Diagnosing Menopause

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Menopause is usually diagnosed in retrospect – once it has been 12 months since your last period, you have gone through menopause.

In order to determine whether you have actually achieved menopause, or if there is some question about whether you have, there are three ways your doctor may make a diagnosis of menopause.

Medical History

If you are having, or have had, symptoms of menopause you may be diagnosed as menopausal or in "perimenopause."

Menstrual History

If you have not had a menstrual period for 12 months, and there are no diseases or conditions that would cause you to stop having periods, then the diagnosis is menopause.

Lab Tests

When there is a question about whether you have gone through menopause, your doctor may order lab tests to check the levels of certain hormones, and confirm the diagnosis. There are several lab tests they may run:

  • Follicle Stimulating Hormone (FSH) – which rises dramatically after menopause

  • Estradiol – an estrogen which decreases during and following menopause

  • Thyroid Stimulating Hormone (TSH) – because thyroid disease can mimic the symptoms of menopause

There are home lab kits to measure FSH in your urine. They are usually consistent with lab tests that measure FSH in the blood, but even if FSH is high according to the home kit, it is not certain that you have stopped menstruating. FSH levels can vary during menopause, and while it may be high on the day you measure it, it is not a guarantee that you have stopped menstruating completely.

Diagnosing menopause is almost always done in hindsight, after you have been without a period for 12 months. Lab tests are ordered in unusual cases where having a definitive diagnosis is important for other medical reasons.

Sources:

North American Menopause Society, (NAMS), Menopause Guidebook: Helping Women Make Informed Healthcare Decisions Around Menopause and Beyond, 6th Edition , North American Menopause Society, 2006. 10 Oct. 2007.

Randolph,J, et al, "The Value of Follicle-Stimulating Hormone Concentration and Clinical Findings as Markers of the Late Menopausal Transition,"Journal of Clinical Endocrinology & Metabolism, Vol. 91, No. 8 3034-3040, Aug. 2006. 10 Oct. 2007.

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