Serum leptin concentrations in pre- and postmenopausal women on sex hormone therapy.

AIM: The aim of the present study was to investigate the influence of endogenous estradiol and estrogen and estrogen-progestin therapies on concentration in pre- and postmenopausal women. MATERIALS AND METHODS: The study groups consisted of 26 women with surgical menopause (mean+/-standard deviation (SD): age 51.8+/-2.6 years, body mass index (BMI) 26.45+/-4.56 kg/m(2)), 54 with natural menopause (mean+/-SD: age 50.5+/-3.0 years, BMI 25.75+/-4.09 kg/m(2)) and 40 premenopausal controls (mean+/-SD: age 48.3+/-2.3 years, BMI 26.23+/-4.12 kg/m(2)). The group with surgical menopause received estradiol transdermally (50 microg/day) and those with natural menopause received additionally medroxyprogesterone acetate (5 mg/day) for the last 12 days of the cycle. Before and after 4 months of therapy, body weight, waist and hip circumferences and blood pressure were measured, and BMI and waist-to-hip ratio (WHR) were calculated. Serum leptin, follicle-stimulating hormone (FSH), estradiol (E(2)), testosterone, prolactin and dehydroepiandrosterone sulfate (DHEAS) were measured prior to and after treatment. RESULTS: Leptin concentrations did not differ statistically among the groups. No correlations between leptin and E(2), FSH, prolactin, testosterone and DHEAS concentrations were found in any of the groups before and after treatment. Leptin level correlated positively with body mass, BMI and hip and waist circumferences in all groups. There were no correlations between leptin and WHR in the pre- and postmenopausal groups. In the premenopausal group and in some postmenopausal groups, serum leptin level correlated with blood pressure. CONCLUSIONS: Endogenous E(2) and androgens in premenopausal women and estrogen and estrogen-progestin therapies in postmenopausal subjects do not influence serum leptin concentrations. Leptin level is related to body mass and BMI, but not to sex hormone status. The distribution of adipose tissue and the type of obesity (android or gynoid) have no influence on serum leptin concentration. The correlation between serum leptin level and blood pressure requires further investigation.     

Serum ghrelin, leptin and resistin levels in adolescent girls with polycystic ovary syndrome

Aim:  The aim of the present study was to investigate the levels of leptin, resistin and ghrelin in polycystic ovary syndrome (PCOS), and to assess their possible correlations with the hormonal and metabolic features of PCOS.
Methods:  Sixteen obese (ObPCOS) and 12 lean (LeanPCOS) subjects with PCOS and 19 obese control subjects were enrolled in the study.
Results:  Ghrelin, leptin and resistin concentrations were similar between groups when body mass index (BMI) was used as a covariate ( P  > 0.05). Mean androgen, SHBG, luteinizing hormone (LH) levels and luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio tended to be similar between polycystic ovary syndrome (PCOS) groups. However, when compared with the control group, SHBG was lower and androgen, LH levels and LH/FSH ratio were higher in the PCOS groups. Free testosterone levels significantly correlated with resistin (r = −0.38), SHBG correlated significantly with body mass index (BMI) (r = −0.45) and resistin (r = −0.67), LH/FSH ratio was significantly correlated with ghrelin (r = −0.52) and estradiol (E2) levels (r = 0.51).
Conclusion:  ObPCOS and LeanPCOS groups having higher LH/FSH ratios and lower SHBG levels suggest that there could be factors other than adiposity responsible for the clinical features of PCOS patients. In the light of our results, those factors can be suggested as ghrelin and E2 for the elevated LH/FSH ratio and resistin for the lowered SHBG.     

