Does AMH Tell Me When I'll Reach Menopause?
What the research says about AMH and the timing of menopause, and what a single result can tell one woman.
Short answer
Partly. A lower AMH level is linked to reaching menopause sooner, and in general AMH predicts timing better than FSH. For one woman, though, a single AMH result points to a range of possible ages rather than a date. Age alone already explains much of the timing, and AMH adds the most when menopause is likely to come early. The American College of Obstetricians and Gynecologists says more data are needed to judge AMH's usefulness as a predictor of time to menopause.
What AMH is
Anti-Mullerian hormone (AMH) is made by small, growing follicles in the ovaries. Its level reflects how many of these follicles remain, so it is widely used as a marker of ovarian reserve. AMH falls with age and becomes very low as the final menstrual period approaches. The international staging system for reproductive aging lists AMH among the supportive markers of the late reproductive years and the menopausal transition.[1]
What the studies show
Penn Ovarian Aging Study
In 401 women followed for 14 years, AMH strongly predicted time to menopause, and age improved the prediction further. With a very low AMH (below 0.20 ng/ml), the median time to menopause was about 6 years for women aged 45 to 48, but about 10 years for women aged 35 to 39. The same AMH result means a different horizon at a different age.[2]
Study of Women's Health Across the Nation (SWAN)
In 1,537 women, AMH in general predicted the timing of the final menstrual period better than FSH. With AMH below 10 pg/mL, the chance of the final period within 12 months ranged from 51% in women under 48 to 79% in women aged 51 or older.[3]
Dutch long-term follow-up study
In 257 women followed for about 11 years, AMH still added information about time to menopause after age was taken into account.[4]
Individual patient data meta-analysis
Pooling 2,596 women, AMH added little to age alone for predicting the age at menopause overall, but added much more for predicting early menopause. Predictions for an individual woman had limited precision, especially for early menopause.[5]
Why one result gives a range, not a date
- Age carries much of the information. The same AMH value points to a different horizon at 38 than at 47.[2][5]
- Prediction models describe the middle of the range better than the extremes, and their prediction intervals are wide.[6]
- Different laboratory AMH assays give different values, which limits how precisely one result can be applied to one woman.[6]
What professional guidance says
The American College of Obstetricians and Gynecologists states that more data are needed to determine the usefulness of AMH as a predictor of time to menopause.[7]
AMH is also often read as a fertility test. The American Society for Reproductive Medicine notes that ovarian reserve markers are poor predictors of reproductive potential independently of age.[8] For women not seeking fertility care, a single AMH value does not appear to be useful in predicting time to pregnancy.[7]
Where forecasting fits
LifeAhead is developing a forecast that combines ovarian reserve measures with age and reports the most likely timing with a prediction interval, for clinicians to use in counseling alongside single-biomarker tests. LifeAhead is in De Novo Class II preparation under FDA CDRH. Read about the science.
References
- Harlow SD, Gass M, Hall JE, et al. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab. 2012;97(4):1159-1168. doi:10.1210/jc.2011-3362
- Freeman EW, Sammel MD, Lin H, Gracia CR. Anti-Mullerian hormone as a predictor of time to menopause in late reproductive age women. J Clin Endocrinol Metab. 2012;97(5):1673-1680. doi:10.1210/jc.2011-3032
- Finkelstein JS, Lee H, Karlamangla A, et al. Antimullerian hormone and impending menopause in late reproductive age: the Study of Women's Health Across the Nation. J Clin Endocrinol Metab. 2020;105(4):e1862-e1871. doi:10.1210/clinem/dgz283
- Broer SL, Eijkemans MJ, Scheffer GJ, et al. Anti-Mullerian hormone predicts menopause: a long-term follow-up study in normoovulatory women. J Clin Endocrinol Metab. 2011;96(8):2532-2539. doi:10.1210/jc.2010-2776
- Depmann M, Eijkemans MJC, Broer SL, et al. Does AMH relate to timing of menopause? Results of an individual patient data meta-analysis. J Clin Endocrinol Metab. 2018;103(10):3593-3600. doi:10.1210/jc.2018-00724
- Depmann M, Broer SL, van der Schouw YT, et al. Can we predict age at natural menopause using ovarian reserve tests or mother's age at menopause? A systematic literature review. Menopause. 2016;23(2):224-232. doi:10.1097/GME.0000000000000509
- American College of Obstetricians and Gynecologists. The use of antimullerian hormone in women not seeking fertility care. ACOG Committee Opinion No. 773. Obstet Gynecol. 2019;133(4):e274-e278. doi:10.1097/AOG.0000000000003162
- Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2020;114(6):1151-1157. doi:10.1016/j.fertnstert.2020.09.134
This article is for general education and does not replace advice from your healthcare provider.
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