Physicians may be able to determine if menopause-related bone loss is already in progress or about to begin by measuring the level of a hormone that declines as women approach their final menstrual period, according to a study recently published in Journal of Bone and Mineral Research.
The findings could help physicians determine when, and how, to treat bone loss in women as they age before that bone loss causes significant health issues, according to the study. Specifically, the study found that for women 42 and older who are not yet postmenopausal, levels of anti-Mullerian hormone, or AMH, can be used to determine if they are experiencing, or about to experience, bone loss related to their transition into menopause.
The researchers examined data from the Study of Women’s Health Across the Nation, or SWAN, a multisite, multi-ethnic study examining the changes women undergo during the transition to menopause. They found that 17% of premenopausal women age 42 or older will have lost a significant fraction of their peak bone mass within two to three years of the date a physician makes the prediction. But among those with less than 50 picograms of AMH per milliliter of blood, nearly double the percentage, 33%, will have lost a significant fraction of peak bone mass in the same timeframe. (A picogram is one-trillionth of a gram.)
In addition, 42% of women in early perimenopause will have lost a significant fraction of peak bone mass within two to three years. But among women in early perimenopause with AMH levels below 25 pg/mL, 65% will have lost a significant percentage of peak bone mass in that time.
The study has some limitations, the researchers note. The findings cannot be applied to women who are already taking osteoporosis medications, have undergone a hysterectomy prior to their final period, or have used exogenous sex hormones during the transition to menopause; and the study did not include Hispanic women, nor did it include women who became menopausal before age 42.
“These findings make feasible the designing and testing of midlife interventions to prevent or delay osteoporosis in women,” the study’s authors write.
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