From the Guidelines
Laboratory tests recommended for perimenopausal women include follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), complete blood count (CBC), lipid panel, and fasting blood glucose. These tests are essential for assessing the health of perimenopausal women, as they can help identify potential issues related to menopause, such as thyroid disorders, anemia, and increased cardiovascular risk. FSH levels above 30 mIU/mL, especially when measured on day 2-3 of the menstrual cycle, can help confirm perimenopause, though a single elevated reading is not definitive as levels fluctuate during this transition 1. TSH testing is important because thyroid disorders can mimic perimenopausal symptoms like hot flashes, mood changes, and irregular periods. CBC screening helps identify anemia, which may develop due to heavy menstrual bleeding common in perimenopause. A lipid panel is recommended as cardiovascular risk increases with declining estrogen levels, while glucose testing screens for diabetes risk which also rises during this life stage. Additional tests to consider based on symptoms include vitamin D levels, especially for women at risk for osteoporosis, and hormone levels like estradiol if hormone therapy is being considered. These tests should be interpreted in the context of clinical symptoms rather than used alone for diagnosis, as perimenopause is primarily a clinical diagnosis based on menstrual irregularity and vasomotor symptoms. It's also important to note that the American Cancer Society recommends regular cancer screenings for women, including mammography, Pap tests, and colorectal cancer screening, as outlined in their guidelines 1. Overall, a comprehensive approach to perimenopausal care should include both laboratory testing and clinical evaluation to ensure the best possible outcomes for women during this transition.
From the Research
Perimenopausal Laboratory Tests
The following laboratory tests are recommended for perimenopausal women:
- Comprehensive screening for physical and psychological problems
- Annual health examination
- Screening for chronic diseases related to postmenopause 2
- Laboratory tests to assess bone mineral density, such as dual-energy X-ray absorptiometry (DXA) scan
- Biochemical markers of bone turnover, such as urinary N-telopeptide of type I collagen and serum bone-specific alkaline phosphatase 3
Lifestyle Modifications
Lifestyle modifications are essential for perimenopausal women, including:
- Balanced diet and fluid intake
- Dietary prevention of cardiovascular diseases
- Adequate sleep
- Key preventive nutrients, such as vitamin D, calcium, vitamin C, B vitamins, and protein intake 4
- Healthy lifestyle counseling
Management of Perimenopausal Symptoms
Management of perimenopausal symptoms may include: