title: Executive summary of the Stages of Reproductive Aging Workshop + 10:  addressing the unfinished agenda of staging reproductive aging.
abstract: OBJECTIVE
  The aim of this article is to summarize the recommended updates to the 2001 Stages of Reproductive Aging Workshop (STRAW) criteria. The 2011 STRAW + 10 reviewed advances in understanding of the critical changes in hypothalamic-pituitary-ovarian function that occur before and after the final menstrual period.
  
  
  METHODS
  Scientists from five countries and multiple disciplines evaluated data from cohort studies of midlife women and in the context of chronic illness and endocrine disorders on change in menstrual, endocrine, and ovarian markers of reproductive aging including antimüllerian hormone, inhibin-B, follicle-stimulating hormone, and antral follicle count. Modifications were adopted by consensus.
  
  
  RESULTS
  STRAW + 10 simplified bleeding criteria for the early and late menopausal transition, recommended modifications to criteria for the late reproductive stage (Stage -3) and the early postmenopause stage (Stage +1), provided information on the duration of the late transition (Stage -1) and early postmenopause (Stage +1), and recommended application regardless of women's age, ethnicity, body size, or lifestyle characteristics.
  
  
  CONCLUSIONS
  STRAW + 10 provides a more comprehensive basis for assessing reproductive aging in research and clinical contexts. Application of the STRAW + 10 staging system should improve comparability of studies of midlife women and facilitate clinical decision making. Nonetheless, important knowledge gaps persist, and seven research priorities are identified.
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA. harlow@umich.edu
authors.forename: Siobán D
authors.initials: SD
authors.lastname: Harlow
authors.forename: Margery
authors.initials: M
authors.lastname: Gass
authors.forename: Janet E
authors.initials: JE
authors.lastname: Hall
authors.forename: Roger
authors.initials: R
authors.lastname: Lobo
authors.forename: Pauline
authors.initials: P
authors.lastname: Maki
authors.forename: Robert W
authors.initials: RW
authors.lastname: Rebar
authors.forename: Sherry
authors.initials: S
authors.lastname: Sherman
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Sluss
authors.forename: Tobie J
authors.initials: TJ
authors.lastname: de Villiers
mesh_terms: D000375:Aging / Q000378:metabolism*; D054304:Anti-Mullerian Hormone / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D035843:Biomedical Research; D015331:Cohort Studies; D003226:Congresses as Topic; D004700:Endocrine System Diseases / Q000378:metabolism*; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D008593:Menopause / Q000378:metabolism*; D010053:Ovary / Q000378:metabolism; D012098:Reproduction / Q000502:physiology; D016387:Women's Health
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone