Can Blood Tests Help To Manage Menopause And Hrt
Reviewed byDr Sarah Jarvis MBE
29-Sep-20·7 mins read
In the UK, the average age a woman will reach menopause is 51, though anywhere between 45 and 55 is still considered to be within the normal range. For some women, menopausal night sweats, painful joints, depression, and vaginal and bladder issues can be hugely debilitating. Hormone replacement therapy is one option to help manage these symptoms and alternatives to HRT are also available.
Can Menopause Affect My Sex Life
After menopause, your body has less estrogen. This major change in your hormonal balance can affect your sex life. Many menopausal women may notice that theyre not as easily aroused as before. Sometimes, women also may be less sensitive to touch and other physical contact than before menopause.
These feelings, coupled with the other emotional changes you may be experiencing, can all lead to a decreased interest in sex. Keep in mind that your body is going through a lot of change during menopause. Some of the other factors that can play a role in a decreased sex drive can include:
- Having bladder control problems.
- Having trouble sleeping through the night.
- Experiencing stress, anxiety or depression.
- Coping with other medical conditions and medications.
Book Your Consultation Today
To have a friendly and helpful chat with one of our menopause experts, you can book an appointment with our menopause clinic.
Or perhaps youd like to take our Menopause Questionnaire its a quick and easy way to see if you have symptoms of the menopause and, importantly, what you can do about them.
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Is There Some Way To Know When Symptoms Will Begin To Lessen And Finally End
Symptoms are very individual. In general, hot flashes and night sweats can start 1-3 years before the last period and last on average between 2-6 years. Some women experience them up to 10 years. Vaginal dryness and vaginal issue symptoms happen in about 50 percent of women, and generally don’t start to be a problem until 1-2 years after the last period. Cardiovascular risks and cholesterol changes, bone changes all start when the periods stop.
What Are The Symptoms Of Menopause
Hormonal changes can cause physical and psychological symptoms before and during menopause. Symptoms may occur for a few weeks, a few months, several years, or not at all. The symptoms may come and go, or they may occur regularly.These physical signs and symptoms are common during menopause:
- irregular or no menstrual periods
- changes in your sleep patterns
- vaginal dryness, sometimes causing discomfort or pain during sex
- grayish vaginal discharge with a bad odor
- more frequent need to urinate, or leakage of urine
- more frequent minor vaginal and urinary infections
- loss of desire to have sex
Menopause usually occurs at a time in your life when other dramatic changes take place. Some of these changes may include loss of parents, adjustment to children growing up and leaving home, becoming a grandparent, retirement, or career changes. These changes, in addition to the changes in your body, may result in psychological or emotional stress. Psychological symptoms of menopause may include:
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What Level Of Oestrogen Is Normal On Hrt
Routinely there is no guidance stating that oestradiol levels should be checked while a woman is taking HRT. This is because the dose of HRT is based on the improvement or otherwise of symptoms. When oestradiol levels are checked, most often in specialist clinics, they can help to guide dosing, but there is no definite level which doctors would call correct.
The reason for this is that the levels of oestrogen required to improve symptoms, while also protecting the bones, varies depending on a womans age and stage of menopause.
Levels of oestradiol can also vary wildly during the perimenopause. Younger women with POI may need much higher levels, while post menopausal, and older women may be better with much lower levels. This is the reason that individualised care, rather than a one size fits all approach, is so important.
When Are Menopause Hormone Blood Tests Recommended
Generally, checking blood hormone levels is neither necessary nor helpful for women aged 45 or older. This is because:
Under the age of 45, though the same problems of hormone levels potentially being normal during perimenopause still apply, blood hormone levels are worth checking as experiencing menopause at this age is classed as early and is managed slightly differently. Hormonal checks must be carried out if you are under 40 and experiencing period changes or symptoms suggestive of menopause. This is because medical professionals need them to detect a condition called premature ovarian insufficiency , or premature menopause, and thus be able to provide you with the correct care.
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Testing Perimenopause And Menopause Hormone Levels: Is It Worth It
We see the numbers a lot: estradiol, estrogens, FSH. But what do they mean, and what can they actually tell a woman about where she is in the menopause transition?