Follicular phase hormone levels and menstrual bleeding status in the approach to menopause

OBJECTIVE: (1) Characterize the relationship between follicular phase hormone levels and menstrual bleeding patterns in the approach to menopause; (2) identify racial differences in hormone levels; (3) determine independent contributions of menstrual status, race, age, BMI, and smoking to hormone levels. DESIGN: Randomly identified, population-based cohort, stratified to obtain equal numbers of African American and Caucasian women, prospectively followed for 5 years. SETTING: Women in Philadelphia County, PA, identified by random-digit telephone dialing. PARTICIPANT(S): Women aged 35 to 47 years with regular menstrual cycles at enrollment (N = 436). DATA COLLECTION: Blood sampling twice in each of 7 assessment periods during days 1-6 of the cycle, menstrual dates identified through structured interview and daily symptom reports, anthropometric measures and standardized questionnaires at each assessment period. MAIN OUTCOME MEASURE(S): Serum levels of follicular E(2), FSH, inhibin B, and LH. RESULT(S): The mean levels of E(2), FSH, inhibin B, and LH were differentially associated with the 5 menstrual status groups defined by changes in bleeding patterns. Significant changes in hormone levels occurred prior to missed menstrual cycles for inhibin B, FSH, and LH. All hormones had a highly significant interaction between menstrual status and BMI. African American women had significantly lower levels of E(2) and LH compared to Caucasian women in univariate analyses. The interaction of race, menstrual status, and BMI was highly significant (P<.001) for E(2), with African American women having lower E(2) levels until postmenopause, when E(2) levels were higher in AA women with BMI > or =25 and BMI > or =30. CONCLUSION(S): Levels of E(2), FSH, LH, and inhibin B are significantly associated with menstrual bleeding patterns in late reproductive age women and differentiate the earliest stages of the menopausal transition. Racial differences in mean levels of E(2) appear strongly mediated by BMI.     

Differential effects on the androgen status of postmenopausal women treated with tibolone and continuous combined estradiol and norethindrone acetate replacement therapy

OBJECTIVE: To determine serum parameters reflective of androgen status in postmenopausal women using two types of hormone replacement therapy (HRT). DESIGN: Randomized, double-blind, prospective 1-year trial of two oral HRT regimens. SETTING: University hospital, department of obstetrics and gynecology, menopause clinic. PATIENT(S): 100 postmenopausal women > or = 45 years. INTERVENTION(S): Daily use of the progestogen tibolone (2.5 mg; n = 50) or continuous combined 17-beta-estradiol (2 mg) and norethindrone acetate (E+NA, 1 mg; n = 50). MAIN OUTCOME MEASURE(S): Measurements of total testosterone (total T), dehydroepiandrosterone sulfate (DHEAS), androstenedione (A), FSH, and sex-hormone-binding globulin (SHBG), and calculations of free testosterone (free T). Assessment of changes from baseline within and between groups after 6 and 12 months. RESULT(S): We found significant differences (% changes) in the tibolone group compared to baseline within the groups after both 6 and 12 months, respectively. Levels of free T doubled, total T decreased slightly, and SHBG decreased by half; DHEAS increased by approximately 20%; and FSH decreased. In the E+NA group, levels of free T, total T, androstenedione, and FSH all decreased, and SHBG increased. Pre-trial levels of DHEAS, A, and total T were significantly higher in the E+NA group. Between groups throughout the study, the changes from baseline were significant due to the different extent of FSH reduction, and opposite changes of free T, SHBG, and DHEAS. CONCLUSION(S): Both regimens modify plasma androgens, DHEAS, and SHBG differently. Tibolone decreased the levels of SHBG, and substantially increased free T and to a lesser extent increased DHEAS; this may reflect a modification of adrenal androgen production. Continuous combined estradiol and norethindrone acetate HRT suppressed the peripheral plasma androgens mediated by increased levels of SHBG.     

Serum androgen and gonadotropin levels decline after progestogen-induced withdrawal bleeding in oligomenorrheic women with or without polycystic ovaries.

