Can Blood Tests Help To Manage Menopause And Hrt
There is increasing interest in whether blood testing can predict the onset of menopause, and whether it is useful in the management of hormone replacement therapy . We ask the experts if blood tests to assess hormones are worth considering.
Reviewed byDr Sarah Jarvis MBE
29-Sep-20·7 mins read
In the UK, the average age a woman will reach menopause is 51, though anywhere between 45 and 55 is still considered to be within the normal range. For some women, menopausal night sweats, painful joints, depression, and vaginal and bladder issues can be hugely debilitating. Hormone replacement therapy is one option to help manage these symptoms and alternatives to HRT are also available.
Blood Tests Versus Other Indicators
Saliva testing which can measure the level of hormones circulating in the bloodstream is now available. Proponents of saliva testing claim it is much more specific and correctly identifies the level of hormones at the cellular level, in contrast to a blood serum test.
“There are a number of new tests becoming available privately,” says Unsworth. “These include hormone tests based on saliva and urine samples. At present, I do not feel there is enough evidence to support the accuracy and reliability of these tests. Given they often have a very high price tag, I would consult a doctor before considering them.”
Both Briggs and Unsworth are keen to point out that, as with all areas of medicine, blood tests can provide helpful information, but should not be used in isolation to make clinical decisions. Most tests provide doctors and patients with a ‘normal range’, but this can vary hugely in some cases, so should only be used in conjunction with an overall picture of symptoms and a full medical history.
Diagnosing And Managing Premature Ovarian Insufficiencystatements 2 And 3
About 1% of women experience POI , either naturally or as a result of medical or surgical treatment.1,4 If a woman aged under 40 years presents with menopausal symptoms, absent or infrequent periods, and raised FSH levels on two blood samples taken 46 weeks apart, then POI can be diagnosed.4 If in doubt, then referral should be made to a specialist with experience in POI.1
Timely diagnosis reduces morbidity and mortality4 and makes it more likely that women with POI will have a positive experience of their diagnosis.
Women diagnosed with POI should be offered sex steroid replacement , for example, HRT or combined hormonal contraceptive, to reduce menopausal symptoms and improve health outcomes.4
A clear local referral management pathway to a specialist with expertise in menopause is essential for cases where there is uncertainty in the diagnosis and management of POI.1
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What Lifestyle Changes Can I Make To Help Manage The Menopause Transition
The reduction in oestrogen levels are the cause of many menopause symptoms and there are long-term risks of cardiovascular disease and osteoporosis after the menopause has taken place.
There are many things you can do to help manage the symptoms of the menopause and reduce your risk of chronic disease, including:
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Understanding Your Menopause Blood Test Results
Your hormones fluctuate a lot, especially leading up to menopause. So it’s often recommended that you do a second test, 4-6 weeks later, if your first FSH level is raised to build a more accurate picture. If your FSH levels are raised in both instances, then it can suggest that youre menopausal.
Heres a brief overview of what your results might show.
Thyroid hormonesIf your thyroid hormones are out of range it can cause symptoms like irregular periods, weight changes, tiredness, anxiety, and restlessness similar to menopausal symptoms. So its a good idea to rule out a thyroid disorder when doing a menopause test.
FSHIn most cases, your FSH levels are the strongest indicator that youre perimenopausal or menopausal especially if its combined with missing periods.
OestrogenYour oestrogen levels drop as you reach menopause which is largely responsible for a lot of symptoms associated with menopause.
If your results show low oestrogen levels this can mean that youre perimenopausal or menopausal.
Luteinising hormone Your LH levels increase as you reach menopause. Raised LH levels, combined with your other hormone levels, can indicate that youre perimenopausal or menopausal.
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What Can I Do To Prevent Osteoporosis
Osteoporosis isnt entirely preventable, but you can take steps to strengthen your bones. Eating foods high in calcium like cheese, yogurt, spinach or fortified cereals can help boost calcium intake. Adding a calcium supplement can also help. Some people also need a vitamin D supplement because it helps their body absorb calcium.
What Are Hormone Blood Tests Used For
These symptoms that might require hormonal blood work are generally indicative of various conditions, such as polycystic ovarian syndrome , thyroid disease, diabetes, obesity, and more.
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Do People In Postmenopause Lose Interest In Sex
No, not all people lose interest in sex after menopause. Vaginal dryness and discomfort during sex can make sex less pleasurable. Using a vaginal lubricant can help with dryness. Some people are less interested in sex because of other symptoms like depression or feeling tired. If your feelings about sex have changed, ask your healthcare provider for help.
