I regularly see women in my clinic asking for a ‘menopause test’. Or, even worse, women who have had a test and told they can’t possibly be menopausal because their blood tests are normal.
For most women, menopause occurs after the age of 45, with the average age being 51. Blood tests in this group of women are not required to diagnose menopause or menopausal symptoms. In fact, during the perimenopausal phase, blood tests can often vary significantly from one day to the next, and as a result can often be falsely interpreted.
The FSH (follicle stimulating hormone) test is what is usually being performed to ‘diagnose’ menopause. It starts to rise during the perimenopause as ovarian function starts to decline, in a bid to keep the ovaries ovulating. However, this rise does not follow a nice gradual pattern – there are often significant peaks and troughs, which means blood test results can often vary. One high reading does not necessarily mean you are post menopause, and, likewise, a low reading does not mean things are not changing.
As the results can be so difficult to interpret, the NICE guidelines do not recommend its use in the diagnosis of menopause in women over 45 years. The test may have a role in some situations (eg when a woman does not have periods for other reasons – eg contraception or previous hysterectomy), and it is still an important test for women who may be going through premature menopause. However, for the majority of women, diagnosing menopause should be based on their symptoms.
Interestingly, it has been estimated by NICE that unnecessary FSH testing in women over 45 years costs the NHS £9.6million! So, don’t ask your GP to do a menopause blood test just to check – it might not give you the right answer!