Turns out, the team at Gennev found that using a menopause hormone levels chart may be less helpful than weâd like.
While there are uses for having hormone levels tested, pinpointing your place on the perimenopause-to-menopause journey probably isnât one of them. Hormones just donât cooperate during this time , and hormone tests can only really offer a limited snapshot of where you are right now â which is probably not where youâll be tomorrow.
To understand all this better, we had a Q & A with our ob/gyn Chief Medical Officer, Dr. Rebecca Dunsmoor-Su, on to test or not to test.
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Testing For Menopause & Early Menopause
Is it possible to test for and diagnose if you are in menopause?
The answer is yes.
The changes in your hormones cause several changes to other hormones in your body which can be picked up with routine blood tests.
What you need to realize is that all of the systems in your body are connected in some way.
If you drop your estrogen, for instance, then that will alter other hormones that are normally produced by your brain to stimulate the release of estrogen.
These hormones and prohormones can be picked up and used to help draw a picture of what is happening in your body.
So which blood tests do you need to diagnose menopause?
Ive included a list below that every woman who is going through menopause should ask their doctor for:
Its also helpful to understand what happens to these values during menopause so that you can understand where you are at in your transition.
Ive included some of the general ranges to look for with these lab tests below:
Get A Clear Picture Of Your Health
With MyFORM® perimenopause test, you will receive an in-depth report on your results that will be available via your Health Dashboard.
View your unique hormone curves
We use AI to map all 4 key hormones across your entire menstrual cycle, giving you much deeper insights into your hormone fluctuations.
Understand your hormone ranges
You’ll be able to view your results in detail with a report showing each of the 4 hormone levels for day 14 and day 21 of your menstrual cycle.
Get personalised expert advice
We provide you with a personalised and detailed report from an endocrinologist who will explain what your results mean for you based on your symptoms.
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Why Do I Need An Estrogen Test
If you are female, you may need estrogen testing if you:
- Have early or delayed puberty
- Are childbearing age and have abnormal periods or no periods at all
- Are having trouble getting pregnant
- Have a high-risk pregnancy
- Have symptoms of menopause, including hot flashes and/or night sweats
- Use hormone replacement therapy after menopause
- Have vaginal bleeding after menopause
- Have a tumor that may be making estrogen
If you’re pregnant, you may have an estriol test between weeks 15 and 20 of your pregnancy. The test may be part of a group of prenatal tests called a triple screen test or a quad screening test. The test can check whether your baby has a high risk for a genetic birth defect such as Down syndrome. You may be more likely to have a baby with a birth defect if you:
- Have a family history of birth defects
- Are age 35 or older
If you are male, you may need estrogen testing if you have:
- Delayed puberty
- Enlarged breasts or other symptoms of too much estrogen
- Have a tumor that may be making estrogen
Top Home Menopause Tests
People can find various home menopause tests online. Below is a range of tests to consider.
Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.
Medical News Today follows a strict product selection and vetting process. Learn more here.
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How Do I Know If I Have Been Through The Menopause
If you previously had regular periods, you can usually tell if you are postmenopause based on your symptoms and if you:
- Have not had a period for at least 12 months and are aged over 45
Most will also notice typical signs, including hot flushes, disturbed sleep and mood changes among others. If this is the case, you generally do not need an FSH or other hormonal test to confirm menopause.
While this makes it sound straightforward, things can be more complicated. For example, you may be on a type of contraception that stops your periods, or you may have a medical condition that makes your periods infrequent. For this reason, it is important to be certain that you have been through menopause before stopping contraception. Pregnancy is rare as you get into your late 40s and 50s, although it can happen. It can even be easy to confuse the symptoms of early pregnancy with menopause in some cases.
Your doctor will be able to advise you if you are unsure and may advise testing. They can also advise if you are seeking help for your symptoms. This may involve lifestyle changes or HRT.
Testing + Symptoms = Diagnosis
Both lab tests and symptom charting are not necessarily 100% accurate.
The problem with menopause is that it occurs over a period of several months .
This time is a period of great fluctuation, both in terms of your symptoms and in terms of your lab tests and hormones.
Your hormones and prohormones may fluctuate wildly during this time which means that checking just one time may not necessarily be accurate.
