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STRAW+10: Addressing the Unfinished Agenda of Staging Reproductive Aging

a PSC Research Project

Investigators:   Sioban D. Harlow, John F. Randolph Jr, Roderick J. Little

We propose a multi-disciplinary symposium entitled, ?STRAW+10: Addressing the Unfinished Agenda of Staging Reproductive Aging? to review and update the 2001 Stages of Reproductive Aging Workshop (STRAW) recommendations. The menopausal transition is a period of critical biologic change in women, including loss of fertility, increase in bone resorption, change in lipid profiles and termporal increases in symptoms including hot flashes, incontinence and depression. STRAW proposed nomenclature, a staging system, and preliminary menstrual and hormonal criteria to define stages of ovarian aging that have become the standard for characterizing reproductive aging through menopause, just as the Tanner Stages characterize pubertal maturation. Ten years later, scientific understanding of the critical junctures in hypothalamic and ovarian function that occur before and after the final menstrual period and of their implications for research on women?s health has advanced considerably. This proposed symposium will convene 25-30 investigators from key research teams in the United States and worldwide. The specific aims are to refine criteria for the onset of early menopause given new population-based scientific data relating to follicle-stimulating hormone, antral follicle count, anti-mullerian hormone and inhibin-B; to assess how to include women with high body-mass-index and smokers in staging algorithms; to assess potential criteria for staging the postmenopause; and to provide recommendations regarding staging of women following gynecological surgery or hormone treatment and in women with endocrine disorders. This two-day symposium is structured to facilitate discussions among a diverse group of scientific and clinical experts. The Day 1 public symposium will present recent scientific advances followed by discussion of the implications of this new evidence for the STRAW staging model. On Day 2, facilitated working groups will propose modifications to the STRAW criteria. Following discussion, final recommendations will be adopted and research priorities defined. The expected symposium outcome will be identification of additional valid and reliable criteria to characterize the end stages of reproductive life that are broadly applicable and inclusive of the range of women?s experience. Short- and long-term research priorities will be specified including studies needed to test, replicate and validate proposed criteria. The meeting will be co-sponsored by The North American Menopause Society (NAMS), The American Society for Reproductive Medicine, The International Menopause Society and The Endocrine Society. It will be held September 20-21, 2011 just prior to the NAMS Annual Meeting in Washington D.C. STRAW+10 proposed recommendations will be presented in a special session at the NAMS meeting. A peer-reviewed executive summary of these recommendations will be published simultaneously in the co-sponsoring societies? journals: Climacteric, Menopause, and Fertility and Sterility; with a lay-version published on their web-sites. The STRAW+10 revised staging system will faciliate classification of menopausal status in women?s health research and clinical trials, improving comparability of studies of midlife women, and facilitate clinical assessment and preventive interventions during the midlife and menopausal transition . Funds will be allocated to support participation of 4 new investigators.

Funding Period: 07/01/2011 to 11/30/2012

Country of Focus: USA

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