A STUDY OF POST-MENOPAUSAL HORMONE PROFILES IN WOMEN RESIDING IN ISLAMABAD AND RAWALPINDI

Abstract

A prospective study was carried at the Women Clinic and Fertility Advisory Center and the Well Mother Clinic of Oil and Gas Development Company Limited. with the purpose of determining the endocrine changes following natural menopause in women from Islamabad and Rawalpindi. A secondary objective was to assess the prevalence of menopausal symptoms among Pakistani women and to correlate them with the hormone levels. Hormone profiles of premenopausal women (n= 25, Gr. I) aged 30 - 40 (35±1 ) years with regular menstruation and post-menopausal women (n= 75) with natural menopause upto 15 years were studied. The Gr. II, III, and IV included women up to 5 years, 10 years, and 15 years of menopause, respectively. Estimation of serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P), prolactin (PRL) and testosterone (T) were carried by commercially available specific enzyme immunoassay (EIA) kits. The average age of menopause in these women was 48.92±0.52 years and a positive correlation with the parity was observed. The mean serum concentrations of FSH were significantly elevated (P<0.001) in the post-menopausal women (Gr.1I - IV) as compared to pre-menopausal women (Gr. I). Mean serum levels of LH were also significantly higher (P<0.0005) in post-menopausal women as compared to pre-menopausal subjects. A marked fall (P<0.0001) was observed in the mean serum estradiol concentrations in post-menopausal women as compared to that in pre-menopausal women. Serum concentrations of progesterone also decreased significantly (P<0.0001) during the post-menopausal years. Mean serum concentrations of prolactin decreased in the post-menopausal group (P<O.0001) as compared to pre-menopausal women. However, there was a significant rise (P<0.01 ) of prolactin concentration in Gr. IV as compared to Gr. III. Mean serum testosterone concentrations were observed to be similar (P>O.05) in the 4 groups. A significant positive (P<0.0001) correlation was observed for serum FSH and LH concentrations with the chronological age. 2 However, a significant negative correlation (P<O.0001) was observed for the serum concentrations of estradiol , progesterone and prolactin with the rising age. Serum testosterone concentrations also increased (P<O.05) with the chronological age. Hot flushes were observed in 29 (38.66 %) women and in 15 (20 %) women other menopausal symptoms like seni le vaginitis, dsypareunea, incontinence etc. were noticed. Thirty-one (41.33%) women had no postmenopausal symptoms. The mean serum estradiol concentrations were significantly lower (P<0.05) in women with hot flushes as compared to those without hot flushes. However, there was no significant difference (P>O.05) in the serum FSH concentrations in the two groups. The present data show that Pakistani women have an average age of menopause simi lar to that observed for the underdeveloped countries and that the menopausal age is positively related with the parity. The serum FSH concentrations rise 8 - 9 times the premenopausal levels, but no further changes in the FSH levels were observed till 15 years of menopause. The LH concentrations were doubled during postmenopausal period but then a fall was observed following 10 years of menopause. Serum estradiol and progesterone concentrations decreased very significantly following menopause. Prolactin concentrations decreased after menopause but registered a rise 15 years following menopause. Serum testosterone concentrations did not rise in the post-menopausal women. The incidence of hot flushes (38.66 %) was much lower in these women as compared to those of western (75 - 80 %) population.