Introduction: There is a tendency among women today to delay the age at which they have their first child or subsequent children. This creates a dilemma for couples, since health professionals tend to counsel against pregnancy in women aged ≥40 years without considering their reproductive potential and their ability to and likelihood of conceiving and carrying to term a healthy newborn at little or no risk.
Objective: Assess hypothalamic-pituitary-gonadal axis function in menopausal women in Havana, to evaluate relevance to reproductive potential.
Methods: A retrospective study was conducted from March 2006 through March 2008 of 230 healthy women aged 40-59 years seen in the Menopause and Osteoporosis Clinic in Havana, Cuba. Chart review yielded data on current age, stage of climacteric and hormone levels expressed in means and standard deviations: serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol and testosterone. Analysis of variance was used for assessment by age group and stage of menopause (eumenorrheic, perimenopausal and postmenopausal), with a p value of <0.05 set as significance level.
Results: Mean serum hormone levels in eumenorrheic women were: FSH 6.97 IU/L, LH 4.23 IU/L and estradiol 314 pmol/L; in perimenopausal women: FSH 34.69 IU/L, LH 20.78 IU/L and estradiol 201 pmol/L; and in postmenopausal women: FSH 75.43 IU/L, LH 37.59 IU/L and estradiol 117 pmol/L (p <0.05 for difference between eumenorrheic and postmenopausal women). There was a progressive increase in FSH and LH and a decline in estradiol with older age. There was no significant difference in testosterone levels by age or stage of menopause.
Conclusions: Menstrual cycle and hormonal levels of the hypothalamic-pituitary-gonadal axis should be considered in addition to chronological age when determining reproductive potential in women aged 40-59 years. KEYWORDS Hormones; hypothalamo-hypophyseal system; luteinizing hormone; follicle stimulating hormone, estradiol; testosterone; sex hormones; infertility, female; middle age; menopause; fertility; climacteric; Cuba.