Normal variation in the length of the follicular phase of the menstrual cycle: effect of chronological age

Lenton, Elizabeth A.; Landgren, Britt-Marie; Sexton, Lynne; Harper, R.

doi:10.1111/j.1471-0528.1984.tb04830.x

Cited by 176 publications

(94 citation statements)

References 12 publications

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“…Cycle parameters and cycle length are more predictable in younger women (18,(37)(38). Younger women's cycles are far more likely to be fertile (8).…”

Section: Discussionmentioning

confidence: 99%

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Assessing menstrual cycles with urinary hormone assays

Santoro

Crawford

Allsworth

et al. 2003

American Journal of Physiology-Endocrinology and Metabolism

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The Study of Women's Health Across the Nation (SWAN) is a multiethnic cohort study of middle-aged women enrolled at seven US sites. A subset of 848 women completed a substudy in which their urinary gonadotropins and sex steroid metabolites were assessed during one complete menstrual cycle or up to 50 consecutive days. Urine was analyzed for LH, FSH, estrone conjugates (E1c), and pregnanediol glucuronide (Pdg). To prepare for serial analysis of this large, longitudinal database in a population of reproductively aging women, we examined the performance of algorithms designed to identify features of the normal menstrual cycle in midreproductive life. Algorithms were based on existing methods and were compared with a "gold standard" of ratings of trained observers on a subset of 396 cycles from the first collection of Daily Hormone Substudy samples. In evaluating luteal status, overall agreement between and within raters was high. Only 17 of the 396 cycles evaluated were considered indeterminate. Of the 328 cycles rated as containing evidence of luteal activity (ELA), 320 were considered ELA by use of a Pdg threshold detection algorithm. Of 51 cycles that were rated as no evidence of luteal activity, only 2 were identified by this algorithm as ELA. Evaluation of the day of the luteal transition with methods that detected a change in the ratio of E1c to Pdg provided 85-92% agreement for day of the luteal transition within 3 days of the raters. Adding further conditions to the algorithm increased agreement only slightly, by 1-8%. We conclude that reliable, robust, and relatively simple objective methods of evaluation of the probability and timing of ovulation can be used with urinary hormonal assays in early perimenopausal women. evidence of luteal activity; day of luteal transition; objective algorithms URINARY HORMONE DETERMINATIONS have been demonstrated to be useful in field studies of women with a variety of reproductive conditions (1-3, 5-6, 9-10, 13, 15, 17, 22-25, 31, 35-42). By use of urinary hormone metabolites as proxy markers of circulating gonadotropin and sex steroid hormones, it was possible to determine the window of fertility in a woman's cycle (3, 41), as well as to describe the effects of exercise (6), smoking (14, 21, 42), weight (40), and reproductive aging (31) on hormone patterns.The day-to-day patterns of secretion of LH, FSH, estradiol, and progesterone are duplicated reliably by use of an overnight urine specimen (24)(25)29). Correction of the urinary hormone value with creatinine excretion reduces within women variations in hormone concentrations, which can be considerable (25). Preservation of urine with glycerol is required to maintain gonadotropin activity in some (31) but not all (35) assays.The Study of Women's Health Across the Nation (SWAN) is a multisite, multiethnic, longitudinal study of midlife women (34). Among the goals of SWAN is the characterization of the reproductive hormone patterns as women approach and traverse the menopausal transition. The Daily Hormone Substudy within...

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“…Cycle parameters and cycle length are more predictable in younger women (18,(37)(38). Younger women's cycles are far more likely to be fertile (8).…”

Section: Discussionmentioning

confidence: 99%

“…In the cycles of women who are in their 40s, follicular phase shortening is often observed, along with increased FSH levels, especially in the early follicular phase of the cycle (16,18,(31)(32). The presumption that progesterone production follows ovulation and that corpus luteum function is Fig.…”

Section: Menstrual Cycle Parametersmentioning

confidence: 99%

Assessing menstrual cycles with urinary hormone assays

Santoro

Crawford

Allsworth

et al. 2003

American Journal of Physiology-Endocrinology and Metabolism

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“…The participants were asked to draw their luteal blood samples (30 mL) 7 to 9 days before the anticipated start of their next menstrual cycle. Because the length of the follicular phase is more variable than the length of the luteal phase, timing of the luteal sample from the estimated first day of the next menstrual cycle is generally more accurate than counting forward from day 1 of the current cycle (25,26).…”