OBJECTIVE: To examine the effect of short-term progestogen treatment on androgen, gonadotropin, and sex hormone-binding globulin (SHBG) levels in oligomenorrheic women. DESIGN: Comparative study of changes in hormonal parameters in patients with or without ultrasonographically diagnosed polycystic ovarian disease (PCOD). SETTING: Open patient clinic of reproductive endocrinology at University Central Hospital of Turku, Finland. PATIENTS: Seventy-five oligomenorrheic women with (n = 51) or without (n = 24) PCOD. MAIN OUTCOME MEASURES: Serum concentrations of testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and SHBG. RESULTS: The levels of T, A, LH, and the LH:FSH ratios decreased significantly after oral treatment with medroxyprogesterone acetate (10 mg/d for 10 days) in non-PCOD women and in women with PCOD decreasing the frequencies of pathological laboratory findings, in particular elevated levels of LH:FSH ratio and A in PCOD women and of LH:FSH ratio in non-PCOD women. The levels of T, A, and LH as well as the LH:FSH ratio were significantly higher in women with PCOD. Obesity was associated with high free androgen indices, low LH:FSH ratios, and low concentrations of LH, A, and SHBG. CONCLUSIONS: The serum samples for hormonal analyses used as an aid in diagnosing PCOD should be obtained without pretreatment with progestogen because it masks the biochemical findings of PCOD.     

Role of sex-hormone-binding globulin in hormonal changes and amenorrhoea in thyrotoxic women.

Plasma levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), oestrogen, testosterone and sex-hormone-binding globulin (SHBG) were determined in 15 thyrotoxic women in the reproductive age before and after treatment with carbimazole. The levels of these hormones and SHBG were compared with those of 12 euthyroid healthy female volunteers of comparable age and parity. Plasma gonadotrophins (LH and FSH), oestrogen, testosterone and SHBG were all markedly elevated in thyrotoxic subjects but became normal when the euthyroid state and normal menstruation were restored after treatment. From the results a hypothesis is suggested that related the hormonal disturbance primarily to a thyroid hormone-induced rise in SHBG levels.     

Endocrine status in patients with mammary gland diseases: correlation between steroid hormones and sex steroid binding globulin.

We have studied 131 women affected by benign or malignant breast disease, in order to explore their endocrine status. We evaluated basal concentrations of the following hormones: FSH, LH, PRL, estrone (E1), estradiol (E2), testosterone (T), androstenedione (A), DHEAS and SHBG. Basal hormone levels in these patients were not significantly different from those in normal age-matched subjects. However, in premenopausal women, 31% of patients with benign disease and 34.4% with malignant lumps exhibited an elevated FSH/LH ratio (greater than 1) and lower T levels, compared to those having a normal FSH/LH ratio. The difference in T levels was not coupled with the expected specular variations in SHBG levels. Moreover, in none of the group considered, T concentrations or E2/T were significantly correlated with SHBG levels. These data seem to suggest an altered regulation of SHBG in these patients, in whom the modulation of SHBG by circulating sexual steroids appears to be different when compared with normal subjects.     

Effects of laparoscopic ovarian drilling on young adult women with polycystic ovarian syndrome

STUDY OBJECTIVE: To assess changes in serum hormone levels and ovarian stromal blood flow after laparoscopic ovarian drilling (LOD) in young adult women with polycystic ovary syndrome (PCOS). DESIGN: Prospective, nonrandomized study (Canadian Task Force classification II-1). SETTING: Tertiary care, major teaching hospitals. PATIENTS: Anovulatory young women with PCOS who were resistant to clomiphene citrate. INTERVENTION: Laparoscopic ovarian drilling. MEASUREMENTS AND MAIN RESULTS: To evaluate the endocrinological effects of LOD, serum leptin, insulin-like growth factor-1, estrone (E1), and estradiol were measured before and after ovarian drilling in the early follicular phase. Three-dimensional transabdominal power Doppler examinations were performed to determine the effects of LOD. Serum leptin was correlated with body mass index (BMI) before LOD. Levels of BMI, fasting blood sugar, and leptin were higher and LH, LH/FSH, and the sugar/insulin ratio were lower in the obese group. There were significant decreases in the free androgen index, and total testosterone, luteinizing hormone (LH), and LH/follicle-stimulating hormone (FSH) levels, and a significant increase in sex hormonebinding globulin (SHBG) concentration in the 3 months after the operation. The vascularization index and vascularization flow index of the intraovarian stroma significantly decreased after treatment. Reversed correlations between leptin and LH, LH/FSH, E1, thyroid-stimulating hormone, and SHBG were noted 3 months after the operation compared with levels obtained before the operation. CONCLUSIONS: Treatment of young adult women with PCOS using LOD did not influence leptin levels but changed the ovarian stromal blood flow dynamics during short-term follow-up. The surgical procedure may be beneficial both to endocrine profiles and to intraovarian stromal flow in patients with PCOS.     

