Context/Objective: To determine if Anti-Mullerian Hormone (AMH) and inhibin B are viable endocrine biomarkers for framing the menopause transition from initiation to the final menstrual period (FMP).

Design: We assayed AMH, inhibin B and follicle stimulating hormone (FSH) in 300 archival follicular phase specimens from 50 women with 6 consecutive annual visits commencing in 1993 when all women were in the pre- and perimenopausal menopause stages. Subsequently, each woman had a documented FMP. The assay results were fitted as individual-woman profiles and then related to time to FMP and age at FMP as outcomes.

Results: Based on annual values from six time points prior to the FMP, _logAMH longitudinal profiles declined and were highly associated with a time point 5 years prior to FMP [including both observed and values below detection (P<0.0001 and P=0.0001, respectively)]. Baseline AMH profiles were also associated with age at FMP (P=0.035). Models of declining _loginhibin B profiles (including both observed and values below detection) were associated with time to FMP (P<0.0001 and P=0.0003, respectively). There was no significant association of _loginhibin B profiles with age at FMP.

Conclusions: AMH, an endocrine marker that reflects the transition of resting primordial follicles to growing follicles, declined to a time point 5 years prior to the FMP; this may represent a critical biological juncture in the menopause transition. Low and non-detectable levels inhibin B levels also were observed 4–5 years prior to the FMP, but were less predictive of time to FMP or age at FMP.