How will I know if I am in the Menopause?

How can you tell if you're nearing menopause, or are already past it? Is there a simple hormone test?

During perimenopause, hormone tests are generally not helpful because hormone levels change throughout the menstrual cycle. Sometimes testing is done to check specific hormone levels, especially to evaluate fertility problems or when periods stop at an early age. This can help women make decisions about beginning or adjusting treatment. For some women, it may make sense to test for other causes of symptoms that can mimic perimenopause, such as thyroid disease.

What about saliva testing?

Some clinicians recommend testing a woman’s saliva for estrogen or other hormone levels. But salivary hormone levels are expensive, are not accurate, and should not be used to evaluate or treat menopausal symptoms.

What about follicle-stimulating hormone testing?

Sometimes, elevated follicle-stimulating hormone (FSH) levels are measured to confirm menopause. When a woman’s FSH blood level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year, it is generally accepted that she has reached menopause.

However, a single FSH level can be misleading in perimenopause since estrogen production does not fall at a steady rate from day to day. Instead, both estrogen and FSH levels can vary greatly during perimenopause. One elevated FSH level is not enough to confirm menopause. More importantly, a low FSH level in a woman who is having hot flashes and changing periods does not eliminate the likelihood that she is still in perimenopause. Also, if a woman is using certain hormone therapies (such as birth control pills), an FSH test is not valid. Over-the-counter urine tests for menopause that measure FSH are often advertised, but are expensive and not informative, for the same reasons discussed above.

The bottom line

When a woman suspects she’s in perimenopause, it is an excellent time to have a complete medical examination by a qualified health professional. The diagnosis of perimenopause can usually be made by reviewing a woman’s medical history, her menstrual history, and her signs and symptoms. 

The most common symptoms women in their 40s notice are changes in periods and the onset of hot flashes. Menopause is defined as 12 months without a menstrual bleed, in the absence of other conditions. To date, there is no simple test to predict or confirm menopause or perimenopause, but research continues. So, check your menstrual calendar and seek your health providers' opinions.

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Perimenopause & Premature Menopause FAQs
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