What tests are used to diagnose menopause?
Diagnosis of menopause typically starts with a conversation about symptoms and medical history, but a number of laboratory tests can diagnose it—especially if the patient is younger than typical for menopause or experiences irregular periods for other reasons.
The most commonly used tests are as follows:
???? 1. Follicle-Stimulating Hormone (FSH)
Most commonly used laboratory test to assess menopause.
With the decreasing responsiveness of ovaries, FSH levels increase.
A persistently high FSH level of more than 30 mIU/mL, especially with no periods, can confirm menopause.
FSH levels do fluctuate, especially in perimenopause, and so this test may be repeated on occasion.
???? 2. Estradiol (an estrogen)
Estradiol levels fall at menopause.
A low estradiol level together with a high FSH level makes a diagnosis of menopause.
???? 3. Luteinizing Hormone (LH)
LH levels also rise at menopause but are less commonly used for diagnosis than FSH.
???? 4. Thyroid Function Tests (TSH, Free T4)
Symptoms of thyroid disease (e.g., fatigue, irregular periods, or mood changes) can mimic menopause.
Doctors often check thyroid function to rule out other causes.
???? 5. Anti-Müllerian Hormone (AMH) – Optional
Evaluates ovarian reserve (number of remaining eggs).
AMH is very low or undetectable in menopausal women.
More common in fertility testing, but can be used to assess premature or early menopause.
???? Further Assessments
Pelvic exam: To assess for thinning or drying of the vagina.
Bone density scan (DEXA): Not diagnostic of menopause, but is recommended post-menopause due to the increased risk of osteoporosis.
???? Remember:
Menopause is not usually diagnosed with lab tests in a woman >45 years with 12 consecutive months of amenorrhea—it’s a clinical diagnosis.
Tests are likely to be done for women aged under 45 or if the symptoms are atypical.
Let me know if you would like information on premature menopause, menopause in diabetics, or the interpretation of results of a specific test—happy to elaborate further.
A follicle-stimulating hormone (FSH) test is sometimes utilized as part of the procedure to assist in diagnosing menopause, but it’s not the sole consideration doctors use. Here’s how it functions and what to understand:
???? What FSH Is
FSH is a hormone made by the pituitary gland.
It triggers the ovaries to make estrogen and develop follicles for ovulation.
???? Why It’s Measured
Estrogen levels decrease during perimenopause and menopause.
As the ovaries produce less estrogen, the pituitary gland responds by increasing FSH in an attempt to stimulate the ovaries to produce estrogen.
High FSH levels can thus be a sign of the ovaries losing their sensitivity — one of the characteristics of menopause.
???? Normal FSH Levels
Premenopausal: FSH levels change during the course of the menstrual cycle, typically below 25 IU/L.
Perimenopausal: FSH levels may be occasionally high.
Postmenopausal: FSH levels are always raised (usually more than 30–40 IU/L), as there is no response from the ovaries.
⚠️ Pitfalls of the Test
FSH levels may fluctuate on a daily basis and even within the same cycle.
Normal FSH levels may be seen in some perimenopausal women.
Results may be affected by birth control pills, stress, or thyroid disease.
✅ When It’s Most Useful
To confirm menopause in women under the age of 45 who are symptomatic.
To rule out other causes of irregular periods or amenorrhea (lack of periods).
As a complement to estradiol levels, menstrual history, and symptoms like hot flashes or sleep disturbance.
Would you like help with how FSH fits into a broader hormone testing panel or how it is being used in conjunction with hormone therapy decisions?
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