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How To Test For Early Menopause

Nice Guidance On Menopause

Ob/Gyn Reacts: Early Menopause (Primary Ovarian Insufficiency)

In November 2015, NICE Guideline 23 on Menopause: diagnosis and management was published, providing recommendations for healthcare professionals who care for women in menopause.1 NICE NG23 also includes a section with information for the public, which provides women with information about what to expect from a healthcare professional if they have menopausal symptoms.

NICE Quality Standard 143,4 published in February 2017, distils the key points from NICE NG23 into measurable statements that can be used to assess the quality of care provided and quantify potential improvements to clinical practice. The five quality statements that make up NICE QS143 are listed in Table 1 and discussed in detail below.

Whats In A Menopause Blood Test

Your ovaries ability to produce hormones gradually declines over time in particular, the hormone oestrogen. The drop in oestrogen triggers the levels of another hormone, follicle-stimulating hormone , to rise a menopause test will usually measure these two hormones to see if theyre in the menopausal range.

An NHS GP will most likely just measure your FSH levels alone. Other tests might be included depending on your symptoms and any current or past medical conditions.

Other things that your doctor might include in your blood test could be:

  • thyroid hormones if these are out of range it can mimic menopausal symptoms
  • luteinising hormone

Testing For Menopause & Early Menopause

Is it possible to test for and diagnose if you are in menopause?

The answer is yes.

The changes in your hormones cause several changes to other hormones in your body which can be picked up with routine blood tests.

What you need to realize is that all of the systems in your body are connected in some way.

If you drop your estrogen, for instance, then that will alter other hormones that are normally produced by your brain to stimulate the release of estrogen.

These hormones and prohormones can be picked up and used to help draw a picture of what is happening in your body.

So which blood tests do you need to diagnose menopause?

I’ve included a list below that every woman who is going through menopause should ask their doctor for:

It’s also helpful to understand what happens to these values during menopause so that you can understand where you are at in your transition.

I’ve included some of the general ranges to look for with these lab tests below:

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Premature Vs Early Menopause

Premature menopause affects 1% of women under the age of 40. The only difference between premature menopause and early menopause is the timing.

Premature menopause occurs before age 40 and early menopause happens after age 40 but before age 45. Many of the same causes of premature menopause also cause early menopause. Both conditions cause similar symptoms.

Blood Tests For Hormone Levels In Menopause

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For many women, working out whether or not youre in perimenopause or menopause can feel like a bit of a guessing game, especially if you are taking hormonal contraception, which can mask or cause one of the key signs of perimenopause and menopause your periods becoming irregular or absent. One option for women looking to understand where they are in their menopause journey is the use of a hormonal blood test, which can take a measure of your hormone levels to determine if you are in menopause. Hormonal blood tests work by measuring your hormone levels to work out whether or not you are menopausal. Menopause specialist GP, Dr Kate Burns, explains everything you need to know about blood tests, including how they work, when you should use them, how to read menopause blood test results, and how they can help.

Can a blood test help to diagnose menopause?

How to understand menopause blood test results

As explained above, test results can be confusing to interpret, but the cut off points for FSH levels are relatively straightforward. A general guide is that a blood FSH level of > 30 IU/L suggests that the ovaries are slowing down, and can be taken as a potential indicator of menopause.

Can a blood test check what stage of menopause you have reached?

The simple answer is, not necessarily. However, a general rule is that FSH levels may be either normal or raised in perimenopause but will be raised at the postmenopausal stage.

When are menopause hormone blood tests recommended?

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How To Read The Test

It is quite easy to read a perimenopause quiz. However, many women are afraid that they will not be able to understand their perimenopausal tests. We want to comfort all anxious ladies. Your blood test will be ready in a minute or even faster. Just as a perimenopause quiz, you can interpret its results even without the doctors comments. You may see the next results:

  • Overranged thyroid hormones. They may provoke bleeding and abnormal tiredness. Changes in weight may take place as well.
  • Level of FSH. This is the clearest sign that your perimenopausal stage is nearing. The changes in FSH levels are commonly accompanied by the violation of natural periods.
  • Low estrogen. If you get through a sufficient loss of estrogen levels, it also shows that perimenopause is near.
  • Enhanced amounts of luteinizing hormone . In case your LH levels enhance a lot, its the real indicator that your climax is about to start.

