EPIDEMIOLOGIC STUDY OF THE LATE REPRODUCTIVE YEARS

Summary

Principal Investigator: Ellen Freeman
Abstract: This is a continuation of a prospective cohort study of ovarian aging. The study focuses on hormone dynamics and associated symptoms as premenopausalwomen enter and move through stages in the transition to menopause. The specific aims are to: 1)) Compare hormone levels and longitudinal trends between African American and Caucasian women;2) Identify how within-woman trends of the study hormones (estradiol, FSH, LH, Inhibin B, DHEAS, and testosterone) and cofactors such as BMI, race, age, symptoms, et al predict the progression through the transition;3) Identify associations of hormonedynamics with physical and behavioral symptoms that occur with ovarian aging and identify racial differences in these factors;4) Identify associations of genetic polymorphisms with levels and longitudinal trends and with menopausal symptoms. Hormone evaluations and a battery of physical and behavioral assessmentsare collected annually on days 1-6 of two consecutive menstrual cycles or 1 month apart in non-cycling women. Continuation of this cohort study will provide new information on hormone dynamics and their influences on menopausal symptoms through the full menopausal transition.- ......... More than 80% of U.S. women experience physical or behavioral symptoms around menopause,with varying degrees of severity and disruption in their functioning, and many of these women seek medical relief for distressing symptoms. The lack of understanding of the contributors to these symptoms and their associations with hormonal factors of ovarian aging is a significant health care problem. Increased understanding of the changes associated with reproductive aging and whether there are racial differences in these changes will lead to better preventive and therapeutic strategies to reduce the short and long term morbidity of women's mid-life and postmenopausalyears.
Funding Period: ----------------1996 - ---------------2012-
more information: NIH RePORT

Top Publications

  1. ncbi Associations of hormones and menopausal status with depressed mood in women with no history of depression
    Ellen W Freeman
    Department of Obstetrics Gynecology, University of Pennsylvania School of Medicine, Philadelphia, 19104, USA
    Arch Gen Psychiatry 63:375-82. 2006
  2. ncbi Hormone variations associated with quantitative fat measures in the menopausal transition
    S Senapati
    Division of Reproductive Endocrinology and Infertility, University of Pennsylvania
    Climacteric 17:183-90. 2014
  3. pmc Menopause effects on verbal memory: findings from a longitudinal community cohort
    C Neill Epperson
    Department of Psychiatry, Penn Center for Women s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
    J Clin Endocrinol Metab 98:3829-38. 2013
  4. pmc Contribution of the rate of change of antim├╝llerian hormone in estimating time to menopause for late reproductive-age women
    Ellen W Freeman
    Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
    Fertil Steril 98:1254-9.e1-2. 2012
  5. pmc Antimullerian hormone and inhibin B are hormone measures of ovarian function in late reproductive-aged breast cancer survivors
    H Irene Su
    Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA
    Cancer 116:592-9. 2010
  6. pmc Association of change in estradiol to lower urinary tract symptoms during the menopausal transition
    Manish Gopal
    Division of Urogynecology, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
    Obstet Gynecol 112:1045-52. 2008
  7. pmc Investigating the associations between nocturia and sleep disorders in perimenopausal women
    Manish Gopal
    Division of Urogynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    J Urol 180:2063-7. 2008
  8. pmc Predictors of sleep quality in women in the menopausal transition
    Grace W Pien
    Division of Sleep Medicine, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
    Sleep 31:991-9. 2008
  9. pmc Body size affects measures of ovarian reserve in late reproductive age women
    H Irene Su
    Department of Obstetrics, Division of Reproductive Endocrinology and Infertility, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
    Menopause 15:857-61. 2008
  10. ncbi Association of anti-mullerian hormone levels with obesity in late reproductive-age women
    Ellen W Freeman
    Department of Obstetrics Gynecology, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania 19104, USA
    Fertil Steril 87:101-6. 2007

Scientific Experts

  • Timothy R Rebbeck
  • Samantha Butts
  • Ellen Freeman
  • Deborah Nelson
  • Mary D Sammel
  • Hui Lin
  • H Irene Su
  • Clarisa R Gracia
  • Manish Gopal
  • S Senapati
  • C Neill Epperson
  • Grace W Pien
  • Clarisa Gracia
  • Tracey L DeBlasis
  • Kathryn H Schmitz
  • C Kim
  • C R Gracia
  • H Lin
  • M D Sammel
  • G W Pien
  • R J Schwab
  • Angela DeMichele
  • Luke Velders
  • Corrie Stankiewicz
  • Jennifer Matro
  • Jamie Green
  • Ziyue Liu
  • Wensheng Guo
  • Grace Pien
  • Lily Arya
  • Tracey DeBlasis
  • Lily A Arya
  • Marjori Mogul
  • Shiv Kapoor
  • Clarissa R Gracia

