Glossary · Tests

STRAW+10

Also called: Stages of Reproductive Aging Workshop +10.

Definition: STRAW+10 (Stages of Reproductive Aging Workshop +10) is the international consensus staging system for the menopause transition. It defines 10 stages from late reproductive years through postmenopause based on cycle patterns and supported by hormone markers (FSH, AMH, inhibin B). It is the standard staging framework in research and specialist practice.

Detailed definition

The Stages of Reproductive Aging Workshop (STRAW) staging system was developed in 2001 and substantially revised in 2011 (STRAW+10). It anchors staging on the final menstrual period (FMP, stage 0) and divides reproductive aging into seven stages before and three after: late reproductive (stages -3b, -3a) defined by subtle cycle changes and rising FSH; early menopausal transition (-2) defined by a 7-day or greater difference in cycle length between consecutive cycles; late menopausal transition (-1) defined by 60+ days of amenorrhea; the FMP itself (0); early postmenopause (+1a, +1b, +1c) covering the first ~6 years; and late postmenopause (+2). Hormone markers are supportive but not required for clinical staging in women of typical age — variable FSH characterizes early transition, persistent FSH >25 mIU/mL characterizes late transition, and very low AMH/inhibin B characterizes late stages.

Why it matters in menopause

STRAW+10 is the technical answer to "where am I in the menopause transition." For most women in their 40s with typical-age presentations, formal STRAW staging is not necessary for treatment decisions. It becomes more useful in atypical situations (women under 40 with concerning symptoms, women with no menstrual history due to hysterectomy or IUD).

Sources

External references: Wikipedia.

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