MENOPAUSE WITHOUT SYMPTOMS - THE ENDOCRINOLOGY OF MENOPAUSE AMONG RURAL MAYAN INDIANS

OBJECTIVE: Our purpose was to determine the characteristics of menopau se among Mayan women who did not have menopausal symptoms. STUDY DESIG N: A cross-sectional study of Mayan women from Chichimila, Mexico, was performed. Demographic information, history and physical examination, hormone concentrations, and radial bone density measurement were obta ined. RESULTS: Fifty-two postmenopausal women were compared with 26 pr emenopausal women. Menopause occurred at 44.3 +/- 4.4 years. None of t he women admitted to hot flushes and did not recall significant menopa usal symptoms. Hormone levels included elevated follicle-stimulating h ormone (66.6 +/- 29 mlU/ml), low estradiol and estrone (9.4 +/- 8.3 an d 13.3 +/- 7.8 pg/ml), estrone greater than estradiol levels, normal l evels of testosterone and androstenedione (0.17 +/- 0.14 and 0.31 +/- 0.17 ng/ml). Bone mineral density declined with age, but height did no t. Clinical evidence of osteoporosis was not detected. CONCLUSIONS: La ck of symptoms during the menopausal transition is not attributable to a difference in endocrinology. Postmenopausal Mayan women are estroge n deprived and experience age-related bone demineralization but do not have a high incidence of osteoporotic fractures.