Are You in Menopause?

What lab tests can (and can’t) tell you about how close you are to menopause.

Rebecca Adler Warren
Photograph: Photo by: iStockphoto

As the first group of women in history to take control of our reproductive lives — from confirming pregnancy (home pregnancy tests) to achieving it (fertility tests, IVF) and checking on its progress (ultrasounds, CVS, amniocentesis) — we’re accustomed to turning to medical tests for answers. Can tests guide us through menopause too? Machelle Seibel, MD, an ob-gyn professor at the University of Massachusetts School of Medicine, weighs in.

Do you need a test to show you’re running low on eggs?

Most home urine tests measure levels of follicle stimulating hormone, which is secreted by the pituitary gland to help eggs develop before ovulation. "As you start to run out of eggs, FSH elevates to encourage a response," Seibel explains. "A high level of FSH can indicate the probability of perimenopause." But what does that really tell you? "Not much," Seibel says. "It means only that you’re on the eight-to-10-year path to menopause." Most women reach for a kit because they’re experiencing symptoms, such as irregular periods or night sweats—but those symptoms are as good an indicator as any test result.

The best "test" for menopause has nothing to do with a blood or urine analysis.

"Menopause is defined as the absence of periods for 12 months, so it’s a diagnosis that’s made based on your history, and it’s made with hindsight," Seibel says. "You don’t say a woman is menopausal until she’s gone for a year without a period." The single exception: Women under 40 who experience menopause-like symptoms may have premature ovarian failure and can benefit greatly from a blood test and other diagnostic procedures as well as prompt medical treatment.

The menopause tests you do need.

Once you’re having symptoms—hot flashes, vaginal dryness, night sweats, sleep disturbances—schedule a complete blood workup, including a cholesterol screen (LDL or "bad" levels rise as estrogen declines, increasing your risk for heart disease), as well as a bone density scan. "A 50-year-old woman has the same likelihood of dying from the complications of osteoporosis as she does from breast cancer," Seibel says. Also schedule a colonoscopy. Colon cancer, which is more of a life threat to menopausal women than breast cancer, is preventable if doctors find a precancerous polyp, Seibel says. 

Originally published in More magazine, December 2005 / January 2006. Updated July 2009.

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