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Circulating Dehydroepiandrosterone Sulfate Concentrations during the Menopausal Transition

Division of Preventive and Behavioral Medicine (S.C.), University of Massachusetts, Worcester, Massachusetts 01655; Division of Reproductive Endocrinology (N.S.), Department of Obstetrics and Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, New York 10461; Department of Family and Preventive Medicine (G.A.L.), University of California San Diego, La Jolla, California 92093; Department of Epidemiology (M.F.S., D.M.), School of Public Health, University of Michigan, Ann Arbor, Michigan 48104; Department of Epidemiology (K.S.-T., M.V.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics and Gynecology and Women’s Health (G.W.), University of Medicine and Dentistry-New Jersey Medical School, Newark, New Jersey 07103; Department of Obstetrics and Gynecology (J.R.), Division of Reproductive Endocrinology, University of Michigan Health System, Women’s Hospital, Ann Arbor, Michigan 48109; and Center for Health and the Environment (B.L.), University of California at Davis, Davis, California 95616

Address all correspondence and requests for reprints to: Bill L. Lasley, Center for Health and the Environment, University of California at Davis, 1 Shields Avenue, Davis, California 95616. E-mail: bllasley{at}ucdavis.edu.

Context: A previous report from the Study of Women Across the Nation indicated a rise in dehydroepiandrosterone sulfate (DHEAS) during the menopausal transition using data from three annual visits.

Objective: Our objective was to examine changes in DHEAS with chronological and ovarian aging, expanding the original analyses to include 10 yr of annual data.

Design: A longitudinal observational study and cross-sectional analyses of baseline data were conducted.

Outcome Measures and Subjects: DHEAS, age, menopause status, ethnicity, smoking, weight, and height were assessed in 2886 women from five ethnic groups aged 42–52 yr at entry. Hysterectomy, bilateral oophorectomy, and hormone use were excluded.

Results: Cross-sectional analysis at baseline showed a linear decline in circulating log-transformed DHEAS with increasing age for either the entire cohort (2.81% per year) or for individual ethnicities. A similar negative association with baseline age (2.44% decline per year) was seen in longitudinal linear mixed modeling including observations from premenopause through late postmenopause, an additional 0.33% decline/year. In contradistinction, a late-transition rise in DHEAS was detected when the same women were analyzed by ovarian status. The average increase in mean circulating DHEAS level between early and late menopause transition, beyond changes predicted by aging, was 3.95%, followed by an average decline of 3.96% during the late postmenopause. Approximately 84.5% of the women had an estimated within-woman increase in DHEAS from premenopause/early perimenopause to late perimenopause/early postmenopause.

Conclusion: These observations underscore differences between cross-sectional and longitudinal studies and the importance of considering ovarian status. Additional investigations regarding adrenal contribution to sex steroids in mid-aged women are warranted.