I am frequently in conversations with women who tell me that their doctor would like them to have a blood test to check their hormone levels before confirming menopause.
You would think if you ticked 10-35 of the recognised symptoms of perimenopause that you could assume you were in the menopause transition. And in the majority of cases, doctors will confirm menopause by symptoms alone, especially for women 45 and over. This is because a blood test is generally not necessary to diagnose menopause.
To clarify, menopause is just one day - the day you haven't had a menstrual period in 12 months. And perimenopause are the years leading to that day, with up to 35 known symptoms - can't really miss them! 4 out 5 women will have noticeable perimenopausal symptoms and 1 in 5 will have milder to no obvious symptoms.Â
As the authors of a recent study noted, "The diagnosis of menopause is primarily based on clinical history and exclusion of other causes of amenorrhea." (Greendale et al., 2019)
As GP's continue to grapple with the whole "menopause conversation", it's not unusual that they would request a blood test before confirming your symptoms are signs of menopause. Mine did! While I knew I was in perimenopause for over four years before taking the plunge to request MHT (menopause hormone therapy), I used the opportunity to experience how women in New Zealand might access MHT if they feel they are a good candidate.Â
I went off for my blood test, on no particular day, and the results didn't show anything that would prove I was in perimenopause. So if I was having 28 symptoms, why would I have needed a blood test?
WHAT A BLOOD TEST CAN TELL YOU
With menopause, a blood test can tell you hormone levels of estradiol (oestrogen), testosterone and SHBG (sex hormone binding globulin)
Testing for estradiol with a view to diagnosing menopause is a challenge. Your estradiol levels change from day to day, and even at different times of the day. And during perimenopause, these fluctuations are even greater. So this is NOT a great test to diagnose menopause.
Follicle Stimulating Hormone (FSH) tests are used to check for menopause in younger women, usually under 45 years. This hormone can be elevated during menopause as it tries to get the ovaries to produce eggs "one more time". Again, the levels of FSH can fluctuate so it's difficult to confirm whether you are in menopause or not.
So in conclusion, if the hormone levels in the blood are "normal" at the time of the blood test, this can be a misleading result in confirming menopause. Diagnosis of perimenopause and menopause can be confirmed by evaluating a woman's symptoms alone, and a blood test isn't necessary in most cases. However, there are some situations where a blood test can be useful.
WHEN IS A BLOOD TEST A GOOD IDEA?
If a women is 45 years and younger and is experiencing symptoms similar to menopause, then a blood test can be used to check for a thyroid disorder as fluctuating oestrogen levels can impact thyroid function. Thyroid hormones are responsible for the bodies metabolism. Too much thyroid hormone and your metabolism speeds up and it's difficult to maintain weight. Too little thyroid hormone and your metabolism slows down causing weight gain, tiredness, constipation and depression.
To check for POI - Premature Ovarian Insufficiency - when your ovaries no longer produce normal amounts of oestrogen and slow down egg production.
And blood tests are used to diagnose PCOS (Polycystic Ovary Syndrome), Decreased Pituitary Function, Anorexia Nervosa, breast and ovarian cancers.Â
To confirm early menopause.
In summary, a blood test is generally not necessary to diagnose menopause, as the condition can be confirmed based on a woman's symptoms alone, especially for those over 45. While blood tests can provide some information about hormone levels, the fluctuations during perimenopause make them an unreliable diagnostic tool in most cases. The key is to listen to your body, track your symptoms, and work closely with your healthcare provider to determine if you are going through the menopausal transition. With the right support and treatment if needed, this natural process can be managed effectively. If you are exploring whether some of those strange changes are due to perimenopause symptoms, download the FREE Symptom Tracker and start to track your symptoms to discuss with your doctor. Ready to take the next step? Check out our Sexy Ageing Fitness app  for personalized workouts, nutrition guidance, and a supportive community to help you thrive during menopause and beyond.
Comments