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Menopause without symptoms: The endocrinology of menopause among rural Mayan Indians

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      Objective: Our purpose was to determine the characteristics of menopause among Mayan women who did not have menopausal symptoms.
      Study Design: 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 obtained.
      Results: Fifty-two postmenopausal women were compared with 26 premenopausal women. Menopause occurred at 44.3 ± 4.4 years. None of the women admitted to hot flushes and did not recall significant menopausal symptoms. Hormone levels included elevated follicle-stimulating hormone (66.6 ± 29 mlU/ml), low estradiol and estrone (9.4 ± 8.3 and 13.3 ± 7.8 pg/ml), estrone greater than estradiol levels, normal levels of testosterone and androstenedione (0.17 ± 0.14 and 0.31 ± 0.17 ng/ml). Bone mineral density declined with age, but height did not. Clinical evidence of osteoporosis was not detected.
      Conclusions: Lack of symptoms during the menopausal transition is not attributable to a difference in endocrinology. Postmenopausal Mayan women are estrogen deprived and experience age-related bone demineralization but do not have a high incidence of osteoporotic fractures.

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