Conclusions

The most striking endocrine marker offemale reproductive ageing is a progressive increase in the concentrations of circulating FSH, possibly beginning in the 20s and becoming more obvious from approximately age 40. This increase in FSH may be the result primarily of a decrease in the concentrations of circulating inhibin B, acting as a marker of primordial follicle number. When follicle numbers fall to critical levels, granulosa cell function becomes impaired and subsequently ceases with falls in circulating oestradiol and inhibin A and further increases in FSH. Changes in circulating androgens appear to occur particularly during reproductive life when levels fall between ages 20 and 50. The implications of ageing of the female reproductive axis for health and health policy remain to be fully determined.

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