Circulating dehydroepiandrosterone sulfate levels in women who underwent bilateral salpingo-oophorectomy during the menopausal transition

Abstract

A rise in circulating dehydroepiandrosterone sulfate (DHEAS) concentration occurs during the menopausal transition (MT) that is ovarian stage related but not age related. The objective of this study was to determine the source of the rise in circulating DHEAS. Circulating DHEAS concentrations in women who had undergone bilateral salpingo-oophorectomy (BSO) were compared with the pattern of circulating DHEAS in women who progressed through the MT naturally. Annual serum samples from the Study of Women's Health Across the Nation (SWAN) over a 10-year study period were used. From 1,272 women in the SWAN cohort who were eligible for longitudinal evaluation of DHEAS annual samples, 81 underwent BSO during the premenopausal or early perimenopausal stage of the MT and were potentially available for study. Of these 81 BSO participants, 20 had sufficient annual samples for evaluation of the post-BSO trajectory of circulating DHEAS. SWAN women not having used hormone therapy previously and those with intact ovaries were compared with women who underwent a BSO immediately after a premenopausal or early perimenopausal annual visit. There were no interventions, and circulating concentration of DHEAS was the main outcome. A detectable rise in DHEAS was observed in 14 (70%) of the 20 BSO women, which is similar to the proportion (85%) of women with intact ovaries who had a detectable DHEAS rise. The mean rise in DHEAS (5%-8%) was similar in both BSO and non-BSO women. The MT rise in DHEAS (5%-8%) occurring in the absence of ovaries is largely of adrenal origin.