From the Research
Hormone testing for suspected menopause is not always necessary and should be individualized based on clinical symptoms and medical history, as stated in the most recent and highest quality study 1. For women over 45 with typical menopausal symptoms like hot flashes, night sweats, and irregular periods, a clinical diagnosis can often be made without the need for hormone testing. However, in some cases, measuring follicle-stimulating hormone (FSH) and estradiol levels in the blood may be helpful in confirming menopause. Testing should be done during the early follicular phase (days 2-5) of the menstrual cycle if periods are still occurring. Additional hormones like luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and prolactin may be tested to rule out other conditions that can mimic menopausal symptoms. Some key points to consider when evaluating menopause include:
- Clinical symptoms such as hot flashes, night sweats, and irregular periods are important for diagnosis 2
- Hormone levels can fluctuate significantly during perimenopause, so clinical symptoms remain an important part of diagnosis 3
- For women under 45 with suspected premature menopause, more comprehensive testing including anti-Müllerian hormone (AMH) and genetic testing may be warranted to determine the cause of early ovarian insufficiency 1 It's also important to note that the diagnosis of menopause is sometimes difficult, and a review of the literature was carried out via Pubmed, Medline, and Cochrane Library, and the recommendations of international societies were also taken into account 1. In a classic situation, the diagnosis of menopause is a clinical diagnosis, made retrospectively, based on a 12-month period of consecutive amenorrhoea in a compatible age group (after 45 years of age), and no hormonal dosage or imaging is indicated to make a diagnosis of menopause in a classic situation 1. The benefits and risks of hormone therapy (HT) in menopausal women have been clarified by the Women's Health Initiative (WHI) hormone therapy trials, and the risk:benefit ratio and safety profile of HT differed markedly by clinical characteristics of the participants, especially age, time since menopause, and comorbidity status 3. Overall, the management of menopausal symptoms should be individualized and based on the latest evidence, as stated in the most recent and highest quality study 2.