Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Menstrual Cycle Hormone Changes in Perimenopausal Women

J Clin Endocrinol Metab; ePub 2017 Mar 22; Santoro, et al

In perimenopausal women, menstrual cycle hormone patterns resemble those of midreproductive aged women until 5 years before menopause, a recent study found, with ovulatory cycles presumably retaining a potentially fertile pattern. This according to the Study of Women’s Health Across the Nation (SWAN) Daily Hormone Study (DHS) at 7 sites across the US. The study included 511 premenopausal or early perimenopausal women at enrollment, and within 10 years before menopause. Researchers found:

  • Mean menstrual cycle length was preserved at 26-27 days in evidence of luteal activity (ELA) cycles; non-ELA cycles had greater variability.
  • Percentage of cycles that were ELA remained high until 5 years before the final menstrual period (FMP) at 87.9%.
  • Only 22.8% of cycles within 1 year of the FMP were ELA.
  • Whole cycle hormones remained relatively stable up to 3 years before the FMP.


Santoro N, Crawford SL, El Khoudary SR, et al. Menstrual cycle hormone changes in women traversing the menopause: Study of Women’s Health Across the Nation. [Published online ahead of print March 22, 2017]. J Clin Endocrinol Metab. doi:10.1210/jc.2016-4017.