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How To Diagnose Menopause With Labs

Tests To Determine Menopausal Status

Are there tests to diagnose menopause?

In the midst and even in the aftermath of treatment for breast cancer, it can be difficult to tell whether youve gone into menopause for good. For instance, maybe your periods stopped during chemotherapy but still havent returned a few months after finishing treatment. The younger you are, the better the odds are that they will return.

Knowing for sure whether or not youre permanently in menopause is likely to matter most to you if you still want to have biological children. However, you may simply be curious about where you stand.

Your doctor may use the following blood tests to help you gauge this:

These blood tests are not the final answer to whether or not you are in menopause, however. Even if you have postmenopausal levels of FSH and estradiol, these levels can change over time. The longer you go without a menstrual period, and the longer that repeat testing suggests you are menopausal, the more likely it is that you are in this stage of life for good.

You may encounter other menopause tests that you can do at home, on your own, using urine or saliva. However, these tests arent considered reliable. If youre interested in testing, be sure to discuss it with your doctor.

If It’s Not Menopause What Is It

Depression, anaemia and hypothyroidism are the most common conditions that may mimic menopausal symptoms or indeed occur concurrently. Unstable diabetes may cause hot flushes. Medication, such as the SSRI family of anti-depressants, may also cause hot flushes.

Doing a blood count, iron studies, ferritin and/or a TSH level will usually establish the diagnosis. However, if a woman presents with low mood or anxiety, there is a need to evaluate whether this is a primary anxiety/depression or one aggravated by the lack of oestrogen. A previous history of depression or an elevated FSH may help to differentiate between the two. Hair loss may be a sign of iron deficiency or hypothyroidism rather than menopause.

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.

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What Do The Results Mean

The meaning of your results will depend on whether you are a woman, man, or child.

If you are a woman, high FSH levels may mean you have:

  • Primary ovarian insufficiency , also known as premature ovarian failure. POI is the loss of ovarian function before the age of 40.
  • Polycystic ovary syndrome , a common hormonal disorder affecting childbearing women. It is one of the leading causes of female infertility.
  • Started menopause or are in perimenopause
  • An ovarian tumor
  • Turner syndrome, a genetic disorder that affects sexual development in females. It often causes infertility.

If you are a woman, low FSH levels may mean:

  • Your ovaries are not making enough eggs.
  • Your pituitary gland is not working correctly.
  • You have a problem with your hypothalamus, a part of the brain that controls the pituitary gland and other important body functions.
  • You are very underweight.

If you are a man, high FSH levels may mean:

If you are a man, low FSH levels may mean you have a disorder of the pituitary gland or hypothalamus.

In children, high FSH levels, along with high levels of luteinizing hormone, may mean puberty is about to start or has already started. If this is happening before age 9 in a girl or before age 10 in a boy , it may be a sign of:

Why Seeing A Doctor Matters

Nulife module 2 menopause basics edited

If you havent been doing routine checkups, taking good care of your health and well-being, menopause is an important opportunity to change that.

When entering menopause, women have a higher risk of developing age-related illnesses, as well as diabetes, heart disease, and osteoporosis. Regular check-ups, healthier lifestyles prevent the development of these diseases and help you catch them early on.

When you understand what your body is going through, you can start taking measures to reduce symptoms and continue thriving with a renewed sense of well-being.

If youre well into the perimenopause or menopause change, you probably have a few questions.

As a woman who is maturing into the best years of my life, I too have countless questions about the change whether or not Im in it, how I should be managing the symptoms, and how its impacting my long-term health?

Another question for me has been: who do I talk to? My friends are awesome on a cathartic level, but whos the right health provider or professional that I can trust through this perimenopause transition?

At Gennev, its our mission to help women live a better life with menopause. Our clinic specializes in the healthcare treatment of menopause symptoms, so you can improve your energy, sleep, mood, sex, reduce hot flashes and thrive.

Get useful, helpful, and relevant health wellness information by checking out our solutions.

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What Is It Used For

FSH works closely with another hormone called luteinizing hormone to control sexual functions. So a luteinizing hormone test is often done along with an FSH test. These tests are used in different ways, depending on whether you are a woman, man, or child.

