How is menopause diagnosed?

Charla Simon
OBGYN (Obstetrics & Gynecology)

Menopause is defined as one year with no uterine bleeding, so is often a diagnosis made retrospectively.

Some common symptoms of women who are transitioning to menopause are cessation of or irregular periods, hot flashes, temperature instability, night sweats, difficulty sleeping, hair loss, changes in fat distribution, and vaginal dryness although many women have minimal or no symptoms aside from periods stopping.

If you are having symptoms of irregular periods or any of the above it is a good idea to have thyroid disorders ruled out and discuss any irregular bleeding with a physician.

There is no specific blood test that can make the diagnosis of menopause, however the fsh test can be used to ascertain fertility and rises dramatically at menopause. If a woman is having symptoms consistent with menopause and thyroid disorder has been excluded, a high fsh gives strong support to the diagnosis.

Patricia Geraghty, NP
Women's Health
Menopause is one year without vaginal bleeding. However, what a woman usually wants to know, while experiencing the changes in her cycles as she approaches that last period is "when will the last bleeding occur?" Just this year an updated study trying to answer that question was published, the STRAW10. They looked at all the various blood tests, hormone measurements, ultrasounds, and examinations available. What was the only reliable predictor of all the methods studied? When a woman goes more than 60 days between menstrual periods, her very last menstrual period will occur within the next 12 to 36 months.
Marjorie Nolan Cohn
Nutrition & Dietetics

Symptoms vary from woman to woman. They may last 5 or more years. Some women may have worse symptoms than others. Symptoms of surgical menopause can be more severe and start more suddenly.

The first thing most women notice is that periods start to change. They become irregular and might occur more or less often. Irregular periods can last for 1 - 3 years before the periods completely stop.

Symptoms of menopause include:

  • Menstrual periods that occur less often and eventually stop
  • Heart pounding or racing
  • Hot flashes, usually worst during the first 1 - 2 years
  • Night sweats
  • Skin flushing
  • Difficulty sleeping

Other symptoms of menopause may include:

  • Decreased interest in sex, possibly decreased response to sexual stimulation
  • Forgetfulness (in some women)
  • Headaches
  • Mood swings including irritability, depression, and anxiety
  • Urine leakage
  • Vaginal dryness and painful sexual intercourse
  • Vaginal infections
  • Joint aches and pains
  • Irregular heartbeat or palpitations

If you are in your, or approaching your menopausal years you may want to consider seeing your doctor. A simple test or two can confirm if you are in or entering menopause. Blood and urine tests can be used to look for changes in hormone levels. Test results can help your doctor advise you on treatment options, whatever stage of menopause you are at.

Tests that may be done include:

  • Estradiol – this is your blood test for estrogen
  • FSH – this is a blood test for follicle-stimulating hormone
  • LH – blood test for Luteinizing Hormone, generally done in conjunction with other tests. LH stimulates ovulation.
Your health care provider will perform a pelvic exam. Decreased estrogen can cause changes in the lining of the vagina.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.