The grade of hirsutism correlated to serum androgen levels and hormonal indices

The degree of hair growth of 64 hirsute women was clinically graded. The patients were divided into two groups with respect to the ratio between the serum luteinizing hormone (LH) and the follicle-stimulating hormone (FSH). The two groups did not differ in terms of the grade of hirsutism, serum testosterone (T), calculated free testosterone (FTc), androstenedione (A), dehydroepiandrosterone sulphate (DHEAS), sex hormone binding globulin (SHBG), estradiol, or cortisol levels. In patients with a LH/FSH ratio of 3.0 or less (n = 49), FTc and A correlated well (rho 0.49, p less than 0.001) to the clinically graded hormonal hirsutism score, while SHBG showed an inverse correlation to it. By contrast, no correlations were found in patients with a serum LH/FSH ratio exceeding 3.0 (n = 15). Various indices for hyperandrogenism were calculated. In patients with lower LH/FSH ratio, T/SHBG, T/SHBG + A/100 and T/SHBG + A/100 + DHEAS/100 showed the best correlation with the clinically scored hair growth. These results show that correlations between hirsutism and hyperandrogenism can be demonstrated.     

The impact of serum FSH and estradiol on postmenopausal osteoporosis related to time since menopause

Aim: To determine the impact on osteopenia/osteoporosis of serum follicle-stimulating hormone (FSH), estradiol levels and time since menopause in a group of Turkish postmenopausal women. Methods: Four hundred and thirty-three healthy postmenopausal women seen at the Marmara University Menopause Outpatient Clinic were enrolled for this prospective cohort study. The women were allocated to one of three groups according to the bone mineral density (BMD) of the lumbar vertebrae and total hip, as measured by dual energy X-ray absorptiometry (DEXA). Serum FSH, estradiol levels, age and time since menopause were compared between the groups. Results: The mean serum FSH, LH, estradiol and testosterone levels for women with normal, osteopenic and osteoporotic BMD at lumbar vertrebra L1-L4 and total hip were comparable. Time since menopause had a stronger predictive value for low BMD (osteopenia or osteoporosis) in the lumbar and hip areas than did serum FSH or estradiol levels. Conclusions: Our study showed that neither FSH nor E2 has a strong impact on postmenopausal BMD. However it appears that time since menopause has a weak non-significant association with postmenopausal osteopenia and osteoporosis.     

Effects of progestin-estrogen combination and progestational contraceptives on pituitary gonadotropins, gonadal steroids and sex hormone-binding globulin

The effects of three kinds of hormonal contraceptives on the levels of follicle-stimulating (FSH), luteinizing hormone (LH), estradiol, progesterone, testosterone, and sex hormone-binding globulins (SHBG) in three groups of normally menstruating women were analyzed. During the administration of a very low-dose combination of 150 micrograms of D-norgestrel and 30 micrograms of ethinylestradiol, a progressive suppression of LH, FSH, estradiol, and (to a lesser extent) testosterone levels was observed while progesterone stayed at levels found during the early follicular phase. SHBG levels in these subjects were within the normal range for women. Oral treatment with 0.5 mg of lynestrenol and the intramuscular administration of 200 mg of norethindrone enanthate produced a suppression of LH but not FSH in all cases. Estradiol levels showed peaks in the three women treated with lynestrenol and in half of those treated with norethindrone enanthate, suggesting follicular activity caused by the unsuppressed FSH stimulus; the subsequent elevation of progesterone in two subjects suggested some luteinization, although there was no evidence of an ovulatory surge of gonadotropins. The SHBG in four subjects treated with norethindrone enanthate fell within our normal range for men, and the mean serum testosterone levels fell 40% below the normal basal levels in these cases.     