In women, these tests are most often used to:

  • Help find the cause of infertility
  • Find out if there is a problem with ovarian function
  • Find the reason for irregular or stopped menstrual periods
  • Confirm the start of menopause, or perimenopause. Menopause is the time in a woman’s life when her menstrual periods have stopped and she can’t become pregnant anymore. It usually starts when a woman is around 50 years old. Perimenopause is the transition period before menopause. It can last for several years. FSH testing may be done towards the end of this transition.

In men, these tests are most often used to:

  • Help find the cause of infertility
  • Find the reason for a low sperm count
  • Find out if there is a problem with the testicles

In children, these tests are most often used to help diagnose early or delayed puberty.

  • Puberty is considered early if it starts before age 9 in girls and before age 10 in boys.
  • Puberty is considered delayed if it hasn’t started by age 13 in girls and by age 14 in boys.

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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Who May Need A Menopause Panel

Women who are between the ages of 40 and 60 who have not had a period for at least a year, or who are exhibiting other signs and symptoms of menopause, are most likely to be prescribed a Menopause Panel by their physician. Outside of missed periods, some of the signs related to menopause include trouble sleeping, mood swings, hot flashes, and cloudy thinking among others. Its important to discuss any of these symptoms with your physician to help them determine if a Menopause Panel is right for you.

Implementing Nice Qs143 In Primary Care

Menopause and Lab Tests

In the authors opinion, the current lack of menopause expertise in both primary and secondary care is the single biggest hurdle to overcome in implementing NICE QS143. The Faculty of Sexual and Reproductive Health offers special skills modules in basic and advanced menopause care.6 Training a menopause lead for each practice and providing a local menopause specialist service could lead to a range of improvements .

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Who Should Consider A Menopause Home Test

According to the Food and Drug Administration , menopause home tests suit people who have irregular periods, hot flashes, and vaginal dryness and want to know if these symptoms could be due to menopause.

However, the FDA also states that these tests do not tell a person definitively if they are in menopause or perimenopause.

Menopause can

9 out of 10 times , but they do not determine whether a person is experiencing menopause. As females grow older, their FSH levels may increase and decrease during menstruation.

The North American Menopause Society notes that saliva tests are not accurate and tend to be expensive. Also, FSH tests may not work if a person is taking birth control pills.

Mylab Box Perimenopause Test

The myLAB Box perimenopause screening test involves providing a blood and saliva sample to identify the FSH, estradiol, and progesterone levels.

According to the company website, individuals do not have to change their diet before taking this test. However, if they decide to stop taking medications before taking the test, they should contact a doctor to discuss whether it is safe for them to do so.

According to myLAB, labs are CLIA-certified, and a person can receive their results within 5 days.

If a persons results suggest they are in perimenopause, they can talk with a myLAB physician for free to discuss the result.

Pros and cons

myLAB Box test has a range of advantages:

  • free consultations with doctors if the result is positive
  • CLIA-certified labs

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Box : Potential Improvements Following Implementation Of A Local Menopause Specialist Service

Implementation of a local menopause specialist service could lead to improvements in:

  • diagnosis of perimenopause and menopause through
  • a reduction in FSH testing for diagnosis of menopause in women over 45 years
  • use of electronic prompts for FSH laboratory requests
  • liaison with local pathology optimisation groups
  • diagnosis of premature ovarian insufficiency through
  • encouraging GPs to consider POI in women aged under 40 years
  • providing a referral pathway for a specialist service, if there is doubt
  • recording positive diagnoses through
  • creating adequate Read codes for menopause, perimenopause, and premature ovarian insufficiency
  • constructing disease registers
  • promoting the use of HRT promptly and up to natural age of menopause, unless contraindicated
  • review of treatments for menopausal symptoms through
  • initiating medication reviews 3 months after starting treatment, annually thereafter
  • providing information for women having treatment likely to cause menopause through
  • working with secondary care to ensure access to and understanding of appropriate information prior to treatment.
  • FSH=follicle-stimulating hormone POI=premature ovarian insufficiency HRT=hormone replacement therapy

    Understanding Your Menopause Blood Test Results

    Nulife module 2 menopause basics edited

    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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    Finding More Information And Resources

    You can see everything NICE says on menopause in the NICE Pathway on menopause.

