A blood test may be an accurate way to predict menopause

Predicting when women will reach menopause has never been an accurate science, but a new study suggests it could become considerably more precise. Researchers have found that concentrations of a specific hormone can be assessed in a blood test, providing a fairly precise forecast.

The hormone in question is the anti-Mullerian hormone, which is produced by cells in ovarian follicles and controls the development of those follicles. Blood samples were taken three times from 266 women ages 20 to 49, and concentrations of the hormone were tested.

Researchers derived a statistical model to predict approximate menopause age from a single measurement of AMH concentration in blood serum. Since 63 of the participants reached menopause during the study, they had something to which they could compare those predictions.

"The average difference between the predicted age at menopause using our model and the women's actual age was only a third of a year and the maximum margin of error for our model was only three to four years," said Dr. Fahimeh Ramezani Tehrani, co-author of the study, in a news release.

Tehrani, president of the reproductive endocrinology department of the Endocrine Research Centre and an associate professor at Shahid Beheshti University of Medical Sciences in Tehran, added, "The results from our study could enable us to make a more realistic assessment of women's reproductive status many years before they reach menopause... We believe that our estimates of ages at menopause based on AMH levels are of sufficient validity to guide medical practitioners in their day-to-day practice, so that they can help women with their family planning."

Tehrani presents the findings of the study Monday at the annual meeting of the European Society of Human Reproduction and Embryology in Rome.

-- Jeannine Stein

Photo credit: Los Angeles Times

Comments

[Smith W]

This has been the holy grail of women reproductive health. Now it seems women would know more about their future than man can ever know. Two things which changed the life a woman: modern contraceptives specially pills and now the prediction power for how long to take the pill. But more interesting than that, is where these two techniques were developed. One was invented in United States while the other was invented in Iran. Two nations poles apart. I guess there is still some hope left in this world, for better. I wonder if instead of colonialism and wars we could have cooperated more with each other so that we could have even better things. After all we only have one planet to live on. Another interesting things about this is that most males are dismissing it out of hand. It is sad to see this still going on in 21st century. Even the male doctors and scientists are dismissing it. So sad. There has been no congrats for the lead female researcher in this study. Even more sad is to see still in this age and time that most of the presidents of gynecology societies are males, the the same males who are dismissing this study and creating doubt instead of working with Iranian scientists to perfect this test.

[laura]

How extraordinary that this truly "feminist" breakthrough is coming out of Tehran. Iran's scientists and doctors have long been very smart - and we have lots of them who's emigrated here to the L A area - but it's a surprise that the current repressive regime has allowed funding for this while in America, the "science" of menopause is crude to non-existent, cruel and degrading.

From my own experience I can say that it's based on nothing more than statistical tables, so once you're in your mid-40's your doctors call you "peri-menopausal" even if your periods are still regular; since the "average age of menopause in America" is allegedly 51 or so, when you go in for check-ups at that age the snotty young assistant smirks, "so you're menopausal," and if you point out you're not (it's defined by no menses for a year, NOT estimated age) even the doctor likely won't believe you. Or it doesn't matter to him/ her anyway - they "treat you" as a broken-down object not worthy of concern.

AS the insusrance premiums soar, of course, every 5 years especially after 50 and then at 55... WOE to the woman who is in exceptional shape and defied the "statistical tables," in America it's ALL about age, far, far more than weight or genetic disposition OR as this study shows, what's going on in her body. Insurance plans generally consider any actual hormonal balancing "alternative therapy" and won't pay for it.

It would be nice to be able to plan pregnancies without the broad assumption that it's very hard after 40 to get pregnant or "statistical odds of the average woman" going into early menopause.

This would also help a woman get treatment for her unique hormonal conditions when she is peri-menopausal or menopausal, for symptoms. Now it's all generalities based on rough age again - one size fits all HRT, if your doctor recommends or allows it at all, based on studies that conflict. The assumption here in "civilized" America is that women "are supposed to feel miserable" at menopause, they scare you into believing that hormonal therapy can do more harm than good. (NOT true latest studies confirm - it's NOT treating your symtoms that lead to heart disease, bone and muscle loss, bladder problems - all the by-products of loss of estrogen.)

Also horrendously, America has the largest percentage of hysterectomies with all their attendant (doctors don't tell them to you) horrible side effects. Because doctors make a lot of money per operation and women "past breeding age" are of no account in terms of their quality of life.

While this Iranian study is designed to plan for children, it can have lots of other benefits as well. Too bad here in America, no one cares enough about women to conduct such simply, common-sense research.

[Bee Gomez]

This is hardly a "breakthrough", despite what the earlier comment thinks.

"The average difference between the predicted age at menopause using our model and the women's actual age was only a third of a year"

4 months difference is hardly a breakthrough--only 63 women in the study were already in menopause, which isn't a big number for a statistical sample.

The test really tells a woman how many years of eggs she's got left.

Here's a better write-up from AP, with actual reporting.

http://www.physorg.com/news196854295.html

[Robert RIVEST]

Unfortunately, I will not be in Rome to listen to the conference.

AMH is used by our lab to assess reproductive capacity. The test is robust but the variance is relatively high when we go down to low levels, those that you expect prior to menopause. Thus, be cautious when using low values to predict actual menopause. A few follicles, too few to be detected, can be activated after a number of months without menses in the pre-menopausal period. We have seen women, apparently in their menopause, come up with a "surprise" child.

There are drawbacks to the use of this test to predict menopause : in some countries, a women can be repudiated if found sterile. Using this test to give a "menopause" diagnostic is fallacious. This test is not specific enough to exclude a sudden burst of fertility after months of "sterility".

Dr. Robert W. Rivest
Scientific Manager
Chemistry and Endocrinology Department
Unilabs Switzerland

[Positive Thinker]

This is good news to all women...I think being prepared is something as important like knowing how or when the changes is life will take. Menopause is a permanent change and all women will experience it, some positively or negatively but then again being prepared is also a way of adjusting to the new life ahead. Good thinking to the women behind this project, not only that you take care of us women but it also shows the respect that we needed.