Menopause is a natural phenomenon in women where their menstrual cycles finally end. The timeframe for menopause in most women is from 45-55 years of age. In the United States, the average age is 51 years. There are exceptions as well. Women experiencing menopause when they are 40-45 years old are in early menopause. Menopause occurring before 40 is premature menopause.
Menopause doesn’t occur right away. It is a long process and begins with perimenopause. Perimenopause, also known as the menopause transition phase, mostly starts when a woman is 40-44. But, it can occur when a woman is in her early 30s or mid-50s as well.
When you have not had your periods for 12 months continuously, it is then that you enter the menopause stage.
It’s we who can tell the best about any changes in our health. But is there any way to confirm through diagnostic tests that menopause has begun? Read on to know more.
How to Tell You Are in the Phase Around Menopause (Perimenopause)?
Well, even before you head to the doctor, your bodily changes and symptoms will give you a hint that things are not the way they should be. The theory is that as you enter your 40s and go through the perimenopause phase, your estrogen levels will act a little weird. There’s a decline in its levels. However, the fluctuations do not happen regularly or consistently.
You may feel the effect on your menstrual cycle. It will be inconsistent. In some months, you’ll bleed heavily. While in some cycles, the bleeding could be scanty. You might even go without periods for a couple of cycles.
If your menstrual cycle is preponed or postponed by about seven days, you could be in your early perimenopause. Whereas, if the gap between your periods is 60 days or greater than that, then late perimenopause has set in.
You may even start experiencing hot flashes marked by a feeling of warmth on the chest, face, and neck. The reason for the same is the reduced estrogen levels as well. True that you may encounter episodes of hot flashes in perimenopause. But the intensity and frequency are lesser than what you may experience in menopause.
You could even find yourself more prone to vaginal infections and urinary incontinence. Blame it again on the low estrogen levels. You’ll eventually begin experiencing low fertility levels. So planning a family then could be pretty challenging, not impossible, though. You may even experience bone loss, skin changes, hair thinning, low mood, lack of sleep, weight gain, etc.
Before you stress, you may not experience all of these symptoms together. The intensity and occurrences vary from one woman to the other. For instance, some women may struggle to deal with urinary problems, while a few may be troubled with irregular menses.
As you start getting close to the menopause phase, the frequency of your periods lessens. You could go for months without periods. When you have not had your periods continuously for twelve whole months, that means menopause has started.
Now that is the way you can detect that you have entered into the menopause phase. But that isn’t enough. You need to know whether all the changes you have encountered are because of menopause or if there is any other reason behind the same. In the following section, let us take a look at the ways or rather tests that may help in determining or confirming menopause.
Tests to Determine Menopause: Are They Any?
In most cases, menopause may be diagnosed through the symptoms themselves without any formal tests. However, if you are going through bothersome symptoms that come in the way of your daily living, it is always advisable to speak to a healthcare provider. He will ask you several questions to conclude. These will include:
- Your age
- Your symptoms
- Details about your menstrual cycle (the flow, the irregularity of your periods)
- Any underlying health conditions
- The supplements or medications you take (if any)
Based on your answers, your doctor will evaluate your condition. He may even advise some bloodwork. This is to rule out the fact that the symptoms are because of menopause and not other medical conditions.
1. Vaginal Swab
Your healthcare provider may do a swab test of your vagina to check the pH levels. In the reproductive years, the pH level of your vagina is between 4.0 and 4.5. As you near menopause, the levels may rise to 6.0 or as much as 7.5.
However, it is important to know that there are other reasons for an elevated vaginal pH level. Bacterial vaginosis is one of them. It happens when there is an increased bacterial infestation in the vagina. If that’s the case, then you may experience other symptoms also. These include burning, vaginal pain, itching, white discharge, etc.
If a bacterial infection isn’t the reason, it could be due to menopause, especially if you have reached menopausal age.
2. FSH (Follicle Stimulating Hormone)Test
This is one of the significant ways to determine menopause. Follicle-stimulating hormones play a significant role in a woman’s menstrual cycle. It even helps in stimulating the egg’s growth in the ovary. FSH plays a significant role in men as well. It helps in controlling sperm production. Here is a detailed analysis of the FSH levels in women in different stages of their life.
|Before puberty||0 - 4.0 mIU/mL|
|During puberty||0.3 - 10.0 mIU/mL|
|After puberty (in menstruating women)||4.7 - 21.5 mIU/mL|
|In menopause||25.8 - 134.8 mIU/mL|
So from this table, it is quite clear that menopause leads to high levels of FSH. So, if you have not had your periods for 12 months, you can get your FSH checked if the doctor advises of the same. When the hormone levels are consistently high, and there are no periods as well, then it could mean that menopause has set in. However, the results of FSH could be misleading in perimenopause. This is because of the fluctuating hormone levels.
