Increased menopausal symptoms have been observed in African American compared to Caucasian women as they approach menopause. The goal of this study was to evaluate levels of estradiol, DHEAS, testosterone and FSH over time to assess possible endocrinologic causes for racial differences in menopausal symptoms. Approximately 200 Caucasians and 200 African Americans 35 to 47 years of age were evaluated in the early follicular phase of the menstrual cycle at 4 time points over 9 months. A multivariate, linear mixed model was used to estimate effects of race, age at enrollment, age at menarche, number of pregnancies, current smoking, alcohol consumption, body mass index (BMI), waist hip ratio (WHR) and menstrual cycle length on hormone levels. Intra-class correlation coefficients were calculated to estimate reproducibility of hormone levels for each racial group. African Americans had significantly lower levels of estradiol and DHEAS with increasing age, with no apparent age effect in Caucasians. African Americans had significantly decreased levels of estradiol and significantly increased levels of DHEAS with increasing BMI, while in Caucasians there was no association with these hormones and BMI. There were no racial differences in levels of FSH or testosterone, nor in the reproducibility of any of the hormones measured. The increased occurrence of menopausal symptoms in African Americans compared to Caucasians may be related to the greater rate of decline in estradiol levels with increasing age and BMI.
Learning Objectives: At the conclusion of this session, the participant will be able to: 1. Identify risk factors for menopausal symptoms in African American vs. Caucasian women 2. Assess the applicability of multivariate, linear mixed models for evaluation of longitudinal hormone data 3. Estimate the use of intra-class correlation coefficients
Keywords: Endocrine, Menopause
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: none
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.