Concordance of hemoglobin A1c and reproductive hormone levels in menstrual and venous blood

Abstract

ObjectiveTo explore whether menstrual blood collected via a modified menstrual pad is a surrogate for venous blood draw in analyzing HbA1c and fertility-associated hormones DesignCross-sectional study SubjectsStudy included 152 female participants who have regular menses, aged 19-50 years old. InterventionsParticipants collected menstrual effluent using a menstrual pad, modified with a removable dried blood spot (DBS) strip. Peripheral blood samples were collected by venipuncture within 60 hours of menstrual pad use. Main Outcome MeasuresMenstrual pad and venous blood draw samples were analyzed for levels of HbA1c, thyroid stimulating hormone (TSH), Follicle Stimulating Hormone (FSH), anti-Mullerian hormone (AMH), and Luteinizing hormone (LH). Correlation between menstrual pad and venipuncture samples was performed by Deming linear regression, and r coefficients were measured using Pearson correlation. ResultsInter-assay variability of menstrual pad DBS sample measurements was <6%. Menstrual HbA1c values were stabilized in the DBS strips through 53 days, and menstrual hormone levels remained stable through 15 days. Menstrual HbA1c levels were highly correlated with venipuncture samples (r=0.96). TSH (r=0.94), AMH (r=0.94), FSH (r=0.91), and LH (r=0.91) also showed high correlation between menstrual strip and venipuncture samples. ConclusionsHbA1c, TSH, AMH, FSH, and LH measurements in menstrual effluent showed high correlation to venous blood samples, supporting use of menstrual effluent as a surrogate sample for hormone testing.