Wednesday Bubble: The Magic Menopause Ball

Posted by Liz on Mar 27, 2013 in menopause | 2 comments

Can you accurately pinpoint the timing of your final menstrual period? Lord, I finally hope so because if you are anything like me, 50+ and over this bleeding thing, the ability to read into the magic menopause ball sounds like heaven. However, more importantly, it may have significant benefits for women’s health overall. For example,  knowing when you will enter menopause provides you with the ability to address bone loss and other risks now (the rate of bone loss greatly accelerates to roughly 2.6% in the year prior through two years after menopause). And there’s no time like the present to start bolstering your defenses against the health-related ravages of aging.

This post comes with a warning: it’s a bit geeky science-y.  Some topics are harder than others to write about. However, I hope that you’ll bear with me and read on; it’s important.

This is not the first time that the future is being explored; you may recall another test that measures the antimullerian hormone, an ovarian marker that relates to the number of immature follicles a woman has (as the marker declines, so do the number of eggs a woman houses, and the closer to menopause she is). Another way to gauge the start of menopause is to monitor bleeding patterns. Not only is this onerous, but, data suggest that more than 60% of women in early perimenopause become postmenopausal with no apparent signs.

A new approach to pinpoint the timing of menopause involves a calculation of changing levels of estradiol (the most important form of estrogen in the body) and follicle stimulating hormone (FSH – the hormone produced by the pituitary gland that stimulates the ovaries to produce eggs). The closer a woman is to menopause, the higher the FSH levels and the lower the estrogen levels. To determine if this test is valid, researchers developed a model based on data collected from 574 women in the ongoing Study of Women’s Health Across the Nation (SWAN). These women were all between the ages of 42 and 53, had an intact uterus and at least one ovary and were not taking hormones. They were ethnically diverse (Caucasian, African-American and Asian) and had given blood samples over a ten year period.

The findings? After adjusting for factors that might influence menopause, including age, smoking and weight, they found that measuring FSH and estradiol could accurately pinpoint three major timepoints: roughly two years and one year prior to the final menstrual period and the final menstrual period. Moreover, the ability of the test to predict the final period increased as women moved closer to the goal.

Now, scientists use variables to gauge how well a test can predict the number of people with a condition (sensitivity) as well as how well a test can identify those people without the condition (specificity). The new model was shown to be able to accurately identify 89% of women who reached their final menstrual period, which is excellent.

Scientific mumbo jumbo aside, the upshot is that it’s likely that we’ll be able to predict the date of our final menstrual with great accuracy in the near future. Better than an 8-ball. The answer is ‘Yes.’

[This study appears in the April 2013 issue of the Journal of Clinical Endocrinology and Metabolism.]