LABORATORY CRITERIA FOR MENOPAUSE IN WOMEN USING ORAL-CONTRACEPTIVES

Objective: To evaluate laboratory criteria for menopause in women taki ng oral contraceptives (OC). Design: Prospective, uncontrolled pilot s tudy. Setting: San Francisco General Hospital, San Francisco, Californ ia, and Magee-Womens Hospital, Pittsburgh, Pennsylvania. Patients: Twe nty-eight menopausal women. Interventions: Fourteen menopausal women r eceived triphasic 35 mu g ethinyl E(2) and 180-215-250 mu g norgestima te, and 14 menopausal women received monophasic 30 mu g ethinyl E(2)-1 50 mu g desogestrel. Main Outcome Measures: Serum FSH, LH, and E(2) le vels were evaluated on days 14 and 28 (day 7 of the pill-free interval ) of the third cycle of pills. Results: Twelve women in each group com pleted the study. Fifteen (62.5%) subjects still had a serum FSH <30 m IU/mL (30 IU/L) on the 7th day of the pill-free interval of the third pill package. All subjects had a serum FSH:LH ratio >1 and 20 of 21 (9 5%) subjects had E(2) < 20 pg/mL (73 pmol/L) at the end of the pill-fr ee interval of the third cycle. Conclusions: Measuring FSH on the 7th day of the pill-free interval is not a sensitive test for menopause. S erum FSH:LH ratio >1 or E(2) < 20 pg/mL (73 pmol/L) on the 7th day of the pill-free interval may be a more appropriate marker of menopause i n women using OC in the later reproductive years.