Changes That Occur During The Transition To Menopause
Menopause is a natural part of ageing when your ovaries produce fewer eggs and make less of the hormones that regulate periods. Your fertility declines and eventually you stop producing eggs. Your periods become irregular and they can be longer or shorter and heavier or lighter.
During the transition to menopause, the fluctuating levels of hormones lead to a variety of symptoms. Flushing, including night sweats, affects most women, usually for no more than one to two years, although about 25 per cent of women have symptoms lasting for five years or more. Night sweats can occur, especially premenstrually, even when periods are still regular. Other effects include insomnia, psychosomatic conditions and vaginal dryness.
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:
Blood Tests For Hormone Levels In Menopause
For many women, working out whether or not youre in perimenopause or menopause can feel like a bit of a guessing game, especially if you are taking hormonal contraception, which can mask or cause one of the key signs of perimenopause and menopause your periods becoming irregular or absent. One option for women looking to understand where they are in their menopause journey is the use of a hormonal blood test, which can take a measure of your hormone levels to determine if you are in menopause. Hormonal blood tests work by measuring your hormone levels to work out whether or not you are menopausal. Menopause specialist, Dr Kate Burns, explains everything you need to know about blood tests, including how they work, when you should use them, how to read menopause blood test results, and how they can help.
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Perimenopause Menopause Or Postmenopause
Perimenopause refers to the time from the onset of menopausal symptoms to 12 months after the last menstrual period1. This can last on average 4 to 8 years. Menopause is the last menstrual period. One year after the last menstrual period the woman is considered “postmenopausal”. Peri-menopausal symptoms can occur when periods are still regular, but typically the symptoms worsen in the premenstrual days. The symptoms experienced during the perimenopause are often the most distressing. Menstrual changes are common and it is normal to have periods that are less frequent or irregular. More frequent periods or those that are very heavy may not be normal and suggest that there may be pelvic or systemic pathology.
Women older than 40 years with more frequent or heavy bleeding, or intermenstrual bleeding require investigation by their doctor. Hormone levels may fluctuate during this time and measurement of sex steroids is rarely clinically helpful once the diagnosis has been made2. At this time of hormone fluctuation, oestradiol can actually briefly be higher than normal, giving symptoms of excess oestrogen, such as breast tenderness. Explaining to women that, at a time when their body is running out of oestrogen, they may get brief periods of high oestrogen symptoms is useful. . Eventually, symptoms of oestrogen deficiency predominate.
The measurement of FSH and oestradiol should be repeated at least once .
Nice Guidance On Menopause
In November 2015, NICE Guideline 23 on Menopause: diagnosis and management was published, providing recommendations for healthcare professionals who care for women in menopause.1 NICE NG23 also includes a section with information for the public, which provides women with information about what to expect from a healthcare professional if they have menopausal symptoms.
NICE Quality Standard 143,4 published in February 2017, distils the key points from NICE NG23 into measurable statements that can be used to assess the quality of care provided and quantify potential improvements