Describing the status of reproductive ageing simply and precisely: A reproductive ageing score based on three questions and validated with hormone levels

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  • Kai Triebner, University of Bergen, Norge
  • Ane Johannessen, Haukeland University Hospital, University of Bergen, Norge
  • Cecilie Svanes, University of Bergen, Haukeland University Hospital, Norge
  • Bénédicte Leynaert, INSERM, Frankrig
  • Bryndís Benediktsdóttir, University of Iceland, Island
  • Pascal Demoly, University Hospital of Montpellier, Frankrig
  • Shyamali C Dharmage, University of Melbourne, Australien
  • Karl A Franklin, Umeå University, Umeå, Sweden., Sverige
  • Joachim Heinrich, University of Melbourne, Ludwig Maximilians University Munich, Australien
  • Mathias Holm, Göteborgs Universitet, Sverige
  • Deborah Jarvis, Imperial College London, Storbritannien
  • Eva Lindberg, Uppsala University, Sverige
  • Jesús Martínez Moratalla Rovira, Servicio de Neurología del Complejo Hospitalario Universitario de Albacete (CHUA), Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, Spain., Spanien
  • Nerea Muniozguren Agirre, 19 Epidemiologia, Salud Pública, Dep. Salud, Gobierno Vasco, Hospital, Galdakao, Spain., Spanien
  • José Luis Sánchez-Ramos, Department of Nursing, University of Huelva, Huelva, Spain., Spanien
  • Vivi Schlünssen
  • Svein Magne Skulstad, Haukeland University Hospital, Norge
  • Steinar Hustad, University of Bergen, Norge
  • Francisco J Rodriguez, University of Málaga, Spanien
  • Francisco Gómez Real, University of Bergen, Haukeland University Hospital, Norge

OBJECTIVE: Most women live to experience menopause and will spend 4-8 years transitioning from fertile age to full menstrual stop. Biologically, reproductive ageing is a continuous process, but by convention, it is defined categorically as pre-, peri- and postmenopause; categories that are sometimes supported by measurements of sex hormones in blood samples. We aimed to develop and validate a new tool, a reproductive ageing score (RAS), that could give a simple and yet precise description of the status of reproductive ageing, without hormone measurements, to be used by health professionals and researchers.

METHODS: Questionnaire data on age, menstrual regularity and menstrual frequency was provided by the large multicentre population-based RHINE cohort. A continuous reproductive ageing score was developed from these variables, using techniques of fuzzy mathematics, to generate a decimal number ranging from 0.00 (nonmenopausal) to 1.00 (postmenopausal). The RAS was then validated with sex hormone measurements (follicle stimulating hormone and 17β-estradiol) and interview-data provided by the large population-based ECRHS cohort, using receiver-operating characteristics (ROC).

RESULTS: The RAS, developed from questionnaire data of the RHINE cohort, defined with high precision and accuracy the menopausal status as confirmed by interview and hormone data in the ECRHS cohort. The area under the ROC curve was 0.91 (95% Confidence interval (CI): 0.90-0.93) to distinguish nonmenopausal women from peri- and postmenopausal women, and 0.85 (95% CI: 0.83-0.88) to distinguish postmenopausal women from nonmenopausal and perimenopausal women.

CONCLUSIONS: The RAS provides a useful and valid tool for describing the status of reproductive ageing accurately, on a continuous scale from 0.00 to 1.00, based on simple questions and without requiring blood sampling. The score allows for a more precise differentiation than the conventional categorisation in pre-, peri- and postmenopause. This is useful for epidemiological research and clinical trials.

TidsskriftPLOS ONE
Antal sider16
StatusUdgivet - jun. 2020

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