Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging

UMMS Affiliation

Department of Preventative and Behavioral Medicine

Publication Date


Document Type



Aging; Anti-Mullerian Hormone; Biological Markers; Drug Therapy; Endometrial Ablation Techniques; Female; Follicle Stimulating Hormone, Human; Humans; Hypothalamo-Hypophyseal System; Hysterectomy; Inhibins; *Menopause; Ovary; Polycystic Ovary Syndrome; *Reproduction; *Terminology as Topic




OBJECTIVE: The aim of this article is to summarize the recommended updates to the 2001 Stages of Reproductive Aging Workshop (STRAW) criteria. The 2011 STRAW + 10 reviewed advances in understanding of the critical changes in hypothalamic-pituitary-ovarian function that occur before and after the final menstrual period.

METHOD(S): Scientists from five countries and multiple disciplines evaluated data from cohort studies of midlife women and in the context of chronic illness and endocrine disorders on change in menstrual, endocrine, and ovarian markers of reproductive aging including antimullerian hormone, inhibin-B, follicle-stimulating hormone, and antral follicle count. Modifications were adopted by consensus.

RESULT(S): STRAW + 10 simplified bleeding criteria for the early and late menopausal transition, recommended modifications to criteria for the late reproductive stage (Stage -3) and the early postmenopause stage (Stage +1), provided information on the duration of the late transition (Stage -1) and early postmenopause (Stage +1), and recommended application regardless of women's age, ethnicity, body size, or lifestyle characteristics.

CONCLUSION(S): STRAW + 10 provides a more comprehensive basis for assessing reproductive aging in research and clinical contexts. Application of the STRAW + 10 staging system should improve comparability of studies of midlife women and facilitate clinical decision making. Nonetheless, important knowledge gaps persist, and seven research priorities are identified. reserved.

DOI of Published Version



Fertil Steril. 2012 Apr;97(4):843-51. Epub 2012 Feb 16. Link to article on publisher's site

Journal/Book/Conference Title

Fertility and sterility


Sybil L. Crawford is a collaborator in the STRAW+10 Collaborative Group.

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Link to Article in PubMed

PubMed ID