What Does a Menopause Test Really Tell Us?

Women in their 40s often wonder if they are approaching menopause as changes begin to take place in their bodies. They may notice vaginal dryness during intercourse. Then they wake up one night soaking wet from night sweats. A woman may feel irritable, and wonder if it’s due to an imbalance of hormones. Then comes the month a period is skipped but pregnancy is ruled out. Is it menopause even though her doctor says she’s too young for it to happen?

Unlike the onset of menstruation, menopause does not occur in one fell swoop. It is a transitional period that typically spans years. Menopause is defined as the cessation of menstruation for twelve consecutive months, but women may experience symptoms for years before or after. It is entirely possible for women to be "a little" menopausal in their 40s, but also in their 30s and even in their 60s.

What a Menopause Test Measures

What about the blood or urine tests that can determine if women are menopausal? The menopause test a doctor performs and the ones available over the counter measure levels of follicle stimulating hormone (FSH) in the blood or urine. The problem is the presence of elevated FSH does not always indicate menopause!

FSH is released in response to low levels of estrogen. Certainly, a decline in estrogen is characteristic of menopause and so are high levels of FSH. But FSH is also normally elevated at various times throughout a woman’s regular menstrual cycle. Many factors influence FSH levels, and they can and do regularly fluctuate in response to many things.

The Ins and Outs of Menopause

It is not uncommon for women to have a period without ovulation. In this case, FSH levels would increase to stimulate ovulation, but menopause may have nothing to do with it. Women may also skip several periods, and after some positive lifestyle changes, resume normal menstruation. FSH levels would indicate menopause during the missed periods, but not afterwards once they resumed.

Furthermore, women may begin to experience symptoms of pre- or peri-menopause with no rise in FSH. Women can and typically do move "in and out of menopause" for years at a time since by nature, it is a transition. Of what value then is an FSH menopause test?

Testing may be helpful in the presence of severe symptoms as a way to rule out illness. But testing for the suspected culprit of symptoms to eliminate illness is probably a more direct approach than trying to test for menopause.

Some women just want to know whether or not they are experiencing the affects of menopause. The best approach in this case is for women to note changes and begin to record the occurrence of any symptoms. If symptoms are discomforting and consistent, women can and should discuss them with their doctor. Treatment for symptom relief can be as basic as lifestyle improvements. There need not be a cut and dry “diagnosis” of menopause for women to make changes to ease symptoms. Menopause is not an illness, and self-care requires no prescription.