Section: Methodsmentioning

confidence: 99%

Racial Differences in Premenopausal Endogenous Hormones

Pinheiro

Holmes

Pollak

et al. 2005

Cancer Epidemiology, Biomarkers &Amp; Prevention

104

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Differences in breast cancer incidence across racial groups are well documented. African Americans have the highest rates of premenopausal breast cancer and Asians have lower breast cancer rates across all age groups. We hypothesized that levels of premenopausal endogenous hormones and growth factors, risk factors that have been predictive of breast cancer, would differ by race. Using a cross-sectional study design, we tested this hypothesis in the Nurses' Health Study II. We assayed estradiol, progesterone, prolactin, sex hormone binding globulin (SHBG), insulin-like growth factor-I (IGF-I), and IGFBP-3 in 111 African American and 111 Asian American women, matched to 111 Caucasian women on age, day of luteal phase, and day, time, and fasting status at blood collection. We analyzed the association between race and hormone levels using robust linear regression methods. In multivariate models, compared with Caucasians, African Americans had 18% higher levels of estradiol (P < 0.01), 17% higher free estradiol (P < 0.01), 11% lower SHBG (P = 0.05), 11% higher IGF-I (P < 0.01), 25% higher free IGF-I (P < 0.01), and 9% lower IGFBP-3 (P < 0.01) levels. In multivariate models, compared with Caucasian women, Asian Americans had 22% higher calculated free estradiol (P < 0.01), 31% lower SHBG (P < 0.01), and 25% higher free IGF-I (P < 0.01) levels. No racial differences were found in progesterone and prolactin levels. Our study showed hormone differences consistent with breast cancer risk between Caucasians and African Americans but inconsistent with breast cancer risk between Asian Americans and Caucasians. Further research is needed to explore differences across racial groups and the link between endogenous hormones and breast cancer risk. (Cancer Epidemiol Biomarkers Prev 2005;14(9):2147 -53)

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“…Menstrual cycles become shorter, due to decreasing follicular phase length (3). After the age of 35, follicle-stimulating hormone (FSH) levels begin to increase together with a subtle decrease in inhibin B without simultaneous changes in oestradiol (E 2 ) (4±6).…”

Section: Introductionmentioning

confidence: 99%

Age-related differences in features associated with polycystic ovary syndrome in normogonadotrophic oligo-amenorrhoeic infertile women of reproductive years

Bili

Laven

Imani

et al. 2001

European Journal of Endocrinology

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Objective: To assess the effect of age on clinical, endocrine and sonographic features associated with polycystic ovary syndrome (PCOS) in normogonadotrophic anovulatory infertile women of reproductive years. Design: Cross-sectional study. Methods: Four hundred and seventy-two oligo-amenorrhoeic infertile patients, presenting with normal FSH and oestradiol concentrations, aged 17±42 years underwent a standardised initial evaluation including: cycle history, body mass index, waist-to-hip ratio and transvaginal ultrasound scanning of ovaries. Fasting blood samples were obtained for extensive endocrine evaluation. Cycle duration, serum levels of gonadotrophins, androgens, oestradiol, insulin, glucose, inhibin B as well as mean number of follicles, ovarian volume and ovarian stroma echogenicity were assessed. Results: Older women had signi®cantly lower LH and androgen and inhibin B serum levels. Similarly, older women presented with a reduced number of ovarian follicles. Age was inversely correlated with cycle duration r 20X112Y P 0X02Y LH r 20X154Y P 0X001Y testosterone r 20X194Y P 0X001Y androstenedione r 20X170Y P 0X001Y dehydroepiandrosterone r 20X157Y P 0X001Y insulin r 20X126Y P 0X02Y inhibin B r 20X118Y P 0X03 serum levels and mean follicle number r 20X100Y P 0X03X A positive correlation was observed between age and glucose to insulin ratio r 0X138Y P 0X009X Conclusions: Advanced age in normogonadotrophic anovulatory infertile women is associated with lower LH and androgen levels and with a decreased number of ovarian follicles. Although during reproductive years observed differences are relatively small, these age-related changes may affect the observed incidence of PCOS. European Journal of Endocrinology 145 749±755

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Normal variation in the length of the follicular phase of the menstrual cycle: effect of chronological age

Cited by 176 publications

References 12 publications

Assessing menstrual cycles with urinary hormone assays

Assessing menstrual cycles with urinary hormone assays

Racial Differences in Premenopausal Endogenous Hormones

Age-related differences in features associated with polycystic ovary syndrome in normogonadotrophic oligo-amenorrhoeic infertile women of reproductive years

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