Serum sex steroid levels and longitudinal changes in bone density in relation to the final menstrual period

Abstract

Context: The associations of serum sex steroid and FSH levels with change of bone mineral density (BMD) across the complete menopausal transition are incompletely understood. Objective: The objective of the study was to examine the associations of annual serum levels of FSH, estradiol (E2), T, and SHBG with the rates of bone loss in 3 phases: pretransmenopausal [baseline to 1 year before the final menstrual period (FMP)], transmenopausal (1 year before to 2 years after the FMP), later postmenopausal (≥ 2 years after the FMP). Design: The design of the study was a repeated-measures, mixed-effects regression. Setting: This was a community-based observational study, with a 10-year follow-up. Participants: A total of 720 participants of the Study of Women's Health Across the Nation Bone Study participated in the study. Outcome Measures: Annualized lumbar spine (LS) and femoral neck (FN) BMD decline was measured. Results: The mean annual change in BMD was slowest in pretransmenopause (0.27%/year in FN) and fastest in transmenopause (2.16%/year in LS). In the pretransmenopausal phase, for every doubling of FSH level, LS BMD change was faster by -0.32%/year (P