    To find out what NICE has said on topics related to this guideline, see our web page on gynaecological conditions.

    For full details of the evidence and the guideline committees discussions, see the full version. You can also find information about how the guideline was developed, including details of the committee.

    NICE has produced tools and resources to help you put this guideline into practice. For general help and advice on putting NICE guidelines into practice, see resources to help you put guidance into practice.

    How Do You Know You’re In Postmenopause

    Your healthcare provider will be able to tell you if you’re in postmenopause based on your symptoms and how long it’s been since your last menstrual period. In some cases, your healthcare provider will take a blood sample and check your hormone levels to confirm you’ve gone through menopause. Remember, you’re not considered to be through menopause until it’s been over one year since youve had a period.

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    Testing + Symptoms = Diagnosis

    Both lab tests and symptom charting are not necessarily 100% accurate.

    The problem with menopause is that it occurs over a period of several months .

    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.

    For instance:

    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.

    When Should You See A Doctor

    How to understand your labs in menopause and perimenopause

    You should definitely see a doctor, gynecologists, or an OB-GYN if you start to notice menopause symptoms. A doctor can determine if its menopause, rule out the possibility of disease by asking questions about your symptoms and taking a few tests.

    Proper doctors can help you alleviate the symptoms and discomfort you experience going through menopause. Some women experience mild symptoms and tolerate them. If your symptoms interfere with your life and well-being, get in touch with a menopause clinic to find out how these symptoms can be reduced, so you can thrive with a renewed sense of energy!

    Heres a little snippet of how we help women to a better life after menopause:

    • Nutrition supplements
    • Prescriptions , Birth Control, UTI, etc.)
    • Natural approaches to menopause relief
    • Video-based appointments
    • Telemedicine expert care
    • Online community with expert advice, so you dont go through it alone

    If you need some support with the transition, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription help. Book an appointment with a doctor here.

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    Will My Hot Flashes Stop After Menopause

    Some people still experience hot flashes after menopause. Postmenopausal hot flashes are caused by decreased estrogen levels. It is not uncommon to experience a random hot flash for years after menopause. If your hot flashes are bothersome or intensify, speak with your healthcare provider to rule out other causes.

    Information For Women Having Treatment Likely To Cause Menopausestatement 5

    Certain medical or surgical treatments, such as cancer treatments and gynaecological surgery, can affect fertility and induce menopause.1,4 It is important that women who require treatment of this kind are provided with information about menopause and fertility before they have their treatment, as they may be younger than women experiencing natural menopause and therefore less likely to be aware of menopausal symptoms.

    Left untreated, menopause symptoms can lead to long-term poor health outcomes and potential psychological trauma.6 Promoting awareness of menopausal symptoms increases the likelihood that women will access treatment and services as soon as they need them, and empowers women to make an informed choice about their ongoing hormonal status.

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    Terms Used In This Guideline

    Compounded bioidentical hormones Unregulated plant-derived hormonal combinations similar or identical to human hormones that are compounded by pharmacies to the specification of the prescriber.

    Fragility fracture Fractures that result from mechanical forces that would not ordinarily result in fracture . Reduced bone density is a major risk factor for fragility fractures, which occur most commonly in the spine, hip and wrist.

    Low mood Mild depressive symptoms that impair quality of life but are usually intermittent and often associated with hormonal fluctuations in perimenopause.

    Menopause A biological stage in a womans life that occurs when she stops menstruating and reaches the end of her natural reproductive life. Usually it is defined as having occurred when a woman has not had a period for 12 consecutive months . The changes associated with menopause occur when the ovaries stop maturing eggs and secreting oestrogen and progesterone.

    Menopausal women This includes women in perimenopause and postmenopause.

    Perimenopause The time in which a woman has irregular cycles of ovulation and menstruation leading up to menopause and continuing until 12 months after her final period. The perimenopause is also known as the menopausal transition or climacteric.

    Postmenopause The time after menopause has occurred, starting when a woman has not had a period for 12 consecutive months.


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