Menopausal Staging Algorithm

The Monash Women’s Health Program Menopausal Staging Algorithm©: a research tool for menopausal staging

We have developed a pragmatic approach to menopausal status classification of clinical research study participants that allows for women who have gynaecological circumstances that mask their natural menstrual pattern. In order to evaluate menopausal status we looked first at the classifications for the transition through the menopause to assist researchers and clinicians in this field that have been developed by others. The Stages of Reproductive Aging Workshop (STRAW) classification provides menopausal transitional stages that are based on menstrual cycle pattern changes combined with serum FSH levels. More recently the endocrine features of the STRAW stages have been described in detail. However, to utilize these staging criteria one needs a detailed description of each woman’s natural menstrual pattern and ideally hormonal measures. In the Study of Women’s Health across the Nation (SWAN), menopausal staging was based on information about each woman’s bleeding collected by questionnaire. However, in the SWAN study, the menopausal staging categories employed did not allow for the classification of women who had a prior hysterectomy such that these women were excluded from several analyses. In contrast the Women’s Ischemia Syndrome Evaluation (WISE) study employed an algorithm that enabled the categorization of hysterectomized women. However, this algorithm also included the use of serum hormone measures such that the application of the algorithm requires collection of blood from study participants.

Thus we have developed a system of classification of menopausal status that enabled the best estimate classification of women who could not provide a description of their natural menstrual cycle, taking into account that a study may not include blood collection for the measurement of gonadotropins and ovarian hormones.

Please click on the link below for the Menopausal staging algorithm.

The Monash Women’s Health Program Menopausal Staging Algorithm©: a research tool for menopausal staging (pdf 394 kb)