Can follicle-stimulating hormone be used to define menopausal status

R K Stellato
Sybil L. Crawford, University of Massachusetts Medical School
S M McKinlay
C Longcope

Abstract

OBJECTIVE: To assess the ability of the level of follicle-stimulating hormone (FSH) to distinguish among premenopausal, perimenopausal, and postmenopausal women.

METHODS: We examined cross-sectional and longitudinal data from the second phase of the Massachusetts Women's Health Study (1986 to 1995), a population-based cohort of 427 premenopausal and perimenopausal women identified from the first phase of the Massachusetts Women's Health Study (1981 to 1986).

RESULTS: Boxplots of FSH levels throughout the menopausal transition displayed considerable overlap. Logistic regressions and their resulting receiver operating characteristic curves further demonstrated that, although FSH is a statistically significant predictor of menopausal status, no single value of FSH is expedient for distinguishing premenopausal from perimenopausal or perimenopausal from postmenopausal women.

CONCLUSION: FSH alone is not an effective predictor of transition into the perimenopausal or postmenopausal period. Specifically, the frequently recommended FSH cutoff of 40 IU/L is inappropriate by itself for clinical determination of postmenopausal status.