New diagnostic test predicts menopausal status of women

PicoAMH is a new diagnostic test that can predict the menopausal status of women.

The U.S. Food and Drug Administration has allowed the marketing of the PicoAMH Elisa diagnostic test as an aid in the determination of a patient’s menopausal status. It will help women to understand their stage of menopausal transition to learn what, if any, additional health risks they may face and any preventative health steps to take.

The PicoAMH Elisa test measures the amount of Anti-Müllerian Hormone (AMH) in the blood. AMH levels represent one indicator available to clinicians to determine whether a woman is approaching or is likely to have reached her final menstrual period.

Menopause is the point in time in the life of a woman when menstrual cycles permanently cease due to the natural depletion of ovarian oocytes from ageing. The diagnosis is typically made retrospectively after the woman has missed menses for 12 consecutive months. It marks the permanent end of fertility and the average age of menopause is 51 years. During this period, lipid profiles may change including increases in low-density lipoprotein (LDL), a type of cholesterol. After menopause, women enter post-menopause, when they are more vulnerable to heart disease and osteoporosis.

“Diagnostic results about a woman’s menopausal status may prompt discussions about preventative care for women experiencing menopausal symptoms,” said Courtney Lias, Ph.D. director of the Division of Chemistry and Toxicology Devices in the FDA’s Center for Devices and Radiological Health. “This test, when used in conjunction with other clinical assessments and laboratory findings, can help inform discussions about preventative care, such as ways to help prevent loss in bone mineral density or to address cardiovascular disease, both of which are known to increase after menopause.”

The FDA reviewed data submitted by the sponsor that included 690 women, aged 42 to 62, who participated in the multi-center, Longitudinal Study of Women’s Health Across the Nation. The data showed that the PicoAMH Elisa test performed reasonably well at determining levels of AMH in the blood and identifying women who had their last menstrual period and women who were more than five years away from their last menstrual period.

Clinicians should carefully evaluate PicoAMH Elisa test results in the context of a full clinical work up to ensure that contraceptives are not discontinued in women who have not yet reached menopause and that uterine bleeding due to endometrial cancer is not dismissed as a diagnosis. The PicoAMH Elisa test should not be used to assess a woman’s fertility status or to monitor or predict the ovarian response in women undergoing or planning to undergo fertility treatments.

The FDA reviewed data for the PicoAMH Elisa test through the de novo premarket review pathway, a regulatory pathway for low-to-moderate-risk devices of a new type. Along with this authorization, the FDA is establishing criteria, called special controls, which set forth the agency’s expectations in assuring the accuracy, clinical performance, and labeling of tests intended to be used as an aid in the determination of a patient’s menopausal status. These special controls, when met along with general controls, provide a reasonable assurance of safety and effectiveness for these tests.