Anti-mullerian hormone and inhibin B in the definition of ovarian aging and the menopause transition

J Clin Endocrinol Metab. 2008 Sep;93(9):3478-83. doi: 10.1210/jc.2008-0567. Epub 2008 Jul 1.


Context/objective: The objective of the study was to determine whether anti-Mullerian hormone (AMH) and inhibin B are viable endocrine biomarkers for framing the menopause transition from initiation to the final menstrual period (FMP).

Design: We assayed AMH, inhibin B, and FSH in 300 archival follicular phase specimens from 50 women with six consecutive annual visits commencing in 1993 when all women were in the pre- and perimenopausal menopause stages. Subsequently each woman had a documented FMP. The assay results were fitted as individual-woman profiles and then related to time to FMP and age at FMP as outcomes.

Results: Based on annual values from six time points prior to the FMP, (log)AMH longitudinal profiles declined and were highly associated with a time point 5 yr prior to FMP [including both observed and values below detection (P < 0.0001 and P = 0.0001, respectively)]. Baseline AMH profiles were also associated with age at FMP (P = 0.035). Models of declining (log)inhibin B profiles (including both observed and values below detection) were associated with time to FMP (P < 0.0001 and P = 0.0003, respectively). There was no significant association of (log)inhibin B profiles with age at FMP.

Conclusions: AMH, an endocrine marker that reflects the transition of resting primordial follicles to growing follicles, declined to a time point 5 yr prior to the FMP; this may represent a critical biological juncture in the menopause transition. Low and nondetectable levels inhibin B levels also were observed 4-5 yr prior to the FMP but were less predictive of time to FMP or age at FMP.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aging / blood*
  • Aging / physiology
  • Anti-Mullerian Hormone / blood
  • Anti-Mullerian Hormone / physiology*
  • Biomarkers / blood
  • Cohort Studies
  • Female
  • Follicle Stimulating Hormone / blood
  • Forecasting
  • Humans
  • Inhibins / blood
  • Inhibins / physiology*
  • Menopause / blood*
  • Menopause / physiology
  • Menstruation / blood
  • Middle Aged
  • Models, Biological
  • Ovary / physiology*


  • Biomarkers
  • inhibin B
  • Inhibins
  • Anti-Mullerian Hormone
  • Follicle Stimulating Hormone