What Is The Difference Between Early And Premature Menopause

Early or premature menopause happens when ovaries stop making hormones and periods stop at a younger age than usual . This can happen naturally or for a medical reason, such as when both ovaries are removed in a hysterectomy.

Early and premature menopause can have the same causes. The only difference is the age at which it happens. Menopause that happens before age 45 is called early menopause. Menopause that happens before age 40 is called premature menopause.

Women who have gone through early or premature menopause cannot get pregnant.

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Ask A Laboratory Scientist

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Learning From Personal Experience

PERIMENOPAUSE: How To Tell If You Are In Early Or Late Perimenopause!

At 41 I found out Id gone through early menopause. But I hadnt experienced any signs of early menopause! The doctor who told me was as shocked as me. At the time it was a devastating diagnosis because I was trying for another child. It was also very confusing as I thought everything was normal.

I was in a new relationship and had wanted another baby since my son was born nearly 10 years earlier. As we were both not exactly spring chickens, it seemed prudent to get a hormone check to see what the possibilities were. The results came as a huge shock.

There were several things going on that made it such a shocking diagnosis. Firstly the average age of menopause in the West is 51. So I was a whole decade early. I had absolutely no knowledge of menopause but had associated it with a much older woman, not who I considered myself to be.

I knew nothing about perimenopause let alone the signs of early menopause. And I felt catapulted into middle age. Gradually I realized that at 41 I was actually already middle-aged! With average life expectancy of 81 in the UK for women I was right smack in the middle of my life. So much for denial!

The second thing was that Id experienced no symptoms whatsoever. Apart from the results of the hormone test, there was nothing to indicate to me that anything was amiss. I had a busy and quite stressful career, and I hadnt even noticed my periods must have been either non-existent or certainly very patchy.

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What Is The Difference Between Premature Menopause And Early Menopause

The difference between premature menopause and early menopause is when it happens. Premature menopause occurs before a woman is 40. Early menopause is when a woman undergoes menopause before age 45.

Many of the causes of premature menopause can also be causes of early menopause. The two types of menopause also share many of the same symptoms.

Bleeding After The Menopause

If you start to have bleeding after youve reached the menopause , see your GP. Many women get this, and there may be a simple explanation. For instance, the normal changes that happen to your vagina after menopause can cause bleeding. But bleeding after the menopause can also be a symptom of certain cancers, including womb cancer, so your GP will want to rule this out.

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How To Seek Help

“It’s a good idea to see if there’s a GP at your practice who specialises in menopause and HRT,” advises Briggs. “And if you feel you need extra support ask to be referred to your local menopause clinic or a specialist consultant.”

The National Institute for Health and Care Excellence provides guidelines on when blood tests are necessary in menopause.

“I would not recommend accessing any blood tests without consulting a doctor,” adds Unsworth. “However, not all doctors may be confident in interpreting these types of hormone results, so I would recommend seeking out a doctor with an interest in menopause to ensure you are given the correct answers and treatment.”

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 Causes Early Menopause

    As mentioned previously, menopause before the age of 40 are considered to be in premature, or early, menopause. One medical causes of premature menopause is known as premature ovarian failure. Technically, premature ovarian failure is not the same as premature menopause. In premature ovarian failure, the ovaries stop functioning normally before the age of 40. Women with premature ovarian failure may still occasionally have menstrual periods, but they typically experience infertility. Premature ovarian failure is usually accompanied primary ovarian insufficiency. Premature ovarian failure is usually accompanied by the symptoms of premature menopause.

    Premature menopause can also be caused by treatments for cancers or other conditions that involve chemotherapy and/or radiation therapy to the pelvis. These treatments can damage the ovaries and result in ovarian failure.

    Surgery to remove the ovaries, either for benign or malignant conditions, results in premature menopause if both ovaries are removed. Surgery to remove the uterus results in menopause only in the sense that menstrual bleeding does not occur. In that case, the ovaries will continue to produce hormones.

    Other infrequent causes that may lead to premature menopause include drugs, chronic diseases, pituitary and hypothalamic tumors, psychiatric disorders, and other relatively rare or undefined conditions.

