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

• Published in: PloS one 2020-06, Vol.15 (6), p.e0235478
• Main Authors: Triebner, Kai, Johannessen, Ane, Svanes, Cecilie, Leynaert, Bénédicte, Benediktsdóttir, Bryndís, Demoly, Pascal, Dharmage, Shyamali C, Franklin, Karl A, Heinrich, Joachim, Holm, Mathias, Jarvis, Deborah, Lindberg, Eva, Rovira, Jesús Martínez Moratalla, Muniozguren Agirre, Nerea, Sánchez-Ramos, José Luis, Schlünssen, Vivi, Skulstad, Svein Magne, Hustad, Steinar, Rodriguez, Francisco J, Gómez Real, Francisco, Tsaneva-Atanasova, Krasimira
• Format: Article
• Language: English
• Subjects: 17β-Estradiol; Adult; Age; Aged; Aging; Aging (Biology); Biology and Life Sciences; Blood; Clinical trials; Cohort Studies; Confidence intervals; cycles; Endocrinology and metabolism; Environmental health; Environmental Health and Occupational Health; Epidemiology; Estradiol; Female; Follicle Stimulating Hormone; Gynecology and obstetrics; Health aspects; Health surveys; Hormones; Hospitals; Human health and pathology; Humans; Life Sciences; Longitudinal Studies; Mathematical analysis; Medical personnel; Medical research; Medicine; Medicine and Health Sciences; Menopause; menopause transition; menstrual; Menstruation; Middle Aged; Miljömedicin och yrkesmedicin; Observations; People and Places; Perimenopause; Population; Post-menopause; Postmenopause; Primary care; Public health; quality-of-life; Questionnaires; Questions; Reproduction; Reproductive health; Research and Analysis Methods; Researchers; Rodriguez, Francisco; Science & Technology - Other Topics; Sex; Sex hormones; Surveys and Questionnaires; unfinished agenda; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0235478

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. 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 17[beta]-estradiol) and interview-data provided by the large population-based ECRHS cohort, using receiver-operating characteristics (ROC). 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. 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.