The purpose of this study is to better understand how hormone levels vary before, during, and just after menopause, and to examine differences in age and symptom experience at menopause among six groups of women. This includes four groups of migrants who came to London from Sylhet, NE Bangladesh at different ages: (a) as adults (over 16 years), (b) as infants (0-2 years), (c) as children (3-8 years), and (d) as pre-adolescents (9-puberty), as well as (e) Sylheti women still living in Bangladesh, and (f) white women living in similar London neighborhoods as the migrants.
Women's hormones change with age and menopausal status. The PIs will be looking at three different hormones from blood samples taken from volunteers that tell roughly how many eggs there are remaining in a woman's ovary. When women run out of eggs, they reach menopause. These hormones are called follicle stimulating hormone, inhibin B and anti-mullerian hormone. Average ages at menopause will be estimated in each group of women, and possible factors associated with variation in menopausal age (e.g., smoking and betel nut chewing) will be examined within and between groups. The frequency of menopausal symptoms, especially hot flashes and headaches, will be measured in all six groups through interviews and questionnaires. Hot flashes will also be measured in some women using an electronic monitor that can be worn with little discomfort for 24 hours. To understand how the different groups of women experience the menopausal transition, the PIs will be looking, in particular, at the relationship between social stress (e.g., marital stress and social isolation) and symptom frequencies, and how local conditions could affect the menopausal experience.
This is the first project to look at specific hormone levels as indicators of reproductive aging among migrants from a developing country. It is also the first study to use hot flash monitors among Bangladeshi women in Bangladesh and abroad. This study also builds on the previous work of Bentley and her colleagues on reproductive function among younger Bangladeshi women (aged 18-39).
The study will extend knowledge of the effects of environmental and development conditions on the experience of reproductive aging. It will further international cooperation, and contribute to the training of students from the United States, UK, and Bangladesh. It also represents an opportunity to contribute to the literature on the topic of stress and the menopausal transition. In addition, there is very little research that specifically addresses the needs of the Bangladeshi immigrant community in England especially research that might be helpful for community workers. Project results could be used in very practical ways to inform the local community and health providers about the menopausal experiences of Bangladeshi migrants.
