Is it menopause? Tests and diagnosis
Until her hormone levels are better adjusted, a woman can experience a variety of symptoms associated with menopause. Because menopause symptoms can be varied, a woman may wonder whether what she is going through is menopause or another condition.
Currently, no single test for menopause is definitive to predict that a woman is going through menopause. However, doctors can perform several different types of tests to work out whether a woman's symptoms are most likely related to menopause or a sign of something else.
There are some symptoms associated with menopause. A doctor may perform several tests to work out if they are caused by menopause or something else.
Over time, a woman's ovaries will produce less of these hormones, giving rise to the symptoms of menopause. This tends to happen slowly over several years and is not usually something that happens all at once.
Symptoms associated with menopause include:
- difficulty sleeping
- dry skin
- loss of breast fullness
- mood swings
- night sweats
- thinning hair
- vaginal dryness
- weight gain
- hot flashes, during which women experience a severe and overwhelming sensation of heat
These symptoms can be similar to those caused by several other health conditions, including depression and low thyroid functioning.
If a woman is going through these symptoms and is uncertain if her condition is menopause, she may wish to consult her doctor for tests.
How does a doctor diagnose menopause?
As menopause causes a reduction in the amount of hormones a woman's body produces, a common misconception surrounding menopause testing is that a doctor can use hormone testing to determine whether or not a woman is in menopause.
However, a woman's hormone levels are constantly rising and falling. A doctor could order hormone tests that are taken when her hormones are at a low point in her ovulation cycle.
For this reason, a doctor will often recommend performing a number of tests at various times to determine if a woman may be going through menopause.
An estradiol test is a blood test that measures the main form of estrogen in the body.
The most common tests for menopause are:
- Anti-mullerian hormone (AMH): AMH is a hormone released by ovarian follicles. Doctors consider it a measure of how many follicles a woman may have left given the amount of hormones released.
- Estradiol: Estradiol is the main form of estrogen circulating in the body when a woman is premenopausal. Estradiol levels fall by as much as 10 times their premenopausal level to below 30 picograms per milliliter. If a woman's estradiol levels are consistently low, this could be a sign that she is in menopause.
- Follicle-stimulating hormone (FSH): FSH is a hormone released by the brain that goes to the ovaries to stimulate follicle production, which in turn results in the release of an egg during ovulation. As menopause causes the ovaries to ignore FSH, the body will have a higher level of FSH compared with a premenopausal woman.
- Thyroid function tests: Because menopause can closely mirror an underperforming thyroid, a doctor may recommend thyroid function tests to determine how well the gland is working. If thyroid hormone levels are low, this could suggest that thyroid concerns are behind the symptoms.
While positive tests could signal menopause, negative tests do not mean that a woman is definitely not in menopause, due to continually changing hormone levels. More testing may be needed to work out the potential cause.
What is 'early menopause?'
While many women may experience menopause in their 40s and 50s, some women go through it much earlier. When menopause occurs before age 40, doctors call it early menopause, or premature menopause.
There are several potential reasons for a woman to experience early menopause. These include:
- Chemotherapy or other cancer treatments, which can damage the ovaries and affect hormone production.
- Surgical removal of the ovaries, which is known as an oophorectomy.
- Surgical removal of the uterus, known as a hysterectomy. While this surgery does not remove the ovaries, a woman may have some menopausal symptoms due to changes in blood supply to the ovaries.
- Chromosome defects, which cause a person to have ovaries that do not function as expected.
- Genetic history, as some women have a family history of early menopause.
- Autoimmune diseases, such as thyroid disease or rheumatoid arthritis.
Early menopause is not life-threatening, but it can be a concern for some women. If a woman was hoping to conceive without assistance, she would be unable to because she no longer ovulates.
While a doctor may not be able to reverse early menopause, they can prescribe treatments such as hormone replacement therapy. However, there are risks associated with hormone replacement therapy that are important for a woman to consider.
Living with menopause symptoms
Some women with menopause do not choose to pursue any medical treatment when they experience it. However, some women have severe symptoms that affect their quality of life, such as severe hot flashes.
Hormone replacement therapy pills may be prescribed by a healthcare professional for women with menopause.
Examples of some medical treatments available for menopause include:
- Hormone replacement therapy, such as taking estrogen therapy at the lowest, most effective dose.
- Vaginal estrogen, which is applied directly to the vaginal tissues to reduce dryness.
- Medications known as selective serotonin reuptake inhibitors, which can reduce the incidence of hot flashes in some postmenopausal women. The medication gabapentin (Neurontin) can also help to reduce hot flashes in women who cannot take estrogen.
In addition to medical treatments, there are many at-home treatments that a woman can use to reduce symptoms whenever possible. These include:
- Avoiding triggers known to contribute to or worsen hot flashes. Examples can include caffeine, eating spicy foods, drinking hot beverages, being in hot weather, or keeping rooms too warm.
- Using water-based vaginal lubricants during sexual activity to reduce discomfort due to thinning tissues.
- Practicing stress-relieving techniques. Examples can include deep breathing, meditation, journaling, massage, guided imagery, or progressive relaxation.
- Refraining from smoking. Smoking can increase the risk of hot flashes and contributes to many other health issues.
- Exercising regularly. Exercising can relieve stress as well as help to build up strong bones and muscles.
Women may also consider trying herbs or other dietary supplements as a means to reduce the incidence of menopause symptoms. Examples include black cohosh, red clover, wild yam, or kava.
However, there is no scientific evidence that suggests these herbs are effective in reducing the symptoms associated with menopause.
In addition, herbs and supplements are not regulated by the United States Food and Drug Administration (FDA). People should always discuss herbs and supplements with their doctor before using them.