Bone Mineral Density in Different Menopause Stages is Associated with Follicle Stimulating Hormone Levels in Healthy Women

Although estradiol (E-2) has been believed to be the most critical factor in the menopause-associated decrease in bone mineral density (BMD), the role of increasing follicle stimulating hormone (FSH) during menopause is relatively unclear. We determined the extent to which hip and lumbar spine BMD differ among the stages of menopause in healthy women, and whether BMD is associated with FSH and E-2 levels. A cross-sectional study of 141 healthy women classified as premenopausal (Pre; 38 +/- 6 yrs; mean +/- SD, n = 30), early perimenopausal (EPeri; 50 +/- 3yrs, n = 31), late perimenopausal (LPeri; 50 +/- 4yrs, n = 30), early postmenopausal (EPost; 55 +/- 3yrs, n = 24), or late postmenopausal (LPost; 62 +/- 4 yrs, n = 26), was conducted. Spine/hip BMD and sex hormones were measured using dual-energy X-ray absorptiometry and enzymatic/colorimetric methods, respectively. Compared to EPeri, spine BMD was lower (p < 0.05) in LPeri, EPost, and LPost and hip BMD was lower (p < 0.05) in EPost and LPost. BMD was inversely associated with FSH (spine: r = -0.341; hip: r = -0.271, p < 0.05) and directly associated with E-2 (spine: r = 0.274; hip: r = 0.256, p < 0.05). The menopause-related loss of spine and hip BMD is associated not only with low E-2 but also higher FSH. Future studies are essential to delineating the mechanisms by which FSH regulates bone health in aging women.

Automated summary

Despite the commonly believed importance of estradiol in menopause-related decrease in bone mineral density, the role of follicle stimulating hormone (FSH) in menopause remains unclear. A study of 141 healthy women revealed that spine and hip bone mineral density was lower in later menopausal stages, with an inverse association with FSH and a direct association with estradiol levels. Future research is needed to further understand how FSH regulates bone health in aging women.