Fast Five Quiz: Do You Know the Conditions Associated With Menopause and How Best to Treat Them?

Michel E. Rivlin, MD


January 20, 2015

Gonadotropin secretion increases dramatically after menopause. FSH levels are higher than LH levels, and both rise to even higher values than those seen in the surge during the menstrual cycle. The FSH rise precedes the LH rise. FSH is the diagnostic marker for ovarian failure. LH is not necessary to make the diagnosis.

Other markers of ovarian aging include anti-Müllerian hormone and Müllerian-inhibiting substance, which are produced by granulosa cells of all follicles. Assessment of these markers may be the earliest and most effective way of measuring progress toward menopause. At present, however, testing is not sufficiently developed to be considered a standard of care. Consequently, an increase in serum FSH and decreases in estradiol and inhibin are the major endocrine changes that indicate the transition to menopause.

Endometrial biopsy can show a range of endometrial appearances, from mildly proliferate to atrophic. No secretory changes are observed after menopause, because no ovulation occurs and therefore no corpus luteum forms to produce progesterone.

For more on the assessment of menstrual transition, read here.


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