    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.

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    Signs: How To Identify Perimenopause

    Of course, women may not require a perimenopause quiz to understand that the early phase of this life stage has begun. Certain health changes and conditions may explain everything. Therefore, you should be attentive to your body signals and remember the following essentials:

    Using a perimenopause quiz, you may recognize most or even all signs mentioned on our list. Therefore, this quiz may be additional evidence that the signs you feel surely mean that early menopause has begun. Nonetheless, you should obligatorily go to your doctor to confirm or refute this crucial assumption.

    You should know about the risk factors, which may cause early menopause. Among them are active smoking, family history, cancer treatments, and a hysterectomy. Each factor may start the phase faster. For example, smoking women are more likely to have perimenopause than the ones who dont smoke. Under these conditions, their climax may come about 1-2 years earlier.

    Home Menopause Testing Kits: Are They Worth It

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    You may have heard about a kit you can use at home to see if you are in menopause. It tests urine for the presence of FSH, or follicle-stimulating hormone.

    Fine, but here’s the first potential trap: Levels of FSH in the blood correlate poorly with menopausal symptoms. So, if a blood test that looks for FSH isn’t a reliable marker, neither is the urine test.

    As disappointing and surprising as it may seem, many aspects of the menopause process remain a mystery to medical science. The medical definition of menopause is when menstrual periods stop for 12 months as a consequence of the ovaries shutting down. Menopause is not defined by a blood test, or a urine test, or any lab test for that matter.

    Women might want to know if their symptoms are a result of menopause, so would FSH testing meet that need? Well, women can have terrible menopause symptoms and yet their FSH level may remain in the “premenopausal” range. Conversely, women without symptoms such as hot flashes may have an FSH level in the “menopausal range.”

    For all of these reasons, FSH testing is not suited as a routine test for every woman around the age of menopause. Encouraging women without any menopausal symptoms to check their FSH levels is not doing them any service.

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    Fit In My 40s: Can A Home

    It turns out that numbers dont necessarily tell the whole storyFitness tips: what you need to know about perimenopause

    Are you sure you want to do a home hormone test? my editor asked. Are you sure its not too personal? Why would that be personal, I think. This is stuff I make without trying. Its not even as revealing as keeping a food diary. Then two tests arrived from medical test-by-post company Thriva one female baseline hormone test and one menopause test, so I realised that actually, yeah, that is pretty personal.

    There are a couple of reasons why someone might want to test. If youre trying to figure out why youre not getting pregnant, you can wait a long time for investigations on the NHS. If youre having menopausal symptoms, you might want to confirm the hunch so you can make a decision about hormone replacement therapy . If youre just curious… well, this is what happened with me.

    Test two, the female baseline, I did at the exact right point day three and it came back with much higher FSH and luteinising hormone, two hormones that surge as you head towards menopause. Since people trying to get pregnant want FSH readings of less than 10, and mine was 20, I assumed this meant perimenopause. But not necessarily, says Hill.

    Possible Signs Of Early Menopause

    So if I had had any clue what I was going through, what would have been the signs of early menopause for me to look out for? The first thing may be quite obvious like a hot flush that you cant explain. Or maybe youre more anxious and irritable than usual.

    Ive learnt over the last decade that hormonal fluctuations during the perimenopause years are very normal and can be pretty extreme. Perimenopause is the years leading up to menopause. Menopause is defined as two years after your last period if you are under 50, and one year if you are over.

    Some doctors are reluctant to test hormones for menopause when a woman is in her 40s because of these day-to-day hormonal fluctuations. But it would appear my doctor didnt know any of that when he told me definitively I had gone through menopause.

    But when your hormones start to fluctuate there may be several things to watch out for. Maybe you start forgetting things and not knowing that even that can be hormone related, you think you have early onset Alzheimers. You likely dont, so stop worrying about that.

    Infertility can be another of the signs of early menopause. I wish it was more well known that perimenopause can start so early and that for many of us, our fertility starts to drop at an alarming rate from our mid 30s. So if you want to have kids, dont leave it too long. Older women giving birth may get lots of publicity but they are still relatively unusual.

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