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Blood test may be able to better predict timing of final menstrual period

Study finds measuring anti-Müllerian hormone gives a more accurate prediction than assessing bleeding patterns

Ingrid Torjesen

Thursday, 23 January 2020

A blood test may be a more accurate way to gauge when a woman is nearing menopause than assessing menstrual periods, suggests research* published in the Journal of Clinical Endocrinology & Metabolism.

The study found measuring levels of anti-Müllerian hormone (AMH) can predict when a woman's final menstrual period will occur. AMH serves as an indicator of how many eggs a woman has remaining.

"Establishing a way to measure time to the final menstrual period has long been the holy grail of menopause research," said researcher Nanette Santoro, of the University of Colorado Medical School in Aurora, Colorado. "Using bleeding patterns or previously available tests to predict the time to menopause can only help us narrow the window to a four-year period, which is not clinically useful. Women can make better medical decisions with the more complete information offered by new, more sensitive anti-Müllerian hormone measurements."

For women who are determining whether to have surgery to manage fibroids or whether it is safe to stop using birth control, having an AMH measurement can provide additional information about the timing of menopause, Santoro said. A low AMH level in a woman who is more than 48-years-old indicates that menopause is likely approaching.

The researchers analysed data on 1,537 women who had blood tests between the ages of 42 and 63 as part of the Study of Women's Health Across the Nation (SWAN) which monitored changes in the women's health as they went through the menopausal transition.  Blood samples of SWAN participants were tested for AMH levels and follicle-stimulating hormone, but in this latest study the researchers used a more sensitive test to assess AMH levels. This process made it possible to predict the final menstrual period's timing within 12 to 24 months in women in their late 40s and early 50s.

"Researchers have long thought AMH would be a superior marker of the time to menopause, but tests haven't been sensitive enough to detect the very, very low levels that occur in the year or two leading up to menopause," said researcher Joel S. Finkelstein of Massachusetts General Hospital in Boston, Mass. "It took a cohort like the Study of Women's Health Across the Nation (SWAN), which followed the same women year after year from well before menopause until well after, to get the kind of data necessary to be able to demonstrate the predictive value of AMH."

*Finkelstein JS, Lee H, Karlamangla A, et al. Anti-Mullerian Hormone and Impending Menopause in Late Reproductive Age: The Study of Women's Health Across the Nation. The Journal of Clinical Endocrinology & Metabolism, DOI: 10.1210/clinem/dgz283

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