What are the Usual tests for Perimenopause?
Tests for perimenopause and menopause can involve a combination of clinical evaluation, symptom assessment, and, in some cases, laboratory tests.
It’s important to note that the diagnosis of perimenopause and menopause is often based on a combination of symptoms, age, and laboratory test results. Hormone levels can vary, and there is no single definitive test for menopause. Additionally, testing may not be necessary in cases where symptoms are clear, and a woman is within the typical age range for menopause.
Clinical Evaluation
If you are experiencing symptoms of perimenopause or menopause you can consult your GP to discuss symptoms, discuss whether menopause testing is appropriate, and explore options for managing symptoms and optimising overall health during this life stage.
A doctor will conduct a thorough medical history and physical examination. Assessing symptoms such as irregular periods, hot flushes, and mood changes can contribute to the diagnosis.
Hormone-based Tests for Perimenopause
Follicle-Stimulating Hormone (FSH) Blood Tests
FSH levels often rise during perimenopause and menopause. A blood test measuring FSH levels can be indicative of the hormonal changes associated with the transition.
FSH is a hormone released by the pituitary gland that stimulates the ovaries to produce estrogen and develop eggs during the menstrual cycle. As a woman enters perimenopause and menopause, the ovaries become less responsive to FSH, leading to an increase in FSH levels. Elevated FSH levels are indicative of the hormonal changes associated with the transition to menopause.
Measuring FSH levels helps assess the status of ovarian function and the overall hormonal milieu. An elevated FSH level, especially when accompanied by symptoms like irregular periods, can support the diagnosis of perimenopause or menopause.
This test is not usually necessary and isn’t recommended on the NHS. It may be used in suspected cases of premature menopause, however.
Estradiol Level Blood Tests for Perimenopause
Estradiol is a form of estrogen. A decline in estradiol levels is common during menopause. Blood tests measuring estradiol levels can provide insight into the hormonal changes occurring in the body.
Estradiol is the most potent form of estrogen and plays a crucial role in regulating the menstrual cycle and maintaining reproductive tissues. The decline in ovarian function during menopause leads to a decrease in estradiol production. Monitoring estradiol levels through blood tests provides insight into the hormonal changes occurring in the body during this transition.
Estradiol levels are a key indicator of the decline in estrogen production, which contributes to the symptoms and physiological changes associated with menopause. This test for perimenopause helps confirm hormonal changes and supports the overall diagnosis.
Anti-Mullerian Hormone (AMH) Blood Tests
This test for perimenopause measures the level of AMH, which is produced by the ovaries. AMH levels can give an indication of ovarian reserve and may be used to assess reproductive aging.
AMH is produced by the ovaries and reflects ovarian reserve, which refers to the number and quality of a woman’s remaining eggs. As a woman approaches menopause, ovarian reserve diminishes, leading to a decline in AMH levels.
The AMH test provides information about a woman’s reproductive aging and the remaining capacity of the ovaries to produce eggs. While not a direct marker for menopause, a low AMH level may indicate a decreased ovarian reserve, contributing to the overall assessment of reproductive health.
Common health tests during Perimenopause
Thyroid Function Tests in Perimenopause
Thyroid dysfunction can sometimes mimic symptoms of menopause. Overlapping symptoms can include tiredness, weight gain, thinning hair and irregular periods.
Testing thyroid hormones, including TSH (Thyroid-Stimulating Hormone), T3, and T4, can help rule out thyroid-related causes of symptoms.
Lipid Profile Tests in Perimenopause
Menopausal hormonal changes can affect lipid metabolism. A lipid profile test measures your cholesterol levels and triglycerides, providing information about cardiovascular health.
Menopausal women may experience changes in lipid metabolism, including an increase in total cholesterol, low-density lipoprotein cholesterol (LDL or “bad” cholesterol), and triglycerides. These changes can contribute to an increased risk of cardiovascular disease. Before menopause, estrogen has a protective effect on the cardiovascular system. It tends to increase high-density lipoprotein cholesterol (HDL or “good” cholesterol) levels and improve the overall lipid profile. However, as estrogen levels decline during menopause, these protective effects may diminish.
Aging itself can also lead to changes in lipid levels, and menopausal women may also experience lifestyle changes that can impact cardiovascular health, such as decreased physical activity and changes in dietary habits.
Bone Density Test (Dual-Energy X-ray Absorptiometry or DXA scan)
Postmenopausal women are at an increased risk of osteoporosis. Bone density testing can assess bone health and the risk of fractures. This is an important test for most post-menopausal women.
It’s important to support your bone density with a calcium supplement (unless you consume plenty of dairy products every day) and a good level of vitamin D to boost calcium absorption, and vitamin K and the mineral boron, which help to deposit the calcium correctly into your bones.
