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Longitudinal Research Project Is Redefining Menopause

woodsMichellwoodsMichellDefining menopause as a physical event is fairly easy: Menopause represents the end stage of a natural transition in a woman's reproductive life, when estrogen and progesterone production decreases dramatically, the ovaries stop producing eggs, menstruation ceases, and a woman is no longer able to naturally conceive children. This simple definition, however, overlooks the individual experience of menopause, which can be enormously complex and variable.

In the past, the subject of menopause was avoided entirely or referred to with euphemisms like the change. Women endured it in isolation and silence. Today, a climate of openness and the ready access of information over the Internet have empowered women with information that was unavailable to prior generations. Still, much about menopause remains a mystery, and many questions remain unanswered.

Addressing these questions has been the goal of a ten-year longitudinal study funded by the National Institutes of Health. Led by Nancy Woods, dean, and Ellen Mitchell, associate professor, the Seattle Midlife Women's Health Study has followed the same group of women subjects since 1990 in order to describe changes in their menstrual cycles and their lives as they progress through the menopausal transition and into the postmenopausal phase of life. Regular specimen and data collection assess participants for menstrual patterns and hormone levels. Participants are also assessed for symptoms such as mood swings, memory problems, hot flashes, irritability, sleep disturbances, and stress, the latter relating to life events such as work, parenting, personal relationships, or dealing with aging parents.

"It's important not to just assume that because women are in this age group, everything can be attributed to menopause," says Woods. So far, she explains, results suggest that women's health and stress levels aren't influenced by menopause, but rather by modern life.

How do you maintain contact with a study group over a ten-year period, one might ask? "With lots of personal contact," Woods explains, including in-person interviews and telephone calls. She also notes that the research team supporting the study has been very stable, which has helped tremendously. "Our research participants have become actively involved over the years, making suggestions about questions we should ask as well as providing input."

And this study is having national significance. In July 2001 Mitchell and Woods presented their results to a workshop of researchers and clinicians sponsored by the National Institute on Aging. Their work is being included in a new set of definitions to be used in other research studies to allow comparison across different groups of women studied.

The Seattle Midlife Women's Study will continue for another five years under the leadership of Mitchell, who anticipates that most of the participants will reach menopause during this time. She also notes that they plan to add a genetic component to the study, to explore whether there are specific variations in genes that influence estrogen metabolism and estrogen receptors. "Such variations could affect age of onset of menopause and menstrual bleeding during the menopause transition," she explains.

CREDIT:  Researchers Nancy Woods, right, and Ellen Mitchell, who have worked together for ten years on a longitudinal research study of women in menopausal transition, confir about menstrual calendars kept by subjects in the study.