Detail Information

Publications24

  1. ncbi Associations of hormones and menopausal status with depressed mood in women with no history of depression
    Ellen W Freeman
    Department of Obstetrics Gynecology, University of Pennsylvania School of Medicine, Philadelphia, 19104, USA
    Arch Gen Psychiatry 63:375-82. 2006
    ..Whether depressed mood reported in the transition to menopause by women with no history of depression is associated with menopausal status and changes in reproductive hormones is controversial and lacks scientific information...
  2. ncbi Hormone variations associated with quantitative fat measures in the menopausal transition
    S Senapati
    Division of Reproductive Endocrinology and Infertility, University of Pennsylvania
    Climacteric 17:183-90. 2014
    ..This study aims to delineate these relationships using quantitative measures of visceral and subcutaneous fat...
  3. pmc Menopause effects on verbal memory: findings from a longitudinal community cohort
    C Neill Epperson
    Department of Psychiatry, Penn Center for Women s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
    J Clin Endocrinol Metab 98:3829-38. 2013
    ..Although cognitive complaints are common among menopausal women, it is debatable whether there is an objective decline in cognition with menopause that exceeds what is expected with normal aging...
  4. pmc Contribution of the rate of change of antim├╝llerian hormone in estimating time to menopause for late reproductive-age women
    Ellen W Freeman
    Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
    Fertil Steril 98:1254-9.e1-2. 2012
    ..We hypothesized that the rate of change between two measures of AMH reflects follicular atresia and varies among women independent of age...
  5. pmc Antimullerian hormone and inhibin B are hormone measures of ovarian function in late reproductive-aged breast cancer survivors
    H Irene Su
    Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA
    Cancer 116:592-9. 2010
    ....
  6. pmc Association of change in estradiol to lower urinary tract symptoms during the menopausal transition
    Manish Gopal
    Division of Urogynecology, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
    Obstet Gynecol 112:1045-52. 2008
    ..To estimate the relationship between changes in estradiol (E2) levels over time and lower urinary tract symptoms in premenopausal women as they transition to menopause...
  7. pmc Investigating the associations between nocturia and sleep disorders in perimenopausal women
    Manish Gopal
    Division of Urogynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    J Urol 180:2063-7. 2008
    ..We determined the associations between nocturia and sleep disorders in perimenopausal women...
  8. pmc Predictors of sleep quality in women in the menopausal transition
    Grace W Pien
    Division of Sleep Medicine, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
    Sleep 31:991-9. 2008
    ..To determine associations between menopausal status, reproductive hormone levels, menopausal symptoms, and poor sleep quality...
  9. pmc Body size affects measures of ovarian reserve in late reproductive age women
    H Irene Su
    Department of Obstetrics, Division of Reproductive Endocrinology and Infertility, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
    Menopause 15:857-61. 2008
    ..To examine the association between obesity and serum and ultrasound measures of ovarian reserve in late reproductive age women...
  10. ncbi Association of anti-mullerian hormone levels with obesity in late reproductive-age women
    Ellen W Freeman
    Department of Obstetrics Gynecology, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania 19104, USA
    Fertil Steril 87:101-6. 2007
    ..To describe anti-mullerian hormone (AMH) levels in healthy late reproductive age women and test the hypothesis that AMH levels are lower in obese compared to non-obese women...
  11. ncbi Hormones and sexuality during transition to menopause
    Clarisa R Gracia
    Department of Obstetrics Gynecology, Center for Clinical Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA
    Obstet Gynecol 109:831-40. 2007
    ..To examine the relationship between reproductive hormonal dynamics and sexual dysfunction assessed in a cohort of women approaching menopause...
  12. ncbi Symptoms associated with menopausal transition and reproductive hormones in midlife women
    Ellen W Freeman
    Departments of Obstetrics Gynecology, Psychiatry, University of Pennsylvania, 3701 Market Street, Philadelphia, PA 19104, USA
    Obstet Gynecol 110:230-40. 2007
    ....
  13. ncbi Longitudinal pattern of depressive symptoms around natural menopause
    Ellen W Freeman
