title: Consistent ovulation may not be enough to make women healthy when approaching menopause: an update from the Study of Women's Health Across the Nation.
abstract: OBJECTIVE
  This study aims to test the hypothesis that consistently ovulatory premenopausal/perimenopausal women have a more favorable cardiometabolic profile than anovulatory women.
  
  
  METHODS
  The first four collections from the Study of Women's Health Across the Nation Daily Hormone Study (DHS) were used. DHS enrollees annually completed a daily collection of first morning voided urine for an entire menstrual cycle or up to 50 days (whichever comes first). A woman was categorized as consistently ovulatory annually (COA) if four ovulatory cycles or two to three ovulatory cycles followed by the final menstrual period (FMP) were observed. A woman was categorized as not consistently ovulatory annually (nCOA) if at least one anovulatory year was observed. Cross-sectional and longitudinal differences were compared between COA and nCOA women. Data were centered at FMP and adjusted for age and body mass index (BMI).
  
  
  RESULTS
  Six hundred thirty-six DHS participants (mean [SD] age, 47.3 [2.5] y; mean [SD] BMI, 27.4 [7.1] kg/m(2)) were included. Thirty-six percent of the DHS participants were COA women. On the fourth follow-up collection, COA women had lower high-density lipoprotein than nCOA women (mean [95% CI], 55.7 [54.0-57.4] vs 59.5 [57.9-61.0] mg/dL, P = 0.002, respectively), which persisted after adjustment. Among 460 women with FMP, 39% were COA women. COA women were slightly older (52.9 vs 52.0 y, P = 0.002) and had lower BMI (geometric mean, 26.1 vs 27.5 kg/m(2), P = 0.06) than nCOA women at FMP. Other cardiometabolic factors did not significantly differ by COA status through FMP.
  
  
  CONCLUSIONS
  Consistent ovulation across the menopausal transition does not seem to reflect superior cardiometabolic health.
authors.affiliation: From the 1Department of Biostatistics and Informatics, School of Public Health, and 2Department of Obstetrics and Gynecology, University of Colorado Denver, Aurora, CO; 3Department of Epidemiology, Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA; and 4Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Amanda A
authors.initials: AA
authors.lastname: Allshouse
authors.forename: Alex
authors.initials: A
authors.lastname: Polotsky
authors.forename: Sybil
authors.initials: S
authors.lastname: Crawford
authors.forename: Hsiang-Yu
authors.initials: HY
authors.lastname: Chen
authors.forename: Samar R
authors.initials: SR
authors.lastname: El Khoudary
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
mesh_terms: D000328:Adult; D000367:Age Factors; D000858:Anovulation / Q000503:physiopathology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008137:Longitudinal Studies; D008597:Menstrual Cycle / Q000502:physiology; D008875:Middle Aged; D010060:Ovulation / Q000502:physiology*; D047648:Perimenopause / Q000502:physiology*; D013997:Time Factors; D014481:United States
chemical_list: D008075:Lipoproteins, HDL