Do you need a test to know if you are in perimenopause, or if you’ve reached menopause?
The short answer is, not usually
If you’ve gone more than a year without a period and you are in your late forties and beyond you would normally be considered to have reached menopause. If you have a bleed beyond this, the doctor will probably want to check that nothing else is going on.
You don’t need a doctor to tell you you are in perimenopause. They’ll probably say “Yes, you’re around that age, and weird things are happening, so it would seem so….” which is not telling you much you hadn’t already figured out.
I created a pack of mapping and tracking tools to allow you to build a visual representation of your symptoms which might help you figure it out. You can get that by clicking here.
I asked my doctors about getting a blood test to confirm perimenopause. I have two very good female doctors who both said pretty much the same. Firstly that it’s only a snapshot and secondly it’ll only tell us what you know from your symptoms.
Getting treatment for perimenopause
The guidelines in the UK state that perimenopause is diagnosed through symptoms and it would be unusual for you to be tested.
HRT or other treatments should be prescribed on the basis of symptoms. The mapping and tracking pack includes a tick list you can take to your doctor.
The exception to this is that if you don’t have periods for some reason, you may need a test to let you know you’re in full menopause. Those reasons might include using a method of contraception that stops your periods such as the Mirena coil, having had an ablation or a hysterectomy.
These tests won’t reliably show whether you are in perimenopause, but they can confirm that you are in full menopause.
Tests like this measure your levels of follicle stimulating hormone (FSH). In the menstrual cycle this hormones makes your egg follicle (the cup that the egg pops out of) mature and release the egg. Once it’s done it’s job, it shrinks and produces progesterone and switches off the production of FSH. So if your oestrogen’s not there to help ripen the egg and get it to pop out, there won’t be a left over egg follicle to produce progesterone and so FSH production won’t switch off. So as your oestrogen and progesterone levels drop your FSH levels rise. If you are interested in this stuff, then I love the You and Your Hormones website. (And if you aren’t you really can skip this bit!).
You can buy your own tests to test your FSH levels
Some of them are expensive, some not so much. I got one for a couple of quid from Wilko.
The small print will say something like this:
“Your hormones do change as you start to go through the perimenopause. However, as you go through the perimenopause your FSH levels can go up and down dramatically. Sometimes, your FSH can even drop back to levels which are normally seen in non-menopausal women.
So, the menopause test kit is less reliable if you think you might be going through the perimenopause. A single blood test isn’t enough to know for sure, so a doctor would normally take a lot of other factors into consideration.
If you get a negative test result but you are having menopause symptoms, it could be a sign of perimenopause.”
So, in other words, the test only gives a snapshot of something which may be changing — and you still have to consider that test alongside any symptoms. It might confirm menopause but probably only after you’ve figured it out for yourself.
Additionally, you can have low FSH levels and lots of symptoms and high FSH levels and hardly any symptoms. And it’s the symptoms that you are going to need to manage, with or without your doctor’s help.
Personally, I’d spend my money on lube and fans, but that’s up to you!
An additional note
Be aware that many of the practitioner offering hormone testing (and usually hormone balancing alongside it) are using methods of testing that are shown to be unreliable. Here’s Abby Langer on one such methodology, the DUTCH test.
Track and record your symptoms
It makes much more sense to notice and track your symptoms. Here’s my tracker again!