Women who suspect they are experiencing perimenopause should have a complete medical examination by a qualified professional. The diagnosis of perimenopause can usually be made by reviewing a woman’s medical history. The most common symptoms women notice are changes in menstrual periods and the onset of hot flashes. Menopause is confirmed when a woman has had no menstrual bleeding for 12 consecutive months.
In most cases, hormone tests aren’t reliable because in menstruating women, hormone levels are changing all the time. However, in younger women when menstrual irregularity is infrequently a sign of menopause, hormone testing may be more valuable to confirm that menopause has indeed occurred. Sometimes testing is done to check specific hormone levels, especially when fertility is an issue. 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 mimic perimenopause, such as thyroid disease.
Sometimes, elevated follicle-stimulating hormone (FSH) levels are used to confirm menopause. FSH is a hormone produced by the pituitary gland that triggers the ovaries to secrete estrogen. As the ovaries’ production of estrogen declines, the pituitary gland tries to stimulate estrogen production by releasing more FSH into the blood. When a woman’s FSH blood level is consistently elevated to 30 mIU/mL or higher, and she is no longer having menstrual periods, it is generally accepted that she has reached menopause.
However, a single FSH level can be misleading in perimenopause since estrogen production doesn’t fall at a steady rate from day to day. Instead, both estrogen and FSH levels fluctuate from fairly high to fairly low during perimenopause. Therefore, one test with an elevated FSH level is not usually enough to confirm menopause. More important, a low FSH in a woman who is having hot flashes and changing periods does not eliminate the likelihood of perimenopause. Also, if a woman is using certain hormone therapies (such as birth control pills), an FSH test isn’t valid.
Some healthcare practitioners recommend testing a woman’s saliva for estrogen levels. There is no conclusive evidence that this test provides accurate information around menopause.
Why Testing is Important?
Whether you visit with your doctor or self-test at home, it is always important to get an accurate picture of what is going on with your body. It can be frustrating to have to deal with symptoms like hot flashes and insomnia and not know why they are happening. Getting a test done to measure your hormone levels could provide you with an explanation for all those uncomfortable symptoms.
Getting tested will also help prepare you for changes that your body may be beginning to experience. Aging is associated with various health issues, including osteoporosis, heart disease, and infertility. By getting your hormones tested you may be able to get on top of these issues sooner, decreasing your chances of having to face a serious illness. Testing for menopause is also a way that you can take control of your body and your health.
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