Blood Test Predicts Menopause Say Scientists
Scientists have developed a method that predicts when women will hit the menopause that requires only a blood test and a statistical model the scientists developed themselves. In a small study the predictions were accurate on average to within four months, with a maximum margin of error of between three and four years, of the actual onset of menopause.
If the results are confirmed in larger studies, the researchers hope this method will give doctors a way to help women patients with family planning by giving them an early indication of how long their reproductive life is likely to be.
The study was the work of Dr. Fahimeh Ramezani Tehrani, President of the Reproductive Endocrinology Department of the Endocrine Research Center and a faculty member and Associate Professor of Shahid Beheshti University of Medical Sciences in Tehran, Iran, and colleagues, and will be presented at the 26th annual meeting of the European Society of Human Reproduction and Embryology (ESHRE) in Rome today, Monday.
The Iranian researchers examined blood samples from 266 women aged 20 to 49 who were taking part in the larger ongoing Tehran Lipid and Glucose Study that started in 1998.
From the blood samples they measured levels of AMH (anti-Mullerian Hormone, a hormone that has been proposed as a measure of ovarian function as it controls the development of follicles that produce the eggs).
The women gave blood samples and underwent physical exams every year for three years, and answered questions about their socioeconomic background, health and reproductive history.
In a statement Ramezani Tehrani explained that they developed a statistical model to estimate the age at menopause using one measure of AMH. When they repeated the estimates using AMH taken at other times, they found a good level of agreement among the estimates and also with a subgroup of 63 women who reached menopause during the study.
“The average difference between the predicted age at menopause using our model and the women’s actual age was only a third of a year and the maximum margin of error for our model was only three to four years,” said Ramezani Tehrani.
She said the method they have developed could make a realistic prediction of a woman’s onset of menopause years in advance.
“For example, if a 20-year-old woman has a concentration of serum AMH of 2.8 ng/ml [nanograms per milliliter], we estimate that she will become menopausal between 35-38 years old,” she added.
The researchers believe this is the first population-based cohort study to give a reliable prediction of age at menopause.
“We believe that our estimates of ages at menopause based on AMH levels are of sufficient validity to guide medical practitioners in their day-to-day practice, so that they can help women with their family planning,” said Ramezani Tehrani.
The researchers were also able to predict early menopause (before the age of 45) in the group. They found that 4.1 ng/ml or less of AMH predicted early menopause in 20-year-olds, 3.3 ng/ml predicted it in 25-year-olds, and 2.4 ng/ml predicted it in 30-year -olds.
But if AMH levels were 4.5 ng/ml or higher at age 20, or 3.8 ng/ml at 25 and 2.9 ng/ml at 30, the predicted age at menopause was over 50.
The average age at menopause for the women in this study was about 52.
Ramezani Tehrani said larger studies that follow women from their 20s are now needed to “validate the accuracy of serum AMH concentration for the prediction of menopause in young women”.
There has been a mixed response to the study so far. Some experts say it is too early to tell, others are skeptical that a single test can be so accurate, and some, like the researchers themselves, say bigger and longer studies should be done to validate the method.
A fertility expert at the University of Sheffield in the UK, Dr. William Ledger, told the Associated Press that:
“This is not something we could start rolling out tomorrow.”
“But if it really does work, it could be immensely useful to young women who are making choices about whether to work or have a family,” added Ledger, who was not involved in the study.
While a number of studies have validated that AMH as a useful marker of ovarian reserve, and some concluded that AMH might be a useful way to predict menopause, so far no long term studies have published results.