title: Longitudinal changes in hypothalamic and ovarian function in perimenopausal women with anovulatory cycles: relationship with vasomotor symptoms.
abstract: OBJECTIVE
  To determine whether the transition to menopausal status is unidirectional and predictable with aging.
  
  
  METHODS
  Longitudinal evaluation of the menstrual cycle hormone patterns and experience of vasomotor symptoms in an anovulatory, perimenopausal cohort, during cycles that occurred 1 and 2 years after an anovulatory cycle.
  
  
  METHODS
  Academic center.
  
  
  METHODS
  One hundred fifty-nine of 840 women in the Daily Hormone Study, a substudy of the Study of Women's Health across the Nation (SWAN), had anovulatory cycles. Their menstrual cycle patterns were previously described. This report describes their cycle patterns and vasomotor symptoms in the subsequent 2 years.
  
  
  METHODS
  None.
  
  
  METHODS
  Daily urinary hormone levels of FSH, LH, and estrogen and P metabolites and reports of daily occurrence of vasomotor symptoms.
  
  
  RESULTS
  While a tendency to develop cycles having a loss of negative feedback of estrogen on LH secretion was seen before menopause, there is no clear progression of cycle patterns in anovulatory women. Anovulation did not predict menopause within 2 years. Vasomotor symptoms occur before menopause, as experienced by 73% of the women. Vasomotor symptoms were not related to cycle pattern.
  
  
  CONCLUSIONS
  Any cycle pattern may be related to vasomotor symptoms. The best predictor of vasomotor symptoms is a prior history of vasomotor symptoms.
authors.affiliation: Department of Preventive Medicine and Community Health, New Jersey Medical School of UMDNJ, Newark, New Jersey 07103, USA.
authors.forename: Joan H
authors.initials: JH
authors.lastname: Skurnick
authors.forename: Gerson
authors.initials: G
authors.lastname: Weiss
authors.forename: Laura T
authors.initials: LT
authors.lastname: Goldsmith
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
authors.forename: Sybil
authors.initials: S
authors.lastname: Crawford
mesh_terms: D000328:Adult; D000858:Anovulation / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D019584:Hot Flashes / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D006945:Hyperhidrosis / Q000453:epidemiology; D007031:Hypothalamus / Q000502:physiology*; D015994:Incidence; D008137:Longitudinal Studies; D008597:Menstrual Cycle / Q000502:physiology; D008875:Middle Aged; D010053:Ovary / Q000502:physiology*; D047648:Perimenopause / Q000502:physiology*; D014666:Vasomotor System / Q000503:physiopathology*