Article

Use of Urine Biomarkers to Evaluate Menstrual Function in Healthy Premenopausal Women

University of California, Davis, Davis, California, United States
American Journal of Epidemiology (Impact Factor: 5.23). 07/1998; 147(11):1071-80. DOI: 10.1093/oxfordjournals.aje.a009401
Source: PubMed

ABSTRACT

A total of 403 healthy, premenopausal women, residing near Santa Clara, California, were recruited from a large health care plan in California for a study of menstrual function. After a telephone interview, participants collected daily urine samples and recorded bleeding and other information in diaries. Data were collected during 1990-1991. Urine samples were analyzed for creatinine and for estradiol and progesterone metabolites by enzyme-linked immunoassay. Computer algorithms were developed to derive menstrual segment length, ovulatory status, day of ovulation, and other parameters from the urine and diary data. (We use "segment" rather than "cycle" to avoid implying that normal cycling occurred.) The average length of participation was 141 (standard deviation, 45) days. The mean segment length was 28.8 (standard deviation, 4.4) days; follicular phase length, 16.0 (standard deviation, 4.4) days; and luteal phase length, 12.9 (standard deviation, 1.7) days; 19 (4.7%) women experienced anovulatory episodes. In exploratory multivariate analyses, important associations included the following: age of > or = 35 years with decreased segment and follicular phase lengths; heavier weight (upper quartile) with anovulation and increased follicular phase and decreased luteal phase lengths; Hispanic ethnicity with anovulation and increased segment length; and past difficulty in achieving pregnancy with anovulation and increased length and variability of segments and follicular phases. Urine biomarkers can be used successfully to evaluate menstrual function in epidemiologic studies.

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Available from: Shanna H Swan, Aug 28, 2014
    • "Anovulation Fraction (%) Population [Source] Method Age (years) N Cycles N Women % Anovulatory New Zealand [Metcalf & MacKenzie 1980; Metcalf 1983] weekly urine 20–24 a 355 113 28 25–29 a 211 70 6 30–39 a 193 62 2 40–44 a 221 67 10 20–24 b , by cycle length: <21 days 13 100 21–35 days 286 20 36–42 days 25 48 >42 days 16 63 25–29 b,c , by cycle length: <21 days 1 0 21–35 days 154 5.2 36–42 days 18 5.6 >42 days 6 0 5–8 years post-menarche: living with parents 117 39 16 not living with parents 142 45 54 20–29: married 60 1 not living with relations 72 37 U.S. d [Collett et al., 1954] BBT 17–18 81 59 31 20–24 112 33 10 25–29 45 21 4 30–34 23 11 0 35–39 33 13 12 40–50 33 11 15 17–50 327 146 14 Switzerland [Vollman, 1977] BBT 29 1 40–45 34 total 14848 621 18 Germany e [Dö ring, 1969] BBT 18–20 282 27 21–25 287 13 26–30 418 5 31–35 822 7 36–40 640 3 41–45 275 12 U.S. (CA) [Waller et al., 1998] daily urine 18–39 372 7 f Chicago g [Vitzthum et al., 2002] salivary progesterone 23–38 22 22 9 Bolivia g,h [Vitzthum et al., 2002] salivary progesterone 23–35, better-off 25 25 12 23–35, poorer 29 29 55 5 West Europe nations [Ecochard et al., 2001] ultrasound 18–45 i 326 107 5 a Percent of all cycles; different number of cycles=woman. b women observed for 3 months. "
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    • "Anovulation Fraction (%) Population [Source] Method Age (years) N Cycles N Women % Anovulatory New Zealand [Metcalf & MacKenzie 1980; Metcalf 1983] weekly urine 20–24 a 355 113 28 25–29 a 211 70 6 30–39 a 193 62 2 40–44 a 221 67 10 20–24 b , by cycle length: <21 days 13 100 21–35 days 286 20 36–42 days 25 48 >42 days 16 63 25–29 b,c , by cycle length: <21 days 1 0 21–35 days 154 5.2 36–42 days 18 5.6 >42 days 6 0 5–8 years post-menarche: living with parents 117 39 16 not living with parents 142 45 54 20–29: married 60 1 not living with relations 72 37 U.S. d [Collett et al., 1954] BBT 17–18 81 59 31 20–24 112 33 10 25–29 45 21 4 30–34 23 11 0 35–39 33 13 12 40–50 33 11 15 17–50 327 146 14 Switzerland [Vollman, 1977] BBT 29 1 40–45 34 total 14848 621 18 Germany e [Dö ring, 1969] BBT 18–20 282 27 21–25 287 13 26–30 418 5 31–35 822 7 36–40 640 3 41–45 275 12 U.S. (CA) [Waller et al., 1998] daily urine 18–39 372 7 f Chicago g [Vitzthum et al., 2002] salivary progesterone 23–38 22 22 9 Bolivia g,h [Vitzthum et al., 2002] salivary progesterone 23–35, better-off 25 25 12 23–35, poorer 29 29 55 5 West Europe nations [Ecochard et al., 2001] ultrasound 18–45 i 326 107 5 a Percent of all cycles; different number of cycles=woman. b women observed for 3 months. "
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    No preview · Article · Apr 2013 · The Journal of Sex Research
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    • "It is not surprising that the luteal phase length did not cluster with the other cycle length variables given that the literature suggests that while total cycle length and follicular phase length are tightly correlated, the luteal phase length tends to be less variable and show only moderate correlations with both (Waller et al., 1998; Fehring et al., 2006). In fact, one study found that only 3% of the variance in the total cycle length was attributable to variation in the luteal phase length, whereas follicular phase variation explained over 84% (Waller et al., 1998). At least one study has identified differences in urinary ovarian steroid concentrations in relation to luteal phase length; however, those differences were in comparisons of cycles with short (≤10 days), average (11–14 days) and long (≥15 days) luteal phases and did not consider luteal phase lengths continuously within the normal range (Windham et al., 2002). "
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    Preview · Article · Dec 2012 · Human Reproduction
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