Menopause Blood Test Results How To Read
After you took a blood sample for the perimenopause test, the results are ready within a few seconds or one minute only. Some doctors recommend repeating a test for perimenopause in one to two months, because the hormones may fluctuate a lot. The first screening may show the following results:
- Overranged thyroid hormones. They lead to irregular menstrual bleeding, extreme tiredness, changes in weight primary symptoms of climax. Thus, perimenopause test will help to figure out the presence of problems with thyroid
- Level of FSH. If it is abnormal, it is the strongest sign of the approximating perimenopausal stage. If a hormone test for menopause clearly shows the changes in level and you experience poor periods, most likely the process of maturing started
- Dropped estrogen. A perimenopause testindicates how much it is dropped and when is the nearest possibility of your hitting a perimenopause stage
- Increased luteinizing hormone. A true indicator of climax is the raised level of LH. A perimenopause test will confirm your condition if again there are also irregular periods and tiredness.
For the top results, it is highly recommended to address the results of the menopause test to the health care provider or gynecologist. They can offer the best guidance and prescribe the solutions to welcome womens health conditions decently.
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If You Want To Know If You Ae Approaching Menopause All You Have To Do Is Just Undergo A Simple Blood Test According To New Research
Written by ANI | Published : January 24, 2020 10:30 AM IST
Menstrual cycle patterns are generally used as an indicator to predict the onset of menopause in women. This approach, however, is severely inaccurate and can pinpoint the beginning of menopause only within a window spanning across four years. In a new study that has been published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism, researchers have developed a blood test that can forecast the commencement of menopause with relatively better accuracy.
The study found that measuring levels of anti-Mullerian hormone can predict when a woman’s final menstrual period will occur. AMH serves as an indicator of how many eggs a woman has remaining. Women are born with their lifetime supply of eggs, and the supply decreases as women approach menopause.
“Establishing a way to measure time to the final menstrual period has long been the holy grail of menopause research,” said co-lead author of the paper Nanette Santoro, M.D., of the University of Colorado Medical School in Aurora, Colorado.
What Causes Postmenopausal Bleeding
Vaginal bleeding during postmenopause isn’t a normal side effect of decreasing hormone levels. In some cases, the dryness in your vagina could cause some light bleeding or spotting after sex. In other cases, it could indicate a condition like endometrial hyperplasia or uterine fibroids, infections like endometritis, or cancer. Contact your healthcare provider if you experience any vaginal bleeding so you can be evaluated.
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Are There Any Health Risks Associated With Postmenopause
People in postmenopause are at an increased risk for several conditions:
Estrogen helps protect against cardiovascular diseases like heart attack, heart disease and stroke. It is also common for people in postmenopause to become more sedentary, which contributes to high cholesterol and high blood pressure. These factors combined can increase a womans risk for cardiovascular diseases after menopause. A healthy diet, not smoking and getting regular exercise are your best options to prevent heart disease. Treating elevated blood pressure and diabetes as well as maintaining cholesterol levels are also ways to lower your risk.
People lose bone more rapidly after menopause due to decreased levels of estrogen. You may lose up to 25% of your bone density after menopause . When too much bone is lost, it increases your risk of developing osteoporosis and bone fractures. The bones of the hip, wrist, and spine are most commonly affected. Bone mineral density testing, also called bone densitometry, can be done to see how much calcium you have in certain parts of your bones. The test is used to detectosteoporosis and osteopenia, a precursor to osteoporosis.
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Final Menstrual Period Blood Tests
Can blood tests tell you when your final period is going to happen?
In About Menopause: Diagnosis of Menopause Is There A Test To Diagnose Perimenopause or Menopause? the Jean Hailes for Womens Health explain:
Blood tests wont tell you when your final period is going to happen and wont help you manage your perimenopause, or what follows. During the perimenopause, hormone levels vary widely and can be low one day and within the normal range the next.3
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When To Do A Menopause Blood Test
The menopause is a completely natural part of ageing and many women self-diagnose themselves as their periods become irregular.
However, you might like to see a GP or specialist if:
- your symptoms are bad
- your periods become irregular early
Your periods being absent for a year combined with your age are the main clinical indicators of menopause so a blood test wont always be offered But in some cases, you will be offered one for example, if youre under the age of 45. You can also do a finger-prick blood test at home to check if you might be menopausal.
Keep in mind that not all blood tests are diagnostic. Some tests are used to build a picture of whats going on inside your body. Checking in on your female hormones at this point can help do that.
What Are The Stages Of The Menopause
There are 3 stages of the menopause:
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When Should I Call My Doctor
If any of your postmenopause symptoms bother you or prevent you from living your daily life, contact your healthcare provider to discuss possible treatment. They can confirm you have completed menopause and are in postmenopause.
Some questions you might ask are:
- Are these symptoms normal for people in postmenopause?
