Hyperandrogenic oligomenorrhea and metabolic risks across menopausal transition

Alex J. Polotsky, Amanda A. Allshouse, Sybil L. Crawford, Sioban D. Harlow, Naila Khalil, Rasa Kazlauskaite, Nanette Santoro, Richard S. Legro

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Abstract

Context: Although there is evidence of metabolic risks in young women with irregular menses and androgen excess, persistence of risks after menopause is unclear. Objective: The objective of the study was to determine the impact of menopause on the cardiometabolic profile in women with high androgens and a history of menstrual irregularity. Methods: Study of Women's Health Across the Nation is a longitudinal cohort study. Data from 1929womenwithout metabolic syndrome (MetS) at baseline were analyzed for incidence of MetS, self-reported stroke, and myocardial infarction. Cox hazard ratios (HRs) were estimated, adjusting for age, ethnicity, body mass, smoking, menopausal status, and study site. Results: Among MetS-free women at baseline, 497 new cases were identified during 20 249 woman- years of follow-up over 12 years. Women with hyperandrogenemia (HA) and oligomenorrhea (Oligo) developed incident cases of MetS at a comparable rate compared with their counterparts: eumenorrheic, normoandrogenic women [HR 1.4 (0.9 -2.2)], oligomenorrheic, normoandrogenic women [HR 1.3 (0.8 -2.2)], and eumenorrheic hyperandrogenic women [HR 1.2 (0.7-1.8)]. Smoking and obesity were the strongest predictors of incident MetS. There was no significant difference in incidence of self-reported stroke or MI by HA/Oligo status. Conclusions: Longitudinal evidence suggests that a history of androgen excess and menstrual irregularity is not associated with worsening of metabolic health after menopause. Our findings challenge the notion that a history of concurrent HA and Oligo reflects ongoing cardiometabolic risk in postmenopausal women.

Original languageEnglish (US)
Pages (from-to)2120-2127
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume99
Issue number6
DOIs
StatePublished - Jun 2014

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All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Polotsky, A. J., Allshouse, A. A., Crawford, S. L., Harlow, S. D., Khalil, N., Kazlauskaite, R., Santoro, N., & Legro, R. S. (2014). Hyperandrogenic oligomenorrhea and metabolic risks across menopausal transition. Journal of Clinical Endocrinology and Metabolism, 99(6), 2120-2127. https://doi.org/10.1210/jc.2013-4170