Gendered personality dispositions,hormone values,and hot flushes during and after menopause

The study aim was to test the relationship between gendered personality dispositions (GPD), sex hormones, and vasomotor complaints in the menopausal transition. Fifty-seven healthy women (mean age 51.1 years, standard deviation 2.0) were drawn from a population registry. At enrollment all women were menstruating regularly, and all women reached menopause in the course of the study. Questionnaire data and blood samples were collected once a year over a period of five years. GPD scores (based on the Bem Sex-Role Inventory, BSRI), frequencies of hot flushes and hormone data (estradiol, follicle-stimulating hormone, luteinizing hormone, testosterone, androstendione and dehydroepiandrostendione sulfate) were determined. Subjects were placed into four categories based on the BSRI: masculine, feminine, androgynous and undifferentiated. GPD did not change during the menopausal transition. Testosterone and androstendione were related to GPD in that testosterone and androstendione were higher in the sex typed categories (masculine and feminine) than in the non sex-typed categories (androgynous and undifferentiated). GPD are related both to androgens and to vasomotor complaints such as hot flushes during the menopausal transition, but the mechanisms of these relationships are not known.     

Endometrial thickness of postmenopausal breast cancer patients treated with tamoxifen.

The effect of administration time of tamoxifen was assessed in 52 postmenopausal patients with mammary cancer in order to evaluate its effect on endometrium and serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and estradiol. Mean age of the patients was 61.5 years, 23% had a history of smoking, mean body mass index (BMI) was 26.9 kg/m(2), and mean age at menarche, menopause and administration time of tamoxifen was 12.9, 48 and 3.5 years, respectively. Serum FSH and LH concentrations were decreased by 41.8% and 44.9%, respectively, compared with mean normal postmenopausal levels. The FSH decrement was associated with BMI and LH level, whereas the LH decrement was associated with patient age and FSH concentration. Endometrium thickness <5 mm was reported in 60.5% of the patients, while endometrium thickness >/=5 mm was found in 39.5% of the cases. Histology revealed that 75% of the patients had atrophic endometrium; the remaining patients (25%) did not show atrophic changes. Administration time of tamoxifen was not associated with endometrial thickness or with serum FSH and LH concentrations.     

Reproductive hormone levels in gynecologic oncology patients undergoing surgical castration after spontaneous menopause.

The endocrine function of the ovary after menopause is perhaps less well understood than at any other time in the female life cycle. To evaluate the hormonal function of the ovary further at this stage of life, reproductive hormone levels were measured in 11 postmenopausal women admitted to the gynecologic oncology service for pelvic surgery which would involve bilateral oophorectomy. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels, along with estradiol, testosterone, dehydroepiandrosterone sulfate (DHEA-S), and androstenedione levels, were measured preoperatively, on Postoperative Days 1 and 4, and at 6 weeks following surgery. Testosterone and androstenedione levels fell by half in these patients, whereas estradiol levels were unaffected. LH and FSH showed a fall in the immediate postoperative period, with a subsequent return to baseline levels by 6 weeks after surgery. DHEA-S levels were unaffected by surgery. There are no discernible differences in subjective menopausal symptoms postoperatively in postmenopausal women undergoing bilateral oophorectomy compared to their preoperative state. The data show that the long-held but inadequately proven thesis that postmenopausal oophorectomy dramatically reduces androgen levels is in fact true. This is further evidence that the postmenopausal ovary is an important source of potent and potentially aromatizable androgens.     

Metformin therapy in women with polycystic ovary syndrome.

