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Physicians will now be able to determine if menopause-related bone loss is already in progress or about to begin by measuring the level of a hormone called anti-Mullerian that declines as women approach their final menstrual period, suggest a recent study.
The findings of the study were published in the 'Journal of Bone and Mineral Research'. These findings could help physicians determine when, and how, to treat bone loss in women as they age before that bone loss causes significant health issues. Specifically, the study found that for women 42 and older who are not yet postmenopausal, levels of the anti-Mullerian hormone, or AMH, can be used to determine if they are experiencing, or about to experience, bone loss related to their transition into menopause. "To be able to intervene and reduce the rate and amount of bone loss, we need to know if this loss is imminent or already ongoing," said the study's lead author, Dr Arun Karlamangla, a professor of medicine in the division of geriatrics at the David Geffen School of Medicine at UCLA. "We do not reliably know before it actually happens when a woman's last menstrual period will be, so we cannot tell whether it is time to do something about bone loss," he added. Bone loss typically begins about a year before a woman's last menstrual period, he said. Women experience significant bone loss during the menopause transition, a roughly three-year window that brackets the final menstrual period and is accompanied by other symptoms such as irregular menstrual cycles, hot flashes, and mood and sleep disorders. Levels of the AMH decline as a woman's final menstrual period draws closer. The researchers examined data from the Study of Women's Health Across the Nation, or SWAN, a multisite, multi-ethnic study examining the changes women undergo during the transition to menopause. They found that 17 per cent of premenopausal women age 42 or older will have lost a significant fraction of their peak bone mass within two to three years of the date a physician makes the prediction. But among those with less than 50 picograms of AMH per millilitre of blood, nearly double the percentage, 33 per cent, will have lost a significant fraction of peak bone mass in the same timeframe. (A picogram is one trillionth of a gram.) In addition, 42 per cent of women in early perimenopause -- meaning that they have irregular menstrual bleeding but with no more than a three-month gap between periods -- will have lost a significant fraction of peak bone mass within two to three years. But among women in early perimenopause with AMH levels below 25 pg/mL, 65 per cent will have lost a significant percentage of peak bone mass in that time. The study has some limitations, the researchers noted. The findings cannot be applied to women who are already taking osteoporosis medications, have undergone a hysterectomy prior to their final period, or have used exogenous sex hormones during the transition to menopause; and the study did not include Hispanic women, nor did it include women who became menopausal before age 42. "These findings make feasible the designing and testing of midlife interventions to prevent or delay osteoporosis in women," the study's authors wrote. (ANI)
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