Recommendations from a multi-study evaluation of proposed criteria for staging reproductive aging

UMMS Affiliation

Department of Medicine, Division of Preventive and Behavioral Medicine

Publication Date


Document Type



Aging; Amenorrhea; Biological Markers; Body Mass Index; Female; Follicle Stimulating Hormone; Hormone Replacement Therapy; Humans; Menopause; Practice Guidelines as Topic; Reproduction


Life Sciences | Medicine and Health Sciences | Women's Studies


In 2001, the Stages of Reproductive Aging Workshop (STRAW) proposed bleeding and endocrine criteria for defining the early and late menopausal transition stages. Based on expert consensus, STRAW recommended a shorter interval of amenorrhea than the commonly used 90-day amenorrhea criteria for late transition and a >7-day change in cycle length for early transition. The ReSTAGE collaboration used prospective menstrual calendar data from four cohorts (TREMIN, Melbourne Women's Midlife Health Project, Seattle Midlife Women's Health Study, and Study of Women's Health Across the Nation) to quantitatively evaluate STRAW's recommendations. This empirical assessment supported the STRAW recommendations that (1) > or =60 days of amenorrhea be used to define the late menopausal transition and (2) that early transition is consistent with a persistent 7 or more day difference in length of consecutive cycles. Serum follicle stimulating hormone (FSH) values > or =40 IU/l was an independent marker of the transition and, when occurring together with a bleeding marker, increased prediction of final menstrual period. Such a FSH criterion could be incorporated into the STRAW paradigm to facilitate prediction of proximity of the final menstrual period.

DOI of Published Version



Climacteric. 2007 Apr;10(2):112-9. Link to article on publisher's site

Journal/Book/Conference Title

Climacteric : the journal of the International Menopause Society

Related Resources

Link to Article in PubMed

PubMed ID