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Reproductive Hormones in the Early Menopausal Transition: Relationship to Ethnicity, Body Size, and Menopausal Status

Clinical Centers: University of Michigan (J.F.R., M.S.), Ann Arbor, Michigan 48109; Massachusetts General Hospital (J.S.F.), Boston, Massachusetts 02114; Rush University, Rush-Presbyterian-St. Luke’s Medical Center (J.L.), Chicago, Illinois 60612; University of California (E.B.G., B.S., B.L.L.), Davis, California 95616; University of California (S.G.K.), Los Angeles, California 90024; University of Medicine and Dentistry/New Jersey Medical School (N.S.), Newark, New Jersey 07103; University of Pittsburgh (K.A.M.), Pittsburgh, Pennsylvania 15213; Laboratories: University of Michigan (D.S.M.), Ann Arbor, Michigan 48109; and Medical Research Laboratories, Highland Heights, Kentucky 41076; Coordinating Centers: University of Pittsburgh, Pittsburgh, Pennsylvania 15261; and New England Research Institute (B.A.M.), Watertown, Massachusetts 02172

Address all correspondence and requests for reprints to: John F. Randolph, Jr., M.D., L4228 Women’s Hospital, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109-0276.

We measured serum reproductive hormone concentrations in a community-based, multiethnic population of premenopausal and early perimenopausal women to determine whether there are ethnic differences in hormones that can be explained by host factors. We studied 2930 participants in the Study of Women’s Health Across the Nation who were aged 42–52 yr and self-identified as African-American (27.6%), Caucasian (47.1%), Chinese (7.4%), Hispanic (8.8%), or Japanese (9.0%) at 7 clinical sites. Outcome measures from this baseline assessment of a longitudinal study were serum estradiol (E2), FSH, testosterone (T), dehydroepiandrosterone sulfate, and SHBG concentrations and calculated estimates of free steroid availability, free testosterone index, and free E2 index from serum collected primarily in the early follicular phase of a spontaneous menstrual cycle. The primary explanatory variables were race/ethnicity, menopausal status, age, body mass index, day of the cycle, smoking, alcohol use, and physical activity. Chinese women had lower unadjusted E2 and SHBG levels, and Hispanic women had lower unadjusted T levels than other ethnic groups. Unadjusted serum FSH levels did not differ by race/ethnicity. E2 levels adjusted for host characteristics, particularly body size, did not differ by race/ethnicity. Adjusted FSH levels were higher, and adjusted T levels were lower in African-American and Hispanic women. Serum E2 and FSH concentrations were highly variable. Serum FSH levels, but no other hormone concentrations, were positively correlated with menopausal status. Serum dehydroepiandrosterone sulfate levels were negatively correlated with age, but not menopausal status. All hormone concentrations were significantly correlated with body mass index. We conclude that serum sex steroid, FSH, and SHBG levels vary by ethnicity, but are highly confounded by ethnic disparities in body size.

This work was supported by NIH Grants K24-DK-02759 (to J.S.F.) and RR-1066. The Study of Women’s Health Across the Nation (SWAN) was funded by the NIA, the National Institute of Nursing Research, and the Office of Research on Women’s Health of the NIH. Supplemental funding from the NIMH, the NICHD, the National Center on Complementary and Alternative Medicine, the Office of Minority Health, and the Office of AIDS Research is also gratefully acknowledged.

Abbreviations: BMI, Body mass index; DHEAS, dehydroepiandrosterone sulfate; DMAE, dimethyl-acridinium ester; E2, estradiol; FEI, free estradiol index; FTI, free testosterone index; SWAN, Study of Women’s Health Across the Nation; T, testosterone.

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