Research in progress

Prospective data from the Vancouver Ovulation and Bone Change Cohort (Prior et al 1996, 1990a) are still being collected as these women become perimenopausal or menopausal. Some of those women continue to keep quantitative basal temperature and Daily Perimenopause Diary (Prior 1999) records, and will potentially provide important comparisons of ovulation and experiences in premenopausal and perimenopausal cycles in relation to subsequent menopause and bone density. As an illustration, one year of ovulatory characteristics (analysed by the QBT least squares method; Prior et al 1990b) are shown from the initial study and 10 years later in one woman (Fig. 5). This woman's initial cycles averaged 29.3 1.6 days in length and became two days shorter (27.0 1.5 days, P = 0.0004). The changes in luteal phase length were even more dramatic with reduction from a mean of 11.2 2.0 to 5.4 2.7 days over the 10 years (P< 0.0001). Note that she had no normally ovulatory cycles in 1994—1995 even though she continued to have regular cycles.

A large selected population to represent the US ethnic mix is being studied with US National Institutes of Health funding (Sowers et al 2000). Although over 3000 women will be followed prospectively, only limited, intermittent documentation of hormone levels is being performed.

The Canadian Multicentre Osteoporosis Study (CaMOS), a national population-based study that includes approximately 35 premenopausal and 60 perimenopausal women in each of nine centres (Kreiger et al 1999), is just completing a three-year follow-up in women who were aged 40—60 at baseline. The 3 year questionnaire includes information about cycle regularity and the experience of premenstrual symptoms and night sweats as well as molimina (Prior 1997). We are currently in the process of evaluating the molimina question in relation with the characteristics in premenopausal women as well as validating its assessment of ovulation. Eventually, prospective population-based data about experiences, weight, diet and exercise as well as bone changes will be available from CaMOS data. Unfortunately, no current methods for prospective continuous ovulation documentation are sufficiently convenient and reliable that they can be used in epidemiological samples.

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