Menstrual Patterns Best Indicator of Aging Path

The next stage adds a change in menstrual pattern, usually shorter cycles, and also some variability in FSH levels early in the cycle (days 2-5). Unfortunately, there is no standardization for the AMH assay, so a quantitative measurement is not available.

The bottom line is that these definitions will be helpful mostly for research, but will give us only some guidance to counsel patients about their fertility.

In terms of the late reproductive stages, there now are three subdivisions based on stabilization of key hormones at this time (FSH and estradiol). Perimenopause also is better defined and the addition of symptoms with a description of bleeding patterns will be helpful both to researchers and clinicians. This will lead to more research and understanding of the key physiologic events that lead to reproductive decline and menopausal changes. There also is a description of what happens to reproduction with various dysfunctions, such as chemotherapy and in polycystic ovarian syndrome, which can be helpful both clinically and particularly in research.