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

Am J Obstet Gynecol. 1993 Jun;168(6 Pt 1):1839-43; discussion 1843-5. doi: 10.1016/0002-9378(93)90699-j.


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.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Androgens / blood
  • Bone Density
  • Endocrine Glands / physiology*
  • Estrogens / blood
  • Female
  • Humans
  • Indians, North American*
  • Menopause / blood
  • Menopause / physiology*
  • Mexico / ethnology
  • Middle Aged


  • Androgens
  • Estrogens