OBJECTIVE: To determine the clinical, biochemical, hormonal, and ultrasonographic effects of 6 months of metformin therapy in women with polycystic ovary syndrome (PCOS) and compare with pretherapy parameters. METHOD: 50 Indian women with PCOS, 25 unmarried and 25 married, infertile women, were enrolled in this prospective clinical study. After a baseline workup, including body mass index (BMI), waist hip ratio (WHR), Ferriman Gallwey hirsutism scoring, menstrual pattern, levels of fasting insulin, lipids, oral glucose tolerance test (OGTT), serum gonadotropins, estradiol (E2), testosterone, androstenedione, sex hormone binding globulin (SHBG), and dehydroepiandrosterone sulphate (DHEAS), patients were given 1000 gm of metformin for 6 months and then reevaluated. RESULT: In 41 of 50 women who completed treatment, significant improvement in BMI, WHR, menstrual cyclicity (80.5%), ovulation rate (66%), and pregnancy rate (28%) was noted. Statistically significant decrease in lutenising hormone (LH) and LH/FSH ratio with an increase in follicle stimulating hormone (FSH) levels were seen. Levels of high-density lipoprotein (HDL) cholesterol (Chol) increased along with a decrease in total cholesterol. Improvement was noted in ovarian volume, stromal thickness, and number of follicles. There was no change in hirsutism, acne, levels of other sex steroid hormones, and lipids. CONCLUSION: A 6-month course of metformin therapy may improve menstrual cyclicity and fertility in women with PCOS.     

Which hormone tests for the diagnosis of polycystic ovary syndrome?

OBJECTIVE: To assess the frequency of abnormal values for hormone measurements commonly used in the biochemical diagnosis of polycystic ovary syndrome (PCOS). DESIGN: Hormone measurements in 63 unselected women with clinical and ultrasound diagnosis of PCOS attending gynaecological and general endocrine clinics in a District General Hospital were compared with those from a group of 20 normal ovulatory controls in the early follicular phase of their cycles. MEASUREMENTS: Serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), LH/FSH ratio, total testosterone, derived free testosterone, sex hormone binding globulin, androstenedione, and dehydroepiandrosterone (DHEA) were measured by radioimmunoassays. LH and FSH measured by two different assays. RESULTS: The mean serum LH and LH/FSH ratio were significantly (P less than 0.01) higher in the women with PCOS compared with the normal group, but these two measurements were in the abnormal range for only 35% and 41-44%, respectively. Absolute gonadotrophin values were significantly different using the two assay methods, which employed the same reference preparation as standard. Mean serum total testosterone concentration was significantly higher in the PCOS group and was the most frequently (70%) abnormal biochemical marker for PCOS. Sex hormone binding globulin (SHBG) did not differ significantly between the two groups but showed a negative correlation with body mass index in women with PCOS. The combination of SHBG and testosterone to derive a free testosterone value did not further aid the biochemical diagnosis of PCOS. Androstenedione was significantly higher in the PCOS group than in the control group, with a frequency of 53%. There was no significant difference in DHEA-S between the two groups. CONCLUSION: When typical ovarian ultrasound appearances plus the clinical features of oligomenorrhea and/or hirsuitism were used to define PCOS total testosterone was the best single hormonal marker of the condition. Testosterone, androstenedione or LH, either alone or in combination, were raised in 86% of women with PCOS and these should be the definitive hormonal tests. Using LH/FSH ratio as a biochemical criterion for diagnosis of PCOS should be abandoned because of its low sensitivity. To be of value the normal range for all hormones should be precisely defined in a group of regularly ovulating women in the early follicular phase of the cycle for the assay used in each laboratory.     

Different dopaminergic control of plasma luteinizing hormone, follicle-stimulating hormone and prolactin in ovulatory and postmenopausal women: effect of ovariectomy

The main aim of this study was to evaluate the effect of dopamine infusion on plasma luteinizing hormone (LH), follicle-stimulating hormone, (FSH) and prolactin (PRL) after acute (1 week postovariectomy) and chronic (postmenopausal women) estrogen withdrawal. We also studied the same group of postmenopausal women after ovariectomy to evaluate the possible influence of other gonadal factors on the endocrine effects of dopamine. In order to have a further indication of neuroendocrine dopamine activity on pituitary secretions, we measured the change in plasma LH, FSH and PRL after the administration of metoclopramide, a dopamine receptor antagonist. Our findings confirm that in fertile women dopamine infusion inhibits plasma LH and FSH levels and show that 1 week after ovariectomy the LH decrease during dopamine administration is still present whereas the FSH decrease is not. In all groups of patients, dopamine significantly inhibited plasma PRL levels. Metoclopramide increased plasma LH levels in reproductive-age women before ovariectomy, but not in postmenopausal women. Plasma FSH levels did not change in any group and PRL levels increased after metoclopramide administration in all subjects. The present findings show that dopamine regulation of LH is impaired in long-term menopause, but not shortly after ovariectomy. These changes in LH control are not followed by similar changes in PRL secretion, which remains under tonic inhibitory regulation by dopamine. The different behavior of LH and FSH after ovariectomy and in postmenopause shows the independence of LH and FSH regulation.     