- Is there treatment for my symptoms?
- Is hormone therapy still an option?
- What can I do to feel better?
If you experience any vaginal bleeding during postmenopause, contact your healthcare provider to rule out a serious medical condition.
Testing + Symptoms = Diagnosis
Both lab tests and symptom charting are not necessarily 100% accurate.
This time is a period of great fluctuation, both in terms of your symptoms and in terms of your lab tests and hormones.
Your hormones and prohormones may fluctuate wildly during this time which means that checking just one time may not necessarily be accurate.
As a woman is going through the menopause transition it’s not uncommon for her body to attempt to menstruate.
This attempted menstruation may cause small to large rises in hormone levels which may alter your symptoms.
Because of this, you don’t want to rely heavily on one form of diagnostic tool over another.
Instead, it’s best to combine both your symptoms and use them in conjunction with your lab tests .
This is especially important if you are suffering from early menopause.
Women who suffer from early menopause may be pushed aside as having depression as opposed to true ovarian failure/menopause.
The good news is that it is easily testable and that you can be sure what is happening in your body with a couple of lab tests.
During menopause, we know that your estradiol levels and progesterone levels WILL fall dramatically.
When in doubt, make sure to ask your doctor for the lab tests listed above as they may help to explain what is happening in your body.
What Menopause Tests Are Available From A Doctor
Your doctor should be able to diagnose perimenopause or menopause based on your age, symptoms, and how often you have periods. Its unlikely youll need a menopause test.
However, if youre taking hormonal treatments it can be more difficult to know when youve reached menopause.
Another reason a doctor may offer you a test for menopause would be if your symptoms are happening early. If youre not pregnant, your doctor may offer you a blood test if youre:
- between 40 and 45 and have menopausal symptoms, including changes in your menstrual cycle
- under 40 and your doctor suspects youre in early menopause.
- The blood test will measure a hormone called FSH , which is found in higher levels during menopause. Two tests are usually done 4 to 6 weeks apart. This is because levels can fluctuate with hormone cycles. However, because of these changing FSH levels, a low or high reading doesnt necessarily mean menopause has started.
You shouldnt be offered an FSH test if youre taking a contraceptive containing oestrogen and progestogen, or highdose progestogen, because the contraceptive changes your natural FSH levels.
There are other conditions that can cause similar symptoms to menopause. If your doctor isnt sure what’s causing them, they may arrange some other blood tests as well.
Blood Tests And The Menopause
I regularly see women in my clinic asking for a menopause test. Or, even worse, women who have had a test and told they cant possibly be menopausal because their blood tests are normal.
For most women, menopause occurs after the age of 45, with the average age being 51. Blood tests in this group of women are not required to diagnose menopause or menopausal symptoms. In fact, during the perimenopausal phase, blood tests can often vary significantly from one day to the next, and as a result can often be falsely interpreted.
The FSH test is what is usually being performed to diagnose menopause. It starts to rise during the perimenopause as ovarian function starts to decline, in a bid to keep the ovaries ovulating. However, this rise does not follow a nice gradual pattern there are often significant peaks and troughs, which means blood test results can often vary. One high reading does not necessarily mean you are post menopause, and, likewise, a low reading does not mean things are not changing.
As the results can be so difficult to interpret, the NICE guidelines do not recommend its use in the diagnosis of menopause in women over 45 years. The test may have a role in some situations , and it is still an important test for women who may be going through premature menopause. However, for the majority of women, diagnosing menopause should be based on their symptoms.
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More Sensitive Testing Can Detect Hormone Changes Signaling Menopausal Transition
- The Endocrine Society
- Blood tests could replace menstrual periods as a gauge for when a women is nearing menopause, according to new research.
Blood tests could replace menstrual periods as a gauge for when a women is nearing menopause, according to new research published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.
The study found measuring levels of anti-Müllerian hormone can predict when a woman’s final menstrual period will occur. AMH serves as an indicator of how many eggs a woman has remaining. Women are born with their lifetime supply of eggs, and the supply decreases as women approach menopause.
“Establishing a way to measure time to the final menstrual period has long been the holy grail of menopause research,” said co-lead author of the paper Nanette Santoro, M.D., of the University of Colorado Medical School in Aurora, Colo. “Using bleeding patterns or previously available tests to predict the time to menopause can only help us narrow the window to a four-year period, which is not clinically useful. Women can make better medical decisions with the more complete information offered by new, more sensitive anti-Müllerian hormone measurements.”
Researchers used a more sensitive test than what has been available previously to measure the participants’ AMH levels. This process made it possible to predict the final menstrual period’s timing within 12 to 24 months in women in their late 40s and early 50s.