What Is Menopause?

Menopause is the time in a woman’s life when her normal menstrual periods have stopped for at least 12 months and she can no longer become pregnant. Usually, menopause is a gradual transition, beginning with a stage called perimenopause between the ages of 45 and 55. Menopause may also be triggered earlier in a woman’s life due to health conditions or medical procedures that affect the body’s production of or response to important hormones.

Before menopause, a woman’s hormones work together to release an egg from the ovaries and either regulate the monthly menstrual period or support the beginning of a pregnancy. During perimenopause, women begin to experience hormonal fluctuations. These hormonal fluctuations cause irregular menstrual periods and other symptoms of perimenopause including hot flashes, sleep problems, and vaginal changes.

The Role of Menopause Tests

Menopause testing is used to determine if a patient’s symptoms are part of menopause or related to another condition. Symptoms related to menopause include:

  • Irregular menstrual periods
  • Hot flashes
  • Sleep problems
  • Vaginal dryness, irritation, or discharge
  • Mood swings
  • Trouble concentrating

In evaluating the cause of these symptoms, a doctor may ask about a patient’s age, symptoms, and family history. In around 75% of women, symptoms of perimenopause begin during the expected age range and doctors can diagnose menopause without laboratory testing. Menopause is confirmed after a woman has had no menstrual period for 12 months.

However, menopause testing is often ordered when the cause of symptoms is not clear. For example, menopause testing may be used for women who have had a hysterectomy, women who begin to have symptoms of menopause several years before age 50, or when a woman experiences abnormal symptoms suggestive of menopause.

Types of Menopause Tests

As women age, the ovaries become less responsive to follicle-stimulating hormone (FSH) and luteinizing hormone (LH), two hormones important for ovulation and regulating menstrual periods. In response, the ovaries stop producing estrogen and progesterone, causing estrogen levels in the body to decrease and FSH levels to increase.

When testing for menopause is warranted, doctors may order an FSH test to detect elevated levels of FSH in the blood. Measuring FSH can help determine if a woman is perimenopausal or has already gone through menopause.

Because FSH levels naturally fluctuate each month to stimulate ovulation, results of FSH testing should be interpreted with caution and may be misleading. Rather than interpreting a single FSH test result, consistently elevated levels over time are used to confirm menopause.

Additional tests that may be ordered to help a doctor diagnose menopause include:

Other conditions can cause irregular menstruation or can stop it completely. In some cases, doctors will perform testing to determine whether something other than menopause is affecting menstruation:

Getting Menopause Testing

Menopause testing usually takes place in a doctor’s office, laboratory, or hospital. Most tests for menopause involve a blood sample that is drawn from your arm using a needle.

Anyone with symptoms of perimenopause should talk with their doctor to determine if menopause testing is appropriate in their case.

At-home testing

At-home test kits are available that can analyze hormones that may be relevant to menopause, such as the following:

  • At-home FSH testing: At-home FSH tests detect elevated levels of FSH in a urine sample. However, this test cannot definitely diagnose menopause. At-home kits may be less accurate than a laboratory test for FSH.
  • At-home estrogen testing: At-home estrogen testing measures the levels of three types of estrogens in a saliva sample: estrone, estradiol, and estriol. Estradiol levels may be used to help determine menopausal status but must be interpreted with the help of a doctor.
  • At-home luteinizing hormone test: At-home luteinizing hormone tests measure levels of luteinizing hormone in a urine sample. This home test may be used to detect ovulation, but is not commonly used to detect menopause.

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