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Endocrinology of menopausal transition
Summary
We are studying the endocrine features of individual ovulatory and anovulatory cycles in women in late reproductive age and during stages of the menopause transition and proposes a classification of menstrual cycles, suggestive of progressively impaired ovarian function. We aim to assess possible markers of such impairment and to examine correlations between reproductive hormones of the pituitary and ovary in order to devise explanatory hypotheses and suggest avenues for future research.
Description
A large clinical study was undertaken in conjunction with Dr Georgina Hale and Professor Ian Fraser of Sydney University to explore the changes in reproductive hormone levels in blood of women as they approach menopause.
A total of 77 women in their mid or late reproductive stages were studied. Serum FSH, LH, E2, progesterone, inhibin A, inhibin B, AMH were determined 3 times a week over the menstrual cycle.
Funding
National Health and Medical Research Council
Outcomes
The menopausal transition has been previously classified in terms of changes in menstrual cycle irregularities. We have attempted to provide a classification based on changes in ovarian and pituitary hormone levels and to clarify the feedback relationships between the ovary and pituitary.
Additional studies exploring the presence of abnormal (LOOP) cycles were also undertaken. Further details are presented in the publications below.
Selected Publications
Hale GE, Hughes CL, Burger HG, Robertson DM, Fraser IS. Atypical estradiol secretion and ovulation patterns caused by luteal out-of-phase (LOOP) events underlying irregular ovulatory menstrual cycles in the menopausal transition. Menopause. 2009 Jan-Feb;16(1):50-9.
Robertson DM, Hale GE, Jolley D, Fraser IS, Hughes CL, Burger HG. Interrelationships between ovarian and pituitary hormones in ovulatory menstrual cycles across reproductive age. J Clin Endocrinol Metab. 2009 Jan;94(1):138-44.
Burger HG, Hale GE, Dennerstein L, Robertson DM. Cycle and hormone changes during perimenopause: the key role of ovarian function. Menopause. 2008;15(4 Pt 1):603-12.
Healy DL, Bell R, Robertson DM, Jobling T, Oehler MK, Edwards A, et al. Ovarian status in healthy postmenopausal women. Menopause. 2008 Nov-Dec;15(6):1109-14.
Robertson DM. Anti-Mullerian hormone as a marker of ovarian reserve: an update. Womens Health (Lond Engl). 2008 Mar;4(2):137-41.
Robertson DM, Hale GE, Fraser IS, Hughes CL, Burger HG. A proposed classification system for menstrual cycles in the menopause transition based on changes in serum hormone profiles. Menopause. 2008 Nov-Dec;15(6):1139-44.