Relationship between bone mineral density and ovarian function and thyroid function in perimenopausal women with endometriosis: a prospective study

Mari Uehara, Osamu Wada-Hiraike, Osamu Wada‐Hiraike, Mana Hirano, Kaori Koga, Noriko Yoshimura, Sakae Tanaka, Yutaka Osuga
BMC women's health · 2022 · vol. 22(1) , pp. 134 · doi:10.1186/s12905-022-01711-3 · PMID:35477494 · PMC9044768 · W4224942884
article OA: gold CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This prospective study found that in perimenopausal women with endometriosis, low ovarian reserve (high FSH, low AMH) and high thyroid-stimulating hormone levels are associated with decreased bone mineral density.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This prospective cohort study assessed 207 perimenopausal women (≥40 years) with a history of endometriosis or current endometriosis lesions, measuring lumbar spine bone mineral density (BMD) by DXA alongside ovarian reserve markers (FSH, AMH) and thyroid hormones (TSH, free T4), with follow-up BMD data available for 142 participants. The authors found weak negative and positive correlations between FSH and BMD and between AMH and BMD, respectively, and reported only a very weak correlation between annual BMD change rate and TSH levels; nonetheless, larger BMD declines were associated with higher TSH and older age at menopause, and higher TSH corresponded to a faster BMD decrease. A major caveat is that only 68.6% completed both baseline and follow-up testing, with losses due to relocation and refusal of follow-up potentially limiting the longitudinal analysis. This paper is centrally about endometriosis — it prospectively links ovarian reserve and thyroid function with BMD changes in perimenopausal women with endometriosis.

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Abstract

Abstract Background In women with endometriosis, the association between ovarian function, hormones, and bone mineral density (BMD) is unclear. Therefore, this study aimed to elucidate the association between changes in bone mineral density (BMD) and clinical data, such as ovarian reserves, in perimenopausal women with endometriosis. Methods In this prospective study, we evaluated 207 female patients who visited the Department of Obstetrics and Gynecology at the University of Tokyo Hospital between December 2015 and December 2020. We included patients aged ≥ 40 years with a history of endometriosis or who presented with endometriosis lesions. Patients with a history of smoking, steroid administration, autoimmune diseases, dyslipidaemia, and heart disease were excluded. During the study period, patients who underwent two tests, an initial and a follow-up test (n = 142, average age: 45.02 years, average BMD: 1.16 g/cm 2 ), were evaluated at regular intervals based on the annual rate of change in BMD. Results There was a weak negative correlation between the follicle-stimulating hormone (FSH) and BMD and a weak positive correlation between the anti-Müllerian hormone (AMH) and BMD. The annual rate of change in BMD showed a very weak correlation with thyroid-stimulating hormone (TSH) levels. A large decline in BMD was associated with high TSH levels and higher average age at menopause. Patients with higher TSH exhibited a higher rate of decrease in BMD than those without. Conclusions High FSH or low AMH levels are associated with decreased BMD. Decreased ovarian reserve is associated with decreased BMD in perimenopausal women with endometriosis. High TSH levels increase the risk of BMD loss. This finding may suggest that women with endometriosis should undergo bone scanning to rule out the possibility of reduced bone mass and subsequent increased risk of fracture.

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Condition tags

endometriosis

MeSH descriptors

Bone Density Bone Density Bone Density Bone Density Bone Density Bone Density Bone Density Bone Density Bone Density Bone Density Bone Density Bone Density Bone Density Bone Density Bone Density Bone Density Endometriosis Endometriosis Endometriosis Endometriosis

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