מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Researchers have developed a staging system that may help classify women according to reproductive potential and eliminate much of the confusing nomenclature that currently exists.
Earlier this year at The Stages of Reproductive Aging Workshop (STRAW) in Park City, Utah, researchers from the American Society for Reproductive Medicine (ASRM) and other health organizations met to discuss a staging system for reproductive aging. From this meeting a 7-stage system was generated that is now published in the November issue of Fertility and Sterility.
"I know physicians and scientists are going to find this system helpful; it will eliminate a lot of confusion," Dr. William Keye, Jr. president of the ASRM, said in a statement. "Right now, it's hard to agree on what so much of the terminology means and no one has been using a staging system."
Dr. Michael R. Soules, from the University of Washington in Seattle, and colleagues generated several criteria for an ideal staging system. The investigators believed the system should rely on objective data only, employ reliable tests that are inexpensive and readily available, allow women to be placed prospectively in an appropriate stage, and allow inclusion in only one stage.
The system developed by Dr. Soules' team consists of three phases that are divided into a total of seven stages. With the exception of early postmenopause, which is 5 years in length, the duration of each stage is variable.
The earliest phase, known as the reproductive phase, includes early, peak, and late stages. Women in the early stage have variable to regular menstrual cycles with normal follicular stimulating hormone (FSH) levels. In the peak stage, menstrual cycles are regular and FSH levels are normal. During the late stage, menstrual cycles are still regular, but FSH levels are now elevated.
The second phase, known as menopausal transition, includes early and late stages. In both stages FSH levels are elevated. During the early stage, menstrual cycles are of variable length with the duration of each differing by 7 days or more. In the late stage, two or more menstrual cycles are skipped and at least 60 days of amenorrhea has occurred.
The final menstrual period heralds the beginning of the postmenopause phase. This phase includes an early and late stage and FSH levels are elevated in both. The early stage lasts 5 years with the remainder of a woman's life spent in the late stage.
The investigators do not recommend applying the staging system to "women who smoke cigarettes, those at the extremes of body weight, those who do heavy aerobic exercise, those with chronic menstrual cycle irregularity, those who have had a hysterectomy, or those who have abnormal uterine or ovarian anatomy."
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