The Study of Women's Health Across the Nation (SWAN) is a multicenter, multiethnic, community based longitudinal study designed to characterize the biological, symptomatic and psychosocial changes that occur during the menopausal transition and the effects of these changes on women's health during and after the transition. Current and prior funding (SWAN I and II) has supported a baseline and six annual follow-up examinations during which 895 (48%) women will have transitioned to postmenopause. This application requests funding to complete four additional follow-up visits (SWAN III) to allow an adequate evaluation of the late perimenopause and early postmenopause, a period that has not been well studied, particularly among non-white women. We will continue our current tracking of changes in reproductive hormones, bleeding patterns, symptoms, bone loss, cardiovascular (CV) risk factors blood pressure, body size, and other related ? characteristics and will undertake new scientific endeavors in targeted areas. These include measurement of vascular stiffness to assess early CV disease, assessment of vertebral morphometry at four sites using DEXA technology, and the addition of one cognitive function test. In addition, we will focus on linking the midlife experience to age-related outcomes (e.g. cognitive function, urinary incontinence) and chronic diseases (e.g. fractures, diabetes and hypertension). Specimens from the additional follow-up visits will continue to contribute to the SWAN biological specimen repository (annual blood and urine samples as well as DNA and immortalized cells). This is a separately funded component that broadens the opportunities to address future hypotheses about health and disease in aging women. As women reach the end of early postmenopause (two years following the final menstrual period), we will shift from an annual to a bi-annual follow-up examination schedule with mail and telephone contact in the alternating years. This will permit cost-effective and less intensive follow-up. SWAN's organization and operations have been modified to enhance productivity and we are poised to publish important biological, symptom and behavioral results pertaining to the menopause ? transition. With SWAN III, many of the original goals of SWAN will be brought to fruition. We will build ? upon the rich foundation developed during SWAN I and II and link these data to important menopauserelated and health outcomes in SWAN III. ? ?

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project--Cooperative Agreements (U01)
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Study Section
Special Emphasis Panel (ZAG1-ZIJ-8 (J2))
Program Officer
Sherman, Sherry
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Albert Einstein College of Medicine
Obstetrics & Gynecology
Schools of Medicine
United States
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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
Delamater, Lara; Santoro, Nanette (2018) Management of the Perimenopause. Clin Obstet Gynecol 61:419-432

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