Abstract
BackgroundPrevious reports have noted that dehydroepiandrosterone-sulfate (DHEAS) increases prior to the final menstrual period (FMP) and remains stable beyond the FMP. How DHEAS concentrations correspond with other sex hormones across the menopausal transition (MT) including androstenedione (A4), testosterone (T), estrone (E1), and estradiol (E2) is not known. Our objective was to examine how DHEAS, A4, T, E1, and E2 changed across the MT by White vs. African-American (AA) race/ethnicity.MethodsWe conducted a longitudinal observational analysis of a subgroup of women from the Study of Women’s Health Across the Nation observed over 4 visits prior to and 4 visits after the FMP (n = 110 women over 9 years for 990 observations). The main outcome measures were DHEAS, A4, T, E1, and E2.ResultsCompared to the decline in E2 concentrations, androgen concentrations declined minimally over the MT. T (β 9.180, p < 0.0001) and E1 (β 11.365, p < 0.0001) were higher in Whites than in AAs, while elevations in DHEAS (β 28.80, p = 0.061) and A4 (β 0.2556, p = 0.052) were borderline. Log-transformed E2 was similar between Whites and AAs (β 0.0764, p = 0.272). Body mass index (BMI) was not significantly associated with concentrations of androgens or E1 over time.ConclusionThis report suggests that the declines in E2 during the 4 years before and after the FMP are accompanied by minimal changes in DHEAS, A4, T, and E1. There are modest differences between Whites and AAs and minimal differences by BMI.
Highlights
Previous reports have noted that dehydroepiandrosterone-sulfate (DHEAS) increases prior to the final menstrual period (FMP) and remains stable beyond the FMP
As adrenal sex hormones exist in equilibrium with ovarian sex hormones in the peripheral circulation, it is plausible that adrenal hormone metabolism changes over the menopausal transition (MT) [11]
We focused upon these 2 racial/ethnic groups as they had sufficient numbers of subjects with a documented final menstrual period (FMP) and complete hormone data for 4 years before and after the FMP, they were the largest number of participants in Study of Women’s Health Across the Nation (SWAN), the largest racial/ethnic differences in sex steroids have previously been observed between these 2 populations, and funds restricted examination of other racial/ethnic groups [3]
Summary
Previous reports have noted that dehydroepiandrosterone-sulfate (DHEAS) increases prior to the final menstrual period (FMP) and remains stable beyond the FMP. How DHEAS concentrations correspond with other sex hormones across the menopausal transition (MT) including androstenedione (A4), testosterone (T), estrone (E1), and estradiol (E2) is not known. Women’s E2 concentrations begin to change more rapidly about 2 years prior to the final menstrual period (FMP) and stabilize several years after the FMP [2]. As adrenal sex hormones exist in equilibrium with ovarian sex hormones in the peripheral circulation, it is plausible that adrenal hormone metabolism changes over the MT [11] This is consistent with the hypothesis that increasing adrenal sex hormone production and aromatization may be concurrent with decreasing ovarian estrogen production [12]. It is possible that DHEAS production may eventually decline over time resulting lower peripheral A4 and E1 concentrations
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