Examining the hormonal dynamics that characterize the menopausal transition by accurately assaying reproductive ligands is central to understanding the impact of menopause on women's health from midlife through old age. Fundamentally, the Endocrinology of the Menopause/CLASS Laboratory component will examine the dynamics and provide the endocrinologic scaffolding for all other projects in SWAN. We will characterize the hormonal changes associated with the menopausal transition and precisely relate these to their clinical manifestations, explore new areas of endocrine importance, and extend the study of hormonal characteristics from the early to late postmenopause. We will challenge the traditional concept of the menopausal transition as simply a loss of ovarian estradiol secretion to a more integrated and data driven model of a shift from an estrogen dominant to an androgen dominant balance of sex steroids modulated by a dynamic hepatic globulin system. Through SWAN I, II and III we have shown, both cross-sectionally and longitudinally: 1) sex hormone binding globulin (SHBG) to be most strongly associated with cardiovascular risk factors, metabolic syndrome, body composition, insulin, and glucose levels;2) androgens to be strongly associated with cardiovascular risk factors, metabolic syndrome, body composition, insulin and glucose levels, and sexual function;3) follicle stimulating hormone to be strongly associated with bone loss, vasomotor symptoms and timing of the final menstrual period;4) a transient increase in adrenal androgen secretion coincides with the late perimenopausal drop in estradiol secretion;5) only modest associations of estradiol with vasomotorsymptoms, metabolic and hemostatic factors but not bone loss. These findings provide endocrinological support for the evolution in thinking of the menopausal transition as an integrated shift from an estrogen dominant to an androgen dominant state with health risks associated with the magnitude of that shift. To characterize completely the natural history of the menopausal transition, we will pursue the following Specific Aims: 1) Add measures of circulating A and E1 to the annually measured T and E2 to provide a more complete estimate of total circulating estrogens and androgens. We shall calculate the equilibrium among these four steroids and the relationship of the equilibrium to SHBG, both cross-sectionally and longitudinally;2) Measure the isoforms of SHBG and relate the relative proportions to sex steroid levels and ethnic differences, both cross-sectionally and longitudinally;and 3) Determine the degree to which the measured circulating adrenal androgens are associated with health outcomes in women traversing the menopause. We will continue serum sampling of previously measured hormones.

Public Health Relevance

These studies will increase our understanding of the hormonal physiology of the entire menopausal transition and assist in the development of evidence-based paradigms for treating peri- and postmenopausal health concerns.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01AG012495-17
Application #
7843593
Study Section
Special Emphasis Panel (ZAG1-ZIJ-8 (J3))
Program Officer
Sherman, Sherry
Project Start
1994-09-30
Project End
2014-04-30
Budget Start
2010-05-15
Budget End
2011-04-30
Support Year
17
Fiscal Year
2010
Total Cost
$788,582
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Crawford, Sybil L; Crandall, Carolyn J; Derby, Carol A et al. (2018) Menopausal hormone therapy trends before versus after 2002: impact of the Women's Health Initiative Study Results. Menopause :
Karlamangla, Arun S; Burnett-Bowie, Sherri-Ann M; Crandall, Carolyn J (2018) Bone Health During the Menopause Transition and Beyond. Obstet Gynecol Clin North Am 45:695-708
Beatty Moody, Danielle L; Chang, Yuefang; Brown, Charlotte et al. (2018) Everyday Discrimination and Metabolic Syndrome Incidence in a Racially/Ethnically Diverse Sample: Study of Women's Health Across the Nation. Psychosom Med 80:114-121
Yoshida, Kazuki; Yu, Zhi; Greendale, Gail A et al. (2018) Effects of analgesics on bone mineral density: A longitudinal analysis of the prospective SWAN cohort with three-group matching weights. Pharmacoepidemiol Drug Saf 27:182-190
Waetjen, L Elaine; Xing, Guibo; Johnson, Wesley O et al. (2018) Factors associated with reasons incontinent midlife women report for not seeking urinary incontinence treatment over 9 years across the menopausal transition. Menopause 25:29-37
Allshouse, Amanda A; Santoro, Nanette; Green, Robin et al. (2018) Religiosity and faith in relation to time to metabolic syndrome for Hispanic women in a multiethnic cohort of women-Findings from the Study of Women's Health Across the Nation (SWAN). Maturitas 112:18-23
Allshouse, Amanda; Pavlovic, Jelena; Santoro, Nanette (2018) Menstrual Cycle Hormone Changes Associated with Reproductive Aging and How They May Relate to Symptoms. Obstet Gynecol Clin North Am 45:613-628
Hanley, Carrie; Shields, Kelly J; Matthews, Karen A et al. (2018) Associations of cardiovascular fat radiodensity and vascular calcification in midlife women: The SWAN cardiovascular fat ancillary study. Atherosclerosis 279:114-121
Chyu, Laura; Upchurch, Dawn M (2018) A Longitudinal Analysis of Allostatic Load among a Multi-Ethnic Sample of Midlife Women: Findings from the Study of Women's Health Across the Nation. Womens Health Issues 28:258-266
Hanley, Carrie; Matthews, Karen A; Brooks, Maria M et al. (2018) Cardiovascular fat in women at midlife: effects of race, overall adiposity, and central adiposity. The SWAN Cardiovascular Fat Study. Menopause 25:38-45

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