Menopause predictor may give women a false sense of reassurance

A new test that can pinpoint the time when a woman enters menopause to within 4 months, has been in the news this week.

In a 1998 Iranian study of 266 women aged 20 - 49, researchers measured levels of a hormone known as the anti-Mullerian Hormone (AMH) produced by the women's cells. AMH controls follicle development in female ovaries. Using the AMH concentration as a model, the researchers were able to predict the actual menopause of 63 study subjects. Then the women were tracked every 3 years to the present. The results were announced this week at the European Society of Human Reproduction and Embryology (ESHRE).

Claudia Hammond of BBC World Service interviewed Dr Ramezani Tehrani, who led the research team. Dr Tehrani discussed the reasons a woman would want to know, as early as her 20s, when she would enter menopause, citing higher education, career plans, osteoporosis and cardiovascular illness, breast cancer and endometriosis as important factors. She expressed confidence in her study, saying that the simple blood test is ready for use immediately.  I can see that there are potential benefits of such a test. There are all sorts of health reasons a woman may want to know when she will enter menopause, including:   

• it may prompt a woman to build preventive health measures into her lifestyle, like weight-bearing exercise and calcium supplements for bone strength; 
  
•  it would be easier to diagnose and treat the symptoms of peri-menopause within the context of the test results;
  
• armed with knowledge of how long they would be fertile, all being well, women could plan ahead about long-term use of the birth control pill, or IUD v. other means of contraception; and
  
• it is thought that women's migraines, and aspects of their emotional health, could be due to or affected by their hormones.  Diagnosis could be more precise and medication more accurately prescribed.
  

There are social reasons also. Think of these as the 'Sex and the City' reasons. While those film characters dated, worked, broke up, partied and obsessed about the men in their lives, they all thought that parenthood and menopause were for later or someone else.  If women like Carrie and Charlotte knew the exact number of years between then and menopause, they might have had more peace of mind about finding the right man.  In real life, just as in gthe SATC version of women's lives, there are predictable scenarios:

1)     Let’s say a woman in her late 30’s hears the ticking of her biological clock, but is unsure of whether her boyfriend is marriage-and-father material. If test results tell her that menopause is going to begin at 51 years old (average age of onset), she knows there is still time to find the right man, rather than marrying the wrong guy for the purpose of having that child.

2)    If a woman places high value on having a baby, but knows that she only has a small window of opportunity, she may decide that she doesn’t want to run the risk of time running out. She has a big decision to make: baby v. stressful position at work, single mother v. part of a couple?

Now, here’s the flip side.  It doesn’t seem like a large enough study group for the results to be claimed as extremely accurate.  Only 63 of the women went the distance within the study and I haven’t seen any statistics about the other 203 women.  It seems that the research group was only correct in a little less than a quarter of the women originally tested.  While most of the 63 women experienced the predicted result, within 4 months of the date, some were as wide apart as 4 years. t’s still a positive result, but only a handful more than those that big, multinational cosmetics companies use to say that 78% of 46 women agree this conditioner reduced their frizzies. I would caution women about relying on its results exclusively. It seems that Stuart Lavery of the British Fertility Society agrees with me: “The issue where we would have a concern is if people become too reassured by this.” My concerns exactly!

Women, who have no reason to believe that they are infertile, could be harmed by false reassurance that they could conceive up until the predicted onset of menopause. Many women can spend 2 to 3 decades following their first sexual experience, trying to avoid pregnancy. It’s already easy, with stories of women having babies later in life, to become complacent about putting off pregnancy. The danger is that a woman may lose out on years of healthy eggs and/or corrective treatment for undiagnosed obstacles to conception. When she decides that it is the right time for her to have children, she may be shocked to find that other conditions, such as endometriosis, blocked fallopian tubes, ovarian cysts, high or low thyroid count, could keep her from achieving that.

It was suggested that this blood test would be available as a home-kit, on sale to the public in 3 years. I would prefer to see the blood test available via gynaecologists, or even general medical practitioners, so that the limits of its application could be explained to the patient. At the very least, the insert in a kit should state the caveat, that knowing when you will reach menopause does not mean that you are fertile and able to conceive without assistance up until that point.

Comments

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Menopause can be a great concern since it may introduce many unexpected symptoms and changes one both psychologically and physically and can cause mood swings and fluctuations among the females.

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What is effect of having menopause? What is the really reason to get menopause.

[Crevan Ferrigno]

Foretelling when menopause will happen is definitely very helpful. Reassurance aside, planning ahead and anticipating of certain things will make the process easier. With the string of inconveniences attached to menopausal years, women will be able to learn ahead about dealing with each of those. If the study's results are true, then we may see an improvement in the quality of life of menopausal women.