Making your way through your forties and fifties will often have you in what feels like a constant state of anxiety, monitoring every little change in your body as a possible sign of the menopause. But while the most common symptoms women in their forties begin to see are changes in their menstrual cycle and well as the occurrence of hot flushes (hot flashes), many suspected symptoms of the menopause could actually be signs of completely unrelated conditions.

To relieve some of this anxiety, you may have looked into having a menopause test. These are tests that your GP or gynecologist can conduct to help determine if you’re beginning menopause. They monitor a wide range of stats, from blood to urine, checking different hormone levels including follicle-stimulating hormone (FSH), which is linked to menstruation and the menopause. To help you understand whether you might need to take a menopause test, we took a closer look into all of the different tests available and how they might help.

Do I need to take a menopause test?

For some women, the signs and symptoms of the menopause (hot flushes, night sweats, and irregular periods) speak for themselves, and it becomes very clear when they begin to enter this transitional stage. In these cases, resources like our Meno Guide and talking to your doctor might be enough to help you understand and track your menopause symptoms. Your doctor will likely recommend simpler physical examinations before blood tests, such as a vaginal swab to test your vaginal pH level. During the reproductive years, the average vaginal pH level is 4.5, but during the menopause it rises to around 6, and this is considered to be a fairly reliable indicator.4

However, women who report irregular periods, begin to experience signs of premature menopause at an earlier age than average (below 45), or enter into their late fifties without any signs at all, may particularly benefit from menopause testing. Below we explore each of the tests available so that you can better understand what they mean and how effective they are before speaking with your GP.

The follicle-stimulating hormone (FSH) level test

Follicle-stimulating hormone (FSH) can be used as an indicator for the menopause. As the hormone responsible for the growth of ovarian follicles, which in turn produce the oestrogen and progesterone necessary to sustain the menstrual cycle, it plays a key role in reproductive function. Typically, high levels of FSH indicate that a woman is experiencing the menopause.

The FSH test is a simple test which measures the level of FSH in your blood. Typically, your GP will conduct this test at a specific time of your menstrual cycle, usually within the first two days. For some women, high levels of FSH in the blood could be an indication of the menopause or perimenopause — but a single test alone will not be enough to gain an accurate indicator because hormone levels constantly fluctuate (particularly FSH and oestrogen levels during the perimenopause). On the other hand, for some women, a low FSH level may not eliminate the possibility that they are perimenopausal.1. As such, a number of FSH tests may need to be conducted alongside other assessments to be conclusive.

The thyroid function test

You may be wondering why you might need a thyroid function test when what you suspect is the menopause. The simple reason is that hypothyroidism (also known as an underactive thyroid) and menopause share some symptoms, and hypothyroidism is also most common in women who are middle-aged — the same age as they may begin to experience the menopause. In fact, if you do have hypothyroidism, it could also increase the risk of long-term complications during the menopause, so if your doctor suspects this is the case for you, it's best to have it checked.2

There are several different blood tests that doctors may recommend to check your thyroid function, starting with the TSH test which tests the concentration of thyroid-stimulating hormone (TSH) in your blood. With a hypothyroid diagnosis, you’ll be better able to work with your GP on a plan to manage your symptoms.

The Anti-Müllerian hormone (AMH) test

This test measures the level of anti-müllerian hormone (AMH) in the blood. In women AMH levels can provide information about fertility, the ability to get pregnant, and therefore the menopause. An AMH test is often used to check a woman's ability to produce eggs that can be fertilized for pregnancy. This number declines as a woman gets older and become less fertile. As such, a low reading from an AMH test can indicate that a woman has entered the menopause.

Unlike FSH levels which fluctuate with the menstrual cycle, AMH levels are relatively steadier and can be used to determine the extent of a woman's ovarian reserves. The AMH level test is not yet considered a fully conclusive menopause or perimenopause test, and is usually conducted alongside other tests.

Are blood tests for menopause accurate?

Blood tests for the menopause are not always 100% accurate — especially as FSH level testing is especially unreliable for women over the age of 45. Results can also often vary from person to person based on a number of factors including contraception, medical conditions and genetics. As such, it’s important to give your doctor a complete, detailed picture of your symptoms and well as your general health, medical history, and any contraceptive methods you use. With the correct information, your doctor will be better equipped to help you manage your symptoms.

Are home menopause test kits effective?

In recent years, many home testing kits have emerged that claim to help you determine whether you are entering the menopause or in perimenopause. Although these are usually urine tests or finger-prick style blood tests that measure your FSH levels, they are not considered by medical professionals to be very accurate.3 Some of these testing kits can also be quite expensive, so it’s a better idea to consult your doctor first rather than taking this route.

Work with your GP

When considering menopause testing, the most important thing to remember is to work alongside your GP. With the correct information, your doctor will be better equipped to help you manage your symptoms. In the meantime, to discover more advice on how you can better navigate your journey through the menopause, visit our Meno Guide and check out our other great resources.

References

1.Menopause Org., How do I know I’m in menopause? (2019). Available at: https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/how-do-i-know-i'm-in-menopause-

2.Healthline, Thyroid and the Menopause (2019). Available at: https://www.healthline.com/health/menopause/thyroid-and-menopause

3.WebMD, Home menopause testing kits (2017). Available at: https://www.webmd.com/menopause/guide/home-menopause-testing-kits

4. Healthline, Diagnosis and tests for menopause (2019). Available at: https://www.healthline.com/health/menopause/tests-diagnosis