3. Estradiol Tests
If your menses have paused, and you experience other menopausal symptoms, then your doctor might also advise you to take a test to check the estradiol levels (E2). If you are in the menopause transition phase or already in menopause, then under such circumstances, your body will have low estradiol levels.
This test even helps in understanding how well your ovaries are working. So if you are below 40, and your periods have stopped, an estradiol test might help determine if you have a tumor in your ovaries or not. It could even be a case of premature menopause, which happens before the age of 40.
For women who are still menstruating, their estimated estradiol levels are 15-350 pg/mL. For women who have already had menopause and are in the postmenopause phase, the levels could be as low as 10 pg/m.
4. AMH (Anti-Müllerian Hormone) Test
One of the basic purposes of the AMH test is to check the number of eggs the ovaries have. If you are in the menopause transition (perimenopause) stage or have already hit the menopause phase, then the egg supply declines. A reduction in eggs in your ovaries means a dip in the AMH levels.
If you are less than 40 or 45 and aren’t having your periods anymore, then AMH may help detect if you are having premature or early menopause. Based on this test, your doctor may even prescribe other tests to check for any underlying conditions.
5. Luteinizing Hormone (LH) Test
The pituitary gland produces the luteinizing hormones. They play a significant role in maintaining the reproductive system of the body. When LH levels are excessively high, it could indicate that you are in the menopause phase.
If you are above 45 and have all the symptoms of menopause alongside stopped periods, then the LH levels test, alongside other tests, could mean that menopause has begun. Let’s take a look at how the LH hormones in women should be in different stages.
|Menstrual cycle (Follicular phase)||1.68 - 15 IU/mL|
|Menstrual cycle (Mid-cycle phase)||21.9 - 56.6 IU/mL|
|Menstrual cycle (Luteal phase)||0.61- 16.3 IU/mL|
|Postmenopause stage||14.2 - 52.3 IU/mL|
High LH levels also indicate other conditions, like polycystic ovary syndrome or pituitary disorder.
6. Progesterone Levels Test
Besides estrogen, progesterone is another significant hormone responsible for reproduction and menopause as well. In the perimenopause phase, there is a fluctuation in estrogen and progesterone levels.
As menopause means that you aren’t ovulating anymore, it will lead to a drop in your progesterone levels. In menopausal women, the progesterone levels are around 0.20 ng/mL. It could be even lesser than this.
7. Thyroid Stimulating Hormone (TSH) Test
No, this isn’t a test for menopause. Rather it helps to determine if the symptoms you are experiencing are because of menopause or thyroid problems. Certain symptoms of hypothyroidism can mimic the signs of menopause, including hot flashes, insomnia, palpitations, weight gain, concentration problems, sleep problems, etc.
So to rule out that your irregular periods and the associated symptoms aren’t because of thyroid problems, your doctor may ask you to test the TSH levels.
For the estradiol levels, a urine or blood sample is needed if doing it at the doctor’s place. But, if doing it at home, a saliva sample is needed. To test the FSH levels in a laboratory blood sample is required. If doing it at home, a urine sample would suffice. The AMH and LH levels test also needs a blood sample. When testing the LH levels at home, you can do the same with a urine sample.
Suppose you are being bothered by the symptoms and also haven’t had periods for quite long, close to a year. Then, doing a test at home would give you an insight into the status of your hormone levels.
You could check your FSH, LH, and estradiol levels at home. However, the home tests may not determine if you are in the menopause transition phase or the menopause stage. To get confirmation about the same, you will have to visit the doctor. Also, the healthcare provider will be able to determine if the symptoms you are facing are due to menopause or any underlying health issues. Even if you do tests at home, it is essential to go to the doctor to get a confirmation.
Yes, the tests to detect premature or early menopause are the same as the ones to identify perimenopause and menopause. Your doctor will advise bloodwork to test your FSH levels, estradiol, and LH hormones. He may even advise a test to check your sugar and thyroid levels. This is to ensure that the symptoms aren’t happening due to other underlying conditions.
If you have already had menopause, it is extremely important to get yourself checked from time to time. Some of the screening tests that are mandated to be done include:
Mammogram (to detect breast tumors)
Bone density test
Pap smear (to determine cervical cancer)
Colonoscopy (for colon cancer)
Tests for blood sugar and cholesterol
Blood pressure monitoring
Blood tests are mostly done to validate the fact that the bodily changes you are undergoing, alongside the irregular periods, are pointing towards menopause. However, the tests would yield better results when your periods have stopped completely for a year. If you are in the perimenopause stage, where your hormones keep fluctuating every other day, the test results may not be accurate.
If your body condition and the tests confirm that you are in your menopause, then you must take extra care of yourself. Follow a proper diet, exercise regularly, and take care of your emotional well-being.
Menopause doesn’t have a treatment. But, you could consult the doctor to manage symptoms like anxiety, hot flashes, sleep problems, etc. He may also prescribe medications if you find it troublesome to deal with them.