Usefulness of FSH measurements for determining menopause in long-term users of depot medroxyprogesterone acetate over 40 years of age.

Objective: To assess the usefulness of follicle-stimulating hormone (FSH) measurements for determining menopause in 40-55-year-old users of depot medroxyprogesterone acetate (DMPA).

Study Design: FSH levels were measured in 355 blood samples from 82 amenorrheic women during an 18-month period. Blood was collected every 90 days immediately prior to DMPA administration.

Results: Using FSH values>35 mIU/mL as being in the post menopausal range, 32 women (39.0%) presented at least one FSH measurement in the postmenopausal range and 14 of them (43.7%) had more than one elevated FSH measurement and were considered postmenopausal. In five users (15.6%), only the last FSH measurement was within the postmenopausal range, and in 13 women (40.6%), FSH returned to normal values following one measurement that was within the postmenopausal range.

Conclusions: The menopausal status in DMPA users in amenorrhea should be determined based on at least two consecutive high FSH evaluations, since, as shown here, 40.6% of the women with high FSH had a low FSH in the subsequent determination. FSH measurements should be done only in women>or=50 years old because there is a greater possibility of being in postmenopause. However, we do not recommend the interruption of DMPA use prior to the quantification of FSH.