    Department of Obstetrics Gynecology, University of Pennsylvania School of Medicine, Philadelphia2Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia
    JAMA Psychiatry 71:36-43. 2014
    ..An increased risk of depressive symptoms has been associated with the transition to menopause, but the risk of depressive symptoms in the early postmenopausal years has not been well characterized...
  14. ncbi Symptoms in the menopausal transition: hormone and behavioral correlates
    Ellen W Freeman
    Department of Obstetrics Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    Obstet Gynecol 111:127-36. 2008
    ..To estimate the association of headache, irritability, mood swings, anxiety, and concentration difficulties with menopausal stage and with reproductive hormones in the menopausal transition...
  15. ncbi Association of physical activity with reproductive hormones: the Penn Ovarian Aging Study
    Kathryn H Schmitz
    Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, 423 Guardian Drive, 921 Blockley Hall, Philadelphia, PA 19104, USA
    Cancer Epidemiol Biomarkers Prev 16:2042-7. 2007
    ..Few studies have examined associations of physical activity on hormone levels. None have examined the potential effect of the menopausal transition on the associations between physical activity and reproductive hormone levels...
  16. pmc Obesity and reproductive hormone levels in the transition to menopause
    Ellen W Freeman
    Department of Obstetrics Gynecology, University of Pennsylvania, Philadelphia, PA, USA
    Menopause 17:718-26. 2010
    ..The aim of this study was to estimate associations of obesity with reproductive hormone levels as women progress from premenopausal to postmenopausal status...
  17. pmc Temporal associations of hot flashes and depression in the transition to menopause
    Ellen W Freeman
    Departments of Obstetrics Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA19104 5509, USA
    Menopause 16:728-34. 2009
    ..The aim of this study was to evaluate associations between hot flashes and depressed mood in the menopausal transition and associations of these symptoms with reproductive hormone changes...
  18. pmc Factors that influence entry into stages of the menopausal transition
    Mary D Sammel
    Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
    Menopause 16:1218-27. 2009
    ..The aim of this study was to estimate the probabilities and identify risk factors for entering the menopausal transition and moving into each subsequent transition stage...
  19. pmc Joint effects of smoking and gene variants involved in sex steroid metabolism on hot flashes in late reproductive-age women
    Samantha F Butts
    Division of Infertility and Reproductive Endocrinology, Perelman School of Medicine, University of Pennsylvania, 3701 Market Street, Suite 800, Philadelphia, Pennsylvania 19104, USA
    J Clin Endocrinol Metab 97:E1032-42. 2012
    ..It is currently not known whether the impact of smoking on hot flashes is modified by the presence of such variants...
  20. pmc Anti-mullerian hormone as a predictor of time to menopause in late reproductive age women
    Ellen W Freeman
    Department of Obstetrics Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
    J Clin Endocrinol Metab 97:1673-80. 2012
    ..Anti-mullerian hormone (AMH) has emerged as a marker of ovarian reserve and a possible surrogate measure of reproductive aging...
  21. pmc Effects of reproductive history on symptoms of menopause: a brief report
    Deborah B Nelson
    Department of Public Health and Obstetrics and Gynecology, Temple University, Philadelphia, PA, USA
    Menopause 18:1143-8. 2011
    ..The aim of this study was to examine the relationship between reproductive history and menopausal symptoms among urban women...
  22. ncbi Associations of depression with the transition to menopause
    Ellen W Freeman
    Department of Obstetrics Gynecology, University of Pennsylvania, Philadelphia, PA, USA
    Menopause 17:823-7. 2010
    ....
  23. pmc Effect of hormone metabolism genotypes on steroid hormone levels and menopausal symptoms in a prospective population-based cohort of women experiencing the menopausal transition
    Timothy R Rebbeck
    Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104 6021, USA
    Menopause 17:1026-34. 2010
    ..This study evaluated whether genes involved in the metabolism of steroid hormones are associated with hormone levels or menopausal symptoms...
  24. pmc Duration of menopausal hot flushes and associated risk factors
    Ellen W Freeman
    Department of Obstetrics Gynecology, the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    Obstet Gynecol 117:1095-104. 2011
    ..To estimate the duration of moderate-to-severe menopausal hot flushes and identify potential risk factors for hot flush duration...