No abstract

In a study of the endocrinology of the perimenopausal years, levels of serum FSH, estradiol (E2), immunoreactive inhibin (INH), testosterone, and sex hormone-binding globulin were measured in a population-based sample of 380 women (mean age, 49.4 yr; range, 45.6-56.9 yr). Subjects were divided into women who reported continuing regular menstrual cycles (27%; group I), a change in menstrual flow without a change in frequency (23%; group II), a change in frequency but no change in flow (9%; group III), changes in both frequency and flow (28%; group IV), and at least 3 months since their last menstrual period (13%; group V). After adjusting for age and body mass index, the geometric mean FSH increased across menstrual groups and, compared with group I, was 53% higher in group IV (P < 0.0005) and 253% higher in group V (P < 0.0001). Age- and body mass index-adjusted geometric means for E2 and INH in group V were 54% and 53% of those in group 1, respectively (P < 0.005, P < 0.0001). Women in group V who did not have a menstrual period in the next year had higher FSH and lower E2 and INH levels than those who subsequently went on to have at least one more menstrual period (P < 0.05). FSH was negatively correlated with E2 (r = -0.30) and INH (r = -0.39), whereas INH was positively correlated with E2 (r = 0.45). We conclude that an increase in serum FSH and decreases in E2 and INH are the major endocrine changes associated cross-sectionally with the menopausal transition.

The objective of the study was to examine moods and adjustment through the transition to parenthood as an issue affecting the couple; to examine not only the postpartum but also the pregnancy experience and to explore how each partner's experiences interact with those of the other. A longitudinal repeated measures design was utilized with 327 healthy couples with a first-time pregnancy who were from Melbourne, Victoria in 1995-98. Each partner was interviewed on four occasions: mid- and late pregnancy, early postpartum and 4 months postnatally. Twenty per cent of mothers and 12% of fathers were significantly distressed at mid-pregnancy (Time 1) and this persisted until the early postpartum (Time 3) phase. Young age (particularly in women), negative mood, poor relationship functioning, gender role stress (particularly performance failure regarding work and sex in males) and low social support predicted distress in mid-pregnancy (Time 1). Negative mood in partner and self, and poor relationship functioning at mid-pregnancy predicted vulnerability to postnatal distress (Time 3 and/or Time 4). The incidence of distress in couples during mid- and late pregnancy is of concern and highlights the importance of considering the total transition to parenthood, not only the onset of postnatal distress. The analyses of predictors of postnatal distress from prenatal variables suggest that a 'contagion of distress' may operate in some couples. The standard management provided for couples experiencing pregnancy may be inadequate for many couples. These findings suggest that it is important to consider the mood and relationship quality of both partners and to offer intervention services as early as possible to offset possible progression into postnatal depression.

ObJectives: To describe Australian-born women's experience of symptoms during the natural menopause transition and the relative contribution of menopausal and health status, social factors and lifestyle behaviours.Design: A community based crosssectional survey by telephone Interview was carried out on a randomly derived sample of Melbourne women.Participants: The participants were 2000 Australian-born women, aged between 45 and 55 years. Outcome measures:A list of 22 symptoms was used. Explanatory variables were: soclodemographlc variables; menopausal and health status; lifestyle behaviours; attitudes to ageing and to menopause.Results: A 70% response rate was achieved for eligible women who could be contacted during the study. Premenopausal women were the least symptomatic and perlmenopausal women the most symptomatic. Factor analysis found seven common factors from the 22 symptoms studied. Menopausal status based on menstrual history was signif-Icantly related to two groups of symptoms: vasomotor symptoms, which Increased through the menopausal transition; and general somatic symptoms which were more frequent in the perlmenopause. Analysis of variance of factor scores found fewer symptoms with Increasing years of education, better self-rated health, the use of fewer non-prescription medications, the absence of chronic health conditions, a low level of Interpersonal stress, the absence of premenstrual complaints, not currently smoking, exercise at least once a week, and positive attitudes to ageing and menopause.Conclusions: Many factors unrelated to hormonal changes contributed to the symptoms. Longitudinal Investigation Is needed to determine the relative Importance of hormonal, psychosocial and lifestyle variables in the aetiology of mid-life symptoms.(Med J Aust 1993; 159: 232-236) M enopause is a normal event experienced by women in midlife. Despite this, very little is known about the normal range of experience of this event and the factors which may influence women's adaptation during this transition.' Much of the accumulating medical literature focuses on the management of women who have presented to clinicians seeking help for troubling symptoms. Clinical experience provides no information about how representative these patients' symptoms are of the symptoms all women experience during the mid-life transition, or about the incidence and prevalence of these complaints. Further, there is no information about whether the frequency of complaints varies according to the physical, psychological or social health determinants of the women.Studies of representative samples of women drawn from general populations provide a better understanding of the menopausal transition. Most populatlon studies to date have been cross-sectional, in which the research strategy has been to compare women of different ages and/or menopausal status.s As there were few adequate data regarding Australian women's experiences of the mid-life years, the Melbourne Women's Midlife Health Project was developed. The establishment of a cross...

The present study investigated whether administration of percutaneous estradiol for the 7 days encompassing menstruation (the paramenstruum) would be effective in alleviating menstrual migraine. The study was a double-blind cross-over placebo comparison of percutaneous estradiol in gel form. Twenty-two women who suffered from regular recurring menstrual migraine were studied during 2 assessment menstrual cycles, 4 treatment cycles (2 of estradiol gel, 2 of placebo gel), and 1 follow-up (no treatment) cycle. Women completed daily records of the occurrence and severity of migraine and medication used. Eighteen women completed the study. There was a significant reduction in the frequency of migraine in the paramenstruum and in the amount of medication taken during use of percutaneous estradiol. Women expressed a significant preference for continuation of therapy with percutaneous estradiol.