Tests to Diagnose Menopause: What You Need to Know

Find out everything about how to diagnose and detect the right symptoms of menopause as you read through.

1. Medical History and Symptoms Review

A detailed medical history is the primary stage of diagnosis of a disease. This may help a healthcare expert understand your condition better and reveal potential causes for your symptoms. In minor cases, even without any tests, a diagnosis can be confirmed based on your detailed medical history. First, it's essential to understand the process of medical history:

Process:

a. Basic information like Name, Age, and Sex is taken.
b. Then, your present complaints, history, and everything else are noted.
c. Menstrual and reproductive history is noted at the end.

2. Blood Tests

Generally, blood tests are prescribed for any disease that is not resolved, even with medications. Similarly, blood tests can be done for menopause. But this does not mean that menopause is a disease. 
Blood tests in menopause are not a necessity but can help better understand the causes of your symptoms. They measure your hormone levels and determine the stage in which you are of menopause (perimenopause, menopause, or post-menopause).

a. Follicle-stimulating hormone (FSH):
An increase in FSH levels indicates early menopause or insufficiency in your ovaries.

b. Estradiol: 
This is a form of estrogen. As estrogen decreases during menopause, levels of this hormone also tend to decrease.

c. LH levels: 
Increased LH levels indicate reduced ovarian function.
According to the tests required, your blood will be taken on an empty stomach or after having a meal. This sample will be then sent to labs for a detailed analysis.

3. Thyroid Function Tests

The thyroid is a butterfly-shaped gland located near your vocal cords. It releases hormones responsible for controlling almost all of your body’s activities. Your pituitary gland is responsible for controlling your thyroid gland. Your pituitary gland releases TSH (Thyroid-stimulating hormone), which stimulates the release of hormones T3 and T4 from your thyroid gland.

The thyroid gland has 2 main diseases: hyperthyroidism and hypothyroidism. 
The symptoms of these diseases can overlap with the symptoms of menopause. Hence, it is essential to differentiate between thyroid disorders and menopause. Some tests which can help confirm this are:

This test includes:

a. TSH:
TSH levels can help you understand if your thyroid gland responds appropriately to TSH. If TSH levels are very high, it can indicate an abnormality in response of your thyroid gland.

b. Free T3 and T4: 
Triiodothyronine (T3) and Tetraiodithyronine (T4) are the main thyroid hormones that act on your body. Changes in their levels can also indicate abnormality.

4. Saliva Testing

Saliva testing is a recently developed form of testing. It is cost-effective, reliable, accurate and can be performed anywhere. They are also non-invasive and can detect the presence of many female hormones and their levels. This is especially beneficial during menopause as saliva testing allows multiple specimens to be collected and stored efficiently. Its popularity is increasing and is becoming more common nowadays.

Procedure:
Your saliva sample is taken and sent to a laboratory for detailed analysis.

5. Urinary Hormone Testing

You may have seen several ads for urinary pregnancy kits. Have you ever wondered how urine can help to know if you are pregnant or not?

Your urine can help detect the presence of various hormones in your body. Urine pregnancy kits use this concept to confirm pregnancy. Other hormones like FSH, LH, estrogen, and progesterone can also be detected similarly to determine fluctuations in your body. This helps to understand the stage of your menopause and can be a reliable option, especially for women who are looking for alternative, non-invasive methods for testing.

Procedure: 
Your urine sample is collected, sent to the labs, and tested for hormones.

6. Pelvic Examination and Ultrasound

Pelvic examination and ultrasound help to understand if your pelvis has any physical abnormalities. Many diseases like fibroids, cysts or carcinoma can cause similar symptoms to menopause, like heavy bleeding, irregular bleeding and so on. This examination helps to rule out these possibilities, which could be immediately treated if early intervention is done. However, bear in mind that this does not help you understand your hormonal levels.

Procedure: 
A pelvic examination is done manually by a certified healthcare provider, while an ultrasound is an examination done using machines either transvaginally or abdominally.

7. Bone Density Test (DEXA Scan)

During menopause, estrogen levels decrease. Estrogen is a hormone that maintains bone health. Due to the lack of estrogen, the osteoprotective action also decreases, which increases the chances of fractures, osteoporosis, and other bone disorders.

A bone density test (DEXA scan) helps assess your bone strength and determine whether you are at risk of bone diseases. This can help you to take adequate preventive and treatment measures to strengthen your bones.

Procedure: 
A dual-energy X-ray absorptiometry (DEXA) scan is performed, which helps to determine your BMD.

8. Mammogram and Routine Screenings

Mammograms are specialised X-rays of your breast. During menopause, due to hormonal changes, sometimes there can be changes in your breast tissue, too. You may notice lumps or hard formations. These are not always concerning and can simply occur due to hormonal changes; however, ruling out any underlying conditions is essential.

After the 40’s, a woman has a higher chance of breast cancer. Regular mammograms and breast examinations are essential after menopause to detect these changes.

Procedure: 
X-ray images of your breast are taken, which can reveal any changes in your breast tissue.

Hormone Replacement Therapy (HRT) Discussion

If you suffer from severe symptoms during menopause, you can opt for HRT. Hormone replacement therapy (HRT) restores ovarian hormones that decrease during your menopausal transition to alleviate associated symptoms, especially hot flashes and night sweats. Typically, HRT combines estrogen and progesterone to replicate your ovarian hormones.

There are many methods of HRT, which include oestrogen, tablets, gels, sprays, and vaginal oestrogen. You can discuss your medical history, needs, and issues with your healthcare provider in detail to tailor a personalised treatment for your HRT.

Wrapping Up

Diagnosing menopause can be tricky and challenging. But with the proper support, it can be very easy. It involves a lot of factors like history, various tests, and other diagnostic tools. Consultation with a healthcare provider is essential to understand more about the tests available, what tests are required for you, and what options are available for HRT if you want to proceed. Our team of Nirva health experts can also help you to understand and manage your menopause effectively. To learn more about menopause, you can refer to this blog by Nirva Health.