Why blood tests aren’t effective in diagnosing menopause

While menopause itself is an inevitable process for women as they age, it’s not as straightforward to diagnose as you may assume. The process of achieving an accurate diagnosis is one that’s often misunderstood, with many misconceptions surrounding how menopause is confirmed. 

One of the largest misunderstandings is around the effectiveness and reliability of blood tests as a part of the diagnostic process. While these can be helpful, they’re one of multiple tools that may be required to accurately diagnose menopause, as well as identify other diseases that may mimic menopause’s symptoms. More diagnostic assessments are needed to accommodate for the fluctuating hormone levels that are part and parcel of perimenopause, meaning women will need to play an active role in their own diagnosis.

Menopause as a point of transition

Menopause is a complex process that’s not always easily diagnosed. For some women, a comprehensive evaluation of symptoms, personal medical history, and blood test results can all be required in order to accurately assess whether menopause has commenced. 

Menopause may first make itself known through its symptoms, which can begin months, or years, before menopause itself actually begins. This phase, known as perimenopause, can include symptoms like:

• Dry skin 
• Thinning hair
• A lowered sexual libido
• Mood swings
• Irregular periods
• Hot flushes
• Night sweats
• Weight gain

During perimenopause, it’s common to go months without a period. If you do miss a period, however, and you’re not using contraception, it’s time to pull out a trusty home test or visit your doctor – you wouldn’t be the first woman to believe she was entering menopause when she was in fact, pregnant!

It can be tempting to use the presence of menopausal symptoms to ‘self-diagnose’ menopause, but by working closely with your doctor, you can confirm an official diagnosis, as well as find crucial support to reduce the impact of menopause’s symptoms. As menopause differs from woman to woman, keeping a close eye on these early symptoms can be helpful in assessing whether or not they’re tied to menopause itself, or to another underlying condition that requires careful management. 

How is menopause diagnosed?

Although your doctor doesn’t require blood tests to diagnose menopause, it’s common for blood or urine tests to be run that look to determine the levels of certain hormones. 

These tests are looking for the levels of follicle-stimulating hormone (FSH) and luteinising hormone (LH). As the ovaries become less responsive to both FSH and LH hormones throughout menopause, the body begins to produce more of these hormones, looking to compensate for this reduction in effectiveness. By looking for these levels within a blood or urine test, your doctor will have a clearer understanding of what’s happening to your hormone levels.

While these tests can be helpful, it’s important to keep in mind that their results can be inconclusive due to the fluctuating nature of perimenopause. In many cases, it’s not until periods have stopped altogether that changes in these levels begin to show up methodically within blood tests. This is why a perimenopause diagnosis is based on symptoms within a clinical setting, not solely on blood test results. 

What to expect in your appointment

If you believe you’re entering into perimenopause, you can prepare for your appointment by arming yourself with as much information as possible about your personal experience. Begin by tracking symptoms as they arise, noting how often they occur, their severity, and any common triggers to their occurrence.

You’ll also need to track when your last period was, as well as any irregularities in timing that may have occurred since. Your doctor will also likely ask for a list of medications you’re currently taking as a part of their overall assessment.

This can be a confronting experience for some women, as they’re not used to discussing some of the symptoms associated with menopause. Clear and accurate communication, however, can be key to achieving an accurate diagnosis, so don’t hesitate to discuss any and all of your symptoms with your healthcare practitioner. The information you provide about your symptoms is likely going to be the key to receiving an official diagnosis of menopause, as well as supporting your need for ongoing resources and treatments to minimise its disruptive impact on your life.

You may find your doctor also orders other tests to rule out other conditions, such as ovarian failure or thyroid issues, including:

• A thyroid function test
• A lipid profile
• Liver and kidney function tests

Even if it seems clear that you’re experiencing consistent symptoms of perimenopause, checking for these other health issues is an integral step to ensuring you’re receiving appropriate and strategic care.

Early menopause: knowing the signs

The large majority of women will experience menopause between the ages of 45 and 55. For some, however, menopause can occur early, classified as menopause that begins between 40-45. Premature menopause is then classified as beginning before the age of 40.

Are you experiencing symptoms of menopause before you turn 40? It’s crucial to share this information with your doctor. There are a number of reasons why this may be happening, including underlying chromosomal defects, autoimmune diseases, chemotherapy, or the surgical removal of the ovaries or uterus.

For women under 40 who go more than 3 months between periods, your doctor can test for early menopause, as well as evaluate any other underlying causes. 

Unfortunately, early menopause is linked to increases in the risk of developing osteoporosis, heart disease, and a range of other chronic illnesses. Proactive consultations with your healthcare providers are the first step in finding appropriate and personalised treatments if you’re experiencing early menopause for yourself. 

Conclusion

Blood tests can play a helpful role in officially diagnosing the commencement of menopause, but they’re not the only tool used by medical professionals in evaluating individual circumstances. By paying close attention to your symptoms and tracking your period, you can build the context needed to move through the menopause diagnostic process with ease, accuracy, and efficiency. 

If you’re looking for more support in taking proactive control of your menopause journey, contact our friendly, expert team at the Australian Menopause Centre. With over 23 years of supporting Australian women through this significant life transition, we’re committed to providing the highest quality of medical and personalised support in every stage of your menopause experience.