Inhibin A and B as markers of menopause: a five-year prospective longitudinal study of hormonal changes during the menopausal transition

OBJECTIVES: A more direct and precise hormonal marker of the menopause has been required for some time. The aim of this study was to identify the most accurate marker of the menopause, based on analyses of inhibin A and B, FSH, LH and estradiol (E(2)), among 59 healthy women without hormonal treatment during the perimenopause and early postmenopause. METHODS: Fifty-nine women, aged 46-56 years (mean age 51.2 years), were examined annually for 5 years during the menopausal transition and had venous blood drawn simultaneously for later analyses of the above-mentioned hormones. RESULTS: Inhibin A showed a steady decline from at least 4 years before the final menstrual period (FMP) until 1 year before menopause, whereas inhibin B had a shorter lasting decline from year 3 to year 2 before menopause, concomitant with a rise in FSH and LH. CONCLUSION: The present study confirmed previous observations that inhibin A had a continuous decline starting before the decline of inhibin B, suggesting that an increasing part of the cycle was anovulatory. The fall in inhibin B and the increase in FSH constitute markers of ovarian aging. One year prior to menopause neither inhibin A nor inhibin B could be detected. The disappearance of these peptide hormones is an important predictor of the approaching menopause.     

Effect of menopause and sex hormones on plasma lipids

Plasma cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and estradiol, FSH, LH, testosterone, prolactin were determined in 102 cases of perimenopausal women. HDL-C HDL-C/TC, HDL-C/LDL-C decreased and LDL-C increased significantly after menopause, while TG increased in group of menopausal years beyond 11 (P less than 0.01). Postmenopausal women also showed abrupt decrease of estradiol and increase of FSH, LH, and slight decrease of prolactin (P less than 0.01), but no change in testosterone. Plasma lipids showed no correlation with sex hormones except estradiol, which was positively related with HDL-C and negatively with TC, LDL-C (P less than 0.001) but no relationship with TG (P greater than 0.05). The effects of surgical menopause was greater than that of natural menopause. This study suggested that the postmenopausal changes of plasma lipids are related to the decrease of estradiol and the ovaries should be preserved when perimenopausal women received pelvic operation whenever possible.     

绝经过渡期妇女性激素与胰岛素敏感性的改变

目的:观察中老年妇女性激素和胰岛素敏感性与月经状态的关系。方法:年龄40~70岁妇女166例,分为5组:月经规律组、绝经过渡期早期组、绝经过渡期晚期组、绝经早期组和绝经中晚期组。分别测定雌二醇(E2)、雌酮(E1)、促卵泡激素(FSH)、睾酮(T)、性激素结合球蛋白(SHBG)、空腹血糖(FBG)、空腹胰岛素(INS),并计算游离睾酮(FT)及胰岛素作用指数(IAI)。结果:(1)T和FT在绝经过渡期早期组较其他各组有显著升高(P<0.05),在绝经中晚期组较绝经过渡期有显著降低(P<0.05)。E1/E2从绝经过渡期早期即上升,至绝经中晚期显著升高(P<0.05)。FSH从绝经过渡期早期组即显著升高。SHBG各组之间无显著性差异;(2)各组之间FBG和IAI无显著性差异。INS在绝经过渡期早期组显著升高,与绝经后比较差异有显著性(P<0.05);(3)T与E1、FBG和INS正相关,与年龄、FSH和IAI负相关,与E2不相关。结论:妇女在绝经过渡期早期,T、FT显著升高;INS显著升高,但FBG和IAI没有明显变化。