From the Research
The gold standard diagnosis for premenopause is primarily clinical, based on a woman's age, menstrual history, and symptoms, rather than a single definitive test. This approach is supported by the most recent and highest quality study, which emphasizes the importance of a comprehensive evaluation, including a detailed medical history, physical examination, and exclusion of other conditions that might cause similar symptoms 1.
Key Considerations
- Elevated follicle-stimulating hormone (FSH) levels (>30 IU/L) in the blood, measured on two occasions at least one month apart, can support the diagnosis, though these levels fluctuate significantly during premenopause.
- Anti-Müllerian hormone (AMH) levels, which decline as ovarian reserve diminishes, can provide additional information about ovarian function.
- Characteristic symptoms include irregular menstrual cycles, vasomotor symptoms (hot flashes, night sweats), sleep disturbances, mood changes, and vaginal dryness.
Diagnostic Approach
- A comprehensive evaluation should include a detailed medical history, physical examination, and exclusion of other conditions that might cause similar symptoms, such as thyroid disorders or pregnancy.
- Transvaginal ultrasound to assess endometrial thickness and ovarian volume may be helpful in some cases.
- It's essential to understand that premenopause is a natural biological process, not a disease, and diagnosis aims to guide appropriate management of symptoms and health risks associated with declining estrogen levels 2.