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Menstrual irregularity and bone mass in premenopausal women: Cross-sectional associations with testosterone and SHBG


Wei, S and Jones, G and Thomson, R and Otahal, P and Dwyer, T and Venn, A, Menstrual irregularity and bone mass in premenopausal women: Cross-sectional associations with testosterone and SHBG , BMC Musculoskeletal Disorders, 11, (288) EJ ISSN 1471-2474 (2010) [Refereed Article]


Copyright Statement

Copyright © 2010 Wei et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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DOI: doi:10.1186/1471-2474-11-288


Background: There have been few studies examining the associations between menstrual irregularity, androgens and bone mass in population-based samples of premenopausal women. This study aimed to describe the associations between menstrual pattern, testosterone, sex hormone binding globulin (SHBG) and bone mass in a population-based sample of premenopausal women. Methods: Cross-sectional study (N = 382, mean age 31.5 years). Menstrual pattern was assessed by questionnaire, bone mass measured by quantitative ultrasound (QUS) and androgen status was assessed by levels of serum testosterone, SHBG and the free androgen index (FAI). Results: Women with irregular cycles (n = 41, 11%) had higher free androgen index (FAI, P = 0.01) and higher QUS measurements including speed of sound (SOS, 1%, P < 0.05), quantitative ultrasound index (QUI, 7%, p < 0.05), and broadband ultrasound attenuation (BUA, 7%, p = 0.10). These associations persisted after adjustment for age and body mass index (BMI). After further adjustment for hormonal factors (either testosterone, SHBG or FAI), the strength of the associations was moderately attenuated, however, women with irregular cycles still had a 6% increase in mean QUS. Total testosterone, FAI and SHBG were also associated with QUS measures (testosterone and FAI, r +0.11 to +0.21, all p < 0.05; SHBG r -0.14 to -0.16, all p < 0.05) and the associations remained significant after adjustment. Conclusion: Irregular menstrual cycles were associated with higher bone mass in this population-based sample of premenopausal women suggesting menstrual disturbance should continue to be evaluated but may be less harmful for bone mass. The association between menstrual irregularity and bone mass was partially mediated by markers of androgen status especially free testosterone.

Item Details

Item Type:Refereed Article
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Wei, S (Mrs Shuying Wei)
UTAS Author:Jones, G (Professor Graeme Jones)
UTAS Author:Thomson, R (Dr Russell Thomson)
UTAS Author:Otahal, P (Mr Petr Otahal)
UTAS Author:Venn, A (Professor Alison Venn)
ID Code:66740
Year Published:2010
Web of Science® Times Cited:13
Deposited By:Menzies Institute for Medical Research
Deposited On:2011-02-10
Last Modified:2011-05-03
Downloads:367 View Download Statistics

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