How do you know if you're nearing menopause, or are already past it? Is there a simple hormone test?
During perimenopause, hormone tests are often not helpful because hormone levels change throughout a menstrual cycle. Sometimes testing is done to check specific hormone levels, especially with fertility problems or when periods stop at an early age. This can help women make decisions about beginning or adjusting medications. For some women, it may make sense to test for other causes of symptoms that can seem like perimenopause, such as thyroid disease.
Some clinicians recommend testing a woman’s saliva for estrogen or other hormone levels. But saliva hormone levels are not accurate and should not be used to evaluate or treat menopausal symptoms.
Sometimes, elevated follicle-stimulating hormone (FSH) levels are measured to confirm menopause. When a woman’s FSH blood level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year, it is generally accepted that she has reached menopause.
However, a single FSH level can be misleading in perimenopause since estrogen production does not fall at a steady rate from day to day. Instead, both estrogen and FSH levels can vary greatly during perimenopause. One elevated FSH level is not enough to confirm menopause. More importantly, a low FSH level in a woman who is having hot flashes and changing periods does not eliminate the likelihood that she is still in perimenopause. Also, if a woman is using certain hormone therapies (such as birth control pills), an FSH test is not valid.
When a woman suspects she’s in perimenopause, it is an excellent time to have a complete medical examination by a qualified health professional. The diagnosis of perimenopause can usually be made by reviewing a woman’s medical history, her menstrual history, and her signs and symptoms. (To find out if there is a menopause practitioner near you, search for a NAMS Menopause Clinician here.)
The most common symptoms women in their 40s notice are changes in periods and the onset of hot flashes. To date, there is no simple test to predict or confirm menopause, but research continues. So, check the calendar, the tests, and the health providers' opinions. And once all suspicions have been confirmed, check back here with NAMS for ongoing information and guidance.
Need more information about what to expect? Try taking our guided tour of menopause.
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