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"Persistence" improves the 60-day amenorrhea marker of entry to late-stage menopausal transition for women aged 40 to 44 years

Taffe, John R. PhD1; Cain, Kevin C. PhD2; Mitchell, Ellen S. PhD, RN2; Woods, Nancy F. PhD, RN, FAAN2; Crawford, Sybil L. PhD3; Harlow, Siobán D. PhD4

doi: 10.1097/gme.0b013e3181b5540e
Brief Report

Objective: The ReSTAGE collaboration evaluated four menstrual markers of entry to late-stage menopausal transition. The aim of this study was to assess the additional usefulness of "persistence" in relation to a clinically accessible menstrual marker of late menopausal transition, taking age into account.

Methods: In this study, a secondary analysis of menstrual calendar data in two ReSTAGE-collaborating studies with comparatively low age at beginning of menstrual calendar observation was performed.

Results: Sixty days of amenorrhea is as useful for predicting time to the final menstrual period as the currently accepted 90-day marker for women older than 45 years. For those aged between 40 and 44 years, recurrence of the 60-day marker within the next 10 cycles is a better indicator than a single occurrence of the 60-day marker or the 90-day marker.

Conclusions: Sixty-day amenorrhea is as reliable a marker of late menopausal transition as the traditional 90-day marker for women older than 45 years. For those aged 40 to 44 years, keeping menstrual records to check for a recurrence of the 60-day marker will be useful.

Sixty-day amenorrhea first occurring to women aged 45 to 49 years predicts menopause within 5 years as well as does the traditional 90-day marker. Similar performance is associated with early recurrence of the 60-day marker for women to whom it first occurs in the age range 40 to 44 years.

From the 1Monash University Melbourne, Australia; 2University of Washington, Seattle, WA; 3University of Massachusetts, Boston, MA; and 4University of Michigan, Ann Arbor, MI.

Received April 26, 2009; revised and accepted June 30, 2009.

Funding/support: ReSTAGE is supported by grant AG 021543 (Siobán Harlow, principal investigator [PI]) from the National Institute on Aging. The Seattle Midlife Women's Health Study was supported by grants NR004141 and NR04001 (Ellen Mitchell, PI) from the National Institute of Nursing Research.

Financial disclosure/conflicts of interest: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging, the National Institute of Nursing Research, or the National Institutes of Health.

Collaborators in ReSTAGE include Siobán Harlow (PI), Roderick Little, MaryFran Sowers, Bin Nan, John Randolph, and Matheos Yosef, University of Michigan; Sybil Crawford, University of Massachusetts; Lorraine Dennerstein, University of Melbourne; John Taffe, Henry Burger, Monash University; and Kevin Cain, Nancy Fugate Woods, and Ellen S. Mitchell, University of Washington.

Address correspondence to: John Taffe, PhD, Centre for Developmental Psychiatry and Psychology, Child and Adolescent Mental Health Service, Monash Medical Centre, 246 Clayton Rd, Clayton, VIC 3168, Australia. E-mail:

©2010The North American Menopause Society