Associations between the serum follicle-stimulating hormone (FSH) levels and intervertebral disc degeneration severity during the menopausal transition.

PURPOSE: This study aimed to examine the relationships between the serum follicle-stimulating hormone (FSH) levels and lumbar intervertebral disc degeneration (IVDD) severity in women undergoing the menopausal transition. METHODS: Consecutive women aged 45-55 years were enrolled in the cross-sectional study. Fasting serum FSH levels were measured, and lumbar IVDD severity was evaluated using modified Pfirrmann grading on magnetic resonance images. RESULTS: A total of 324 subjects, including 117 pre, 62 peri- and 145 postmenopausal women, were included. Compared with the pre- and perimenopausal groups, the postmenopausal group demonstrated higher FSH levels and IVDD severity, which was better supported by an age-matched comparison. Notably, the serum FSH levels showed statistically positive correlations (P < 0.001) with L1/2 (r(s) = 0.534), L2/3 (r(s) = 0.633), L3/4 (r(s) = 0.568), L4/5 (r(s) = 0.365) and L5/S1 (r(s) = 0.430). For the first time, immunohistochemistry results revealed FSH receptor (FSHR) expression in human nucleus pulposus tissue, although histochemistry scores did not differ across groups. CONCLUSION: There were significant associations between elevated FSH levels and IVDD severity in women during the menopausal transition, which is beneficial for further exploring the potential mechanisms underlying postmenopausal IVDD. These findings suggest that FSH may be a novel biomarker for assessing IVDD risk in menopausal women and highlight the FSHR as a potential therapeutic target for mitigating disc degeneration.