title: Serum sex steroid levels and longitudinal changes in bone density in relation to the final menstrual period.
abstract: BACKGROUND
  The associations of serum sex steroid and FSH levels with change of bone mineral density (BMD) across the complete menopausal transition are incompletely understood.
  
  
  OBJECTIVE
  The objective of the study was to examine the associations of annual serum levels of FSH, estradiol (E2), T, and SHBG with the rates of bone loss in 3 phases: pretransmenopausal [baseline to 1 year before the final menstrual period (FMP)], transmenopausal (1 year before to 2 years after the FMP), later postmenopausal (≥ 2 years after the FMP).
  
  
  METHODS
  The design of the study was a repeated-measures, mixed-effects regression.
  
  
  METHODS
  This was a community-based observational study, with a 10-year follow-up.
  
  
  METHODS
  A total of 720 participants of the Study of Women's Health Across the Nation Bone Study participated in the study.
  
  
  METHODS
  Annualized lumbar spine (LS) and femoral neck (FN) BMD decline was measured.
  
  
  RESULTS
  The mean annual change in BMD was slowest in pretransmenopause (0.27%/year in FN) and fastest in transmenopause (2.16%/year in LS). In the pretransmenopausal phase, for every doubling of FSH level, LS BMD change was faster by -0.32%/year (P < .0001). In the transmenopausal phase, for every doubling of FSH level, LS BMD change was -0.35%/year faster (P < .0001); for every doubling of SHBG level, LS BMD change was -0.36%/year faster (P < .0001). In the later postmenopausal phase, for each doubling of the E2 level, the LS BMD change was slower by +0.26%/year (P = .049); for each SHBG doubling, the LS BMD change was 0.21%/year slower (P = .048). The FN associations were weaker and inconsistent.
  
  
  CONCLUSIONS
  Higher E2 levels and lower FSH levels were associated with lower rates of LS bone loss in some but not all menopausal transition phases.
authors: Divisions of General Internal Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90024, USA. ccrandall@mednet.ucla.edu
authors: Carolyn J
authors: CJ
authors: Crandall
authors: Chi-Hong
authors: CH
authors: Tseng
authors: Arun S
authors: AS
authors: Karlamangla
authors: Joel S
authors: JS
authors: Finkelstein
authors: John F
authors: JF
authors: Randolph
authors: Rebecca C
authors: RC
authors: Thurston
authors: Mei-Hua
authors: MH
authors: Huang
authors: Huiyong
authors: H
authors: Zheng
authors: Gail A
authors: GA
authors: Greendale
mesh_terms: D000328:Adult; D015519:Bone Density / Q000502:physiology*; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005272:Femur Neck; D012739:Gonadal Steroid Hormones / Q000032:analysis / Q000097:blood*; D006801:Humans; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae; D008593:Menopause / Q000097:blood* / Q000502:physiology; D008597:Menstrual Cycle / Q000097:blood / Q000502:physiology; D008598:Menstruation / Q000097:blood* / Q000502:physiology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000175:diagnosis
chemical_list: D012739:Gonadal Steroid Hormones; D004958:Estradiol