Follicle stimulating hormone and estradiol trajectories from menopausal transition to late postmenopause in indigenous Chinese women

Abstract

Objective

The aim of this study was to examine follicle stimulating hormone (FSH) and estradiol (E2) trajectories in indigenous Chinese women through the ovarian aging process from 10 years before the final menstrual period (FMP) to 20 years after.

Methods

A prospective community-based longitudinal cohort study of 362 Chinese middle-aged women with a clearly determined FMP was performed.

Results

FSH and E2 trajectories were identified according to years from FMP and the Stages of Reproductive Aging Workshop + 10 (STRAW + 10), and further classified by body mass index. E2 decreases relatively steadily from Stage −2 to +1c, while FSH stabilizes quickly from Stage −2 to +1a. Obese women have higher E2 levels and lower FSH levels during menopausal transition, which last for decades after the FMP. There was no obvious decline in FSH levels for at least 20 years after the FMP.

Conclusions

The FSH and E2 trajectories in this indigenous Chinese cohort appear similar to those discussed in the Study of Women’s Health Across the Nation, with ethnic differences. STRAW + 10 criteria may be used to ascertain the ovarian aging process in Chinese women. Obese women may experience different levels of hormonal fluctuations during the menopause transition, while FSH levels in all women appear to remain high even at late postmenopause.

摘要

目的：本研究的目的是研究中国本土女性在最终月经（FMP）前10年至FMP后20年的卵巢老化过程中卵泡刺激素（FSH）雌二醇（E2）的变化轨迹。

方法：对362名FMP明确的中国中年女性进行了一项基于社区的前瞻性纵向队列研究。

结果：FSH和E2的轨迹根据FMP的年份和生殖衰老分期研讨会 + 10（STRAW + 10）确定, 并进一步根据体重指数进行分类。E2从-2到+1c期下降相对稳定, 而FSH从-2快速稳定到+1a。肥胖女性在绝经过渡期有较高的E2水平和较低的FSH水平, 这种情况在FMP后持续了几十年。FMP后至少20年内FSH水平没有明显下降。

结论：在这个中国本土队列中, FSH和E2的轨迹似乎与“全国妇女健康研究”中讨论的相似, 但存在种族差异。STRAW + 10标准可能可以用来确定中国女性的卵巢老化过程。肥胖女性在绝经过渡期间可能会经历不同程度的激素波动, 而所有女性的FSH水平即使在绝经后晚期也似乎保持在较高水平。

Keywords:

• Follicle stimulating hormone
• estradiol
• menopause
• obesity
• Stages of Reproductive Aging Workshop + 10

Acknowledgements

The findings of this study were presented at The 6th National Congress of Chinese Menopause Society on 13 October 2018, in Hangzhou, Zhejiang Province, China. The authors sincerely appreciated Dr. Howard Li from Department of Obstetrics, Gynecology, and Reproductive Sciences from Yale School of Medicine for his help in revising English language for this manuscript.

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Chinese Academy of Medical Sciences and the National Natural Science Foundation of China.