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Circulating dehydroepiandrosterone sulfate levels in women who underwent bilateral salpingo-oophorectomy during the menopausal transition

L. Lasley, Bill PhD1; Crawford, Sybil L. PhD2; Laughlin, Gail A. PhD3; Santoro, Nanette MD4; McConnell, Daniel S. PhD5; Crandall, Carolyn MD6; Greendale, Gail A. MD6; Polotsky, Alex J. MD4; Vuga, Marike PhD7

doi: 10.1097/gme.0b013e3181fb53fc
Original Articles

Objective: A rise in circulating dehydroepiandrosterone sulfate (DHEAS) concentration occurs during the menopausal transition (MT) that is ovarian stage related but not age related. The objective of this study was to determine the source of the rise in circulating DHEAS.

Methods: Circulating DHEAS concentrations in women who had undergone bilateral salpingo-oophorectomy (BSO) were compared with the pattern of circulating DHEAS in women who progressed through the MT naturally. Annual serum samples from the Study of Women's Health Across the Nation (SWAN) over a 10-year study period were used. From 1,272 women in the SWAN cohort who were eligible for longitudinal evaluation of DHEAS annual samples, 81 underwent BSO during the premenopausal or early perimenopausal stage of the MT and were potentially available for study. Of these 81 BSO participants, 20 had sufficient annual samples for evaluation of the post-BSO trajectory of circulating DHEAS. SWAN women not having used hormone therapy previously and those with intact ovaries were compared with women who underwent a BSO immediately after a premenopausal or early perimenopausal annual visit. There were no interventions, and circulating concentration of DHEAS was the main outcome.

Results: A detectable rise in DHEAS was observed in 14 (70%) of the 20 BSO women, which is similar to the proportion (85%) of women with intact ovaries who had a detectable DHEAS rise. The mean rise in DHEAS (5%-8%) was similar in both BSO and non-BSO women.

Conclusions: The MT rise in DHEAS (5%-8%) occurring in the absence of ovaries is largely of adrenal origin.

From the 1Center for Health and the Environment, University of California at Davis, Davis, CA; 2Division of Preventive and Behavioral Medicine, University of Massachusetts, Worcester, MA; 3Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA; 4Department of Obstetrics and Gynecology, University of Colorado at Denver, Aurora, CO; 5Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI; 6Department of Medicine, UCLA Medical School, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA; and 7University of Pittsburgh,Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA.

Received July 23, 2010; revised and accepted August 25, 2010.

Funding/support: The Study of Women's Health Across the Nation was funded by the National Institute on Aging, the National Institute of Nursing Research, and the National Institutes of Health Office of Research on Women's Health.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Bill L. Lasley, PhD, Center for Health and the Environment, University of California at Davis, 1 Shield Ave., Davis, CA 95616. E-mail:

©2011The North American Menopause Society