness of FSH measurements for determining menopause in long-term users of depot medroxyprogesterone acetate over 40 years of age.
OBJECTIVE
To assess the usefulness of follicle-stimulating hormone (FSH) measurements for determining menopause in 40-55-year-old users of depot medroxyprogesterone acetate (DMPA).


METHODS
FSH levels were measured in 355 blood samples from 82 amenorrheic women during an 18-month period. Blood was collected every 90 days immediately prior to DMPA administration.


RESULTS
Using FSH values>35 mIU/mL as being in the post menopausal range, 32 women (39.0%) presented at least one FSH measurement in the postmenopausal range and 14 of them (43.7%) had more than one elevated FSH measurement and were considered postmenopausal. In five users (15.6%), only the last FSH measurement was within the postmenopausal range, and in 13 women (40.6%), FSH returned to normal values following one measurement that was within the postmenopausal range.


CONCLUSIONS
The menopausal status in DMPA users in amenorrhea should be determined based on at least two consecutive high FSH evaluations, since, as shown here, 40.6% of the women with high FSH had a low FSH in the subsequent determination. FSH measurements should be done only in women>or=50 years old because there is a greater possibility of being in postmenopause. However, we do not recommend the interruption of DMPA use prior to the quantification of FSH.
Juliato
Cassia Teatin
CT
Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medicine, Universidade Estadual de Campinas (UNICAMP), Caixa Postal 6181, 13084-971 Campinas, SP, Brazil.
Fernandes
Arlete
A
Marchi
Nadia Maria
NM
Castro
Sara
S
Olivotti
Bruna
B
Bahamondes
Luis
L
D000328:Adult; D000568:Amenorrhea; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D008593:Menopause / Q000097:blood* / Q000378:metabolism; D017698:Postmenopause / Q000097:blood / Q000187:drug effects; D011446:Prospective Studies; D012016:Reference Values
D003271:Contraceptive Agents, Female; D005640:Follicle Stimulating Hormone; D017258:Medroxyprogesterone Acetate