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Hormone May Predict Age at Menopause
April 30, 2008 -- A hormone that is used to help assess the potential for pregnancy in assisted reproduction might prove to be an accurate predictor of a woman's age at menopause, a study shows.
If early findings are confirmed, researchers say anti-Mullerian hormone (AMH) levels may predict age at menopause within one or two years in women as young as age 30.
Researcher Jeroem van Disseldorp, MD, tells WebMD that the early study shows the hormone to be a more sensitive predictor of age at menopause than chronological age alone.
Van Disseldorp and colleagues from University Medical Center Utrecht in the Netherlands developed a predictive model based on AMH levels in fertile women.
The next step is to see if the women actually reach menopause when the model says they will.
"Right now it looks like AMH is quite sensitive for determining a woman's age at menopause within one or two years," van Disseldorp says. "But we can't say this with certainty yet."
(Do you suspect you may be in menopause? Why? Share your thoughts and questions with others on WebMD's Women's Health: Friends Talking message board.)
AMH and Menopause
Anti-Mullerian hormone is undetectable in girls until they reach puberty, and after that levels of the hormone appear to increase until around the age of 30.
AMH levels in the blood reflect the number of small follicles present in a woman's ovaries. These follicles enable reproduction by ensuring monthly ovulation.
Low levels of AMH in the blood are indicative of poor ovarian reserve. Because of this, AMH measurement is increasingly being done in women seeking medical treatment for infertility.
The hormone may prove to be an even more useful marker of fertility in this setting than the most widely used assessment, follicle-stimulating hormone (FSH), because unlike FSH, AMH levels do not appear to fluctuate with the menstrual cycle.
In an effort to examine the hormone's potential as an early predictor of menopause, van Disseldorp and colleagues measured AMH levels in 144 healthy, fertile women between the ages of 25 and 45, and the researchers used this information to estimate the change in mean levels of the hormone with age.
Based on these findings, the researchers then estimated the distribution of the age at menopause in a group of 3,384 postmenopausal women between the ages of 50 and 70.
These data were used to develop a model which showed AMH to be a sensitive predictor of menopause for women in their 30s and older, with the possible exception of women who experience menopause much earlier (age 41 or younger) or later (age 57 or older) than normal.
The researchers plan to follow the older, but still fertile women in the study to see if their predicted and actual ages at menopause are the same.
Understanding a Woman's Biological Clock
If the model proves accurate, AMH may one day help women as young as their early 30s better understand their personal biological clocks.
"This would be a better indicator than chronological age, which is what we use now," van Disseldorp says.
But Columbia University menopause researcher Michelle Warren, MD, remains skeptical about the hormone's potential for predicting age at menopause in young women.
Warren is director of the Columbia University Center for Menopause, Hormonal Disorders and Women's Health.
"That remains to be seen," she says. "AMH is finding a place in the evaluation of women seeking treatment for infertility, but we can't say much more than that until more research is done."
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VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
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