As a woman is going through the menopause transition its not uncommon for her body to attempt to menstruate.
This attempted menstruation may cause small to large rises in hormone levels which may alter your symptoms.
Because of this, you dont want to rely heavily on one form of diagnostic tool over another.
Instead, its best to combine both your symptoms and use them in conjunction with your lab tests .
This is especially important if you are suffering from early menopause.
Women who suffer from early menopause may be pushed aside as having depression as opposed to true ovarian failure/menopause.
The good news is that it is easily testable and that you can be sure what is happening in your body with a couple of lab tests.
For instance:
During menopause, we know that your estradiol levels and progesterone levels WILL fall dramatically.
When in doubt, make sure to ask your doctor for the lab tests listed above as they may help to explain what is happening in your body.
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When To Ask A Doctor About The Perimenopause Blood Test
Women who enter into the perimenopause transitionary phase may experience symptoms which are similar to menopause. This can include hot flashes, tenderness in the breasts, more severe monthly cycles that include heavier bleeding, fatigue, trouble sleeping, mood swings, and changes to their urinary habits. These symptoms can come in any combination, but all women will experience at least one symptom once they enter into a perimenopause state.
It is important to note that women who have entered into this transitionary state may have irregular periods. Other health conditions can also cause irregular periods to occur, however, so a visit to a medical provider is necessary to rule out a more serious condition. Speak to your doctor if your bleeding is heavier than normal, contains blood clots, there is spotting between periods, or you have spotting happen after intercourse.
Bleeding can occur for many reasons. Oral contraceptives are known to cause spotting and bleeding as well.
Symptom Assessment And Diagnosis At Perimenopause And Menopause
The time when most women are trying to understand what is happening to them is during the peri- menopause. During this time of hormonal fluctuation women may experience some, but not all of the symptoms listed in the table. For instance, she may come with severe joint aches and tiredness, which may be suggestive of a rheumatological disease. Checking a symptom score will often reveal many more unreported menopausal symptoms.
In most cases, recording a symptom score helps to make the diagnosis, at the same time educates the woman and is a basis for assessing efficacy of treatment. Checking FSH or AMH levels or serum oestradiol and progesterone are unnecessary tests in diagnosing menopause for most women. Checking an androgen profile as a routine on all peri-menopausal women is also unnecessary and costly. Many women come to the consultation expecting a blood test to diagnose menopause, and it is important to explain to them why we use the symptom score rather than a blood test in establishing a diagnosis. It is important to explain to women that the blood tests of FSH/oestradiol can fluctuate on a daily basis and therefore are not useful or necessary. It is especially unhelpful to do hormone blood tests while women are on MHT/OCP symptoms, not blood levels, guide therapy. Treat the symptoms, not the biochemistry.
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How To Test For Menopause
When it comes to a menopause test, sometimes you can have a blood test to measure the level of certain hormones but it depends on a few factors, such as age and the medication you are taking.
Women under 45 with menopausal symptoms can have a blood test measuring their follicle stimulating hormone . While this can be useful even this can be quite inaccurate, especially if youre taking medication such as the combined contraceptive pill or progesterone-only pill.
Whats Included In This Test
- Two blood sample kits
- Royal Mail 1st class postage
- Free return envelopes for blood samples
- Discreet packaging
- 8 sets of results from day 14 and day 21
- Graph showing hormones across cycle
- Ovarian function analysis
Forths service is intended to enable people to improve wellbeing and optimise sports performance. It is not intended for clinical diagnosis. Test results are for information purposes only. If you do have concerns about your health, please discuss these directly with your GP.
Beaufort Park, Chepstow NP16 5UH
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When To Do A Menopause Blood Test
Menopause is a completely natural part of ageing and many women self-diagnose themselves as their periods become irregular.
However, you might like to see a GP or specialist if:
- your symptoms are bad
- your periods become irregular early
Your periods being absent for a year combined with your age are the main clinical indicators of menopause so a blood test wont always be offered. But in some cases, you will be offered one for example, if youre under the age of 45.
A blood test can also help rule out other conditions that cause menopause-like symptoms for example, an underactive thyroid or an overactive thyroid .
Keep in mind that not all blood tests are diagnostic. Some tests are used to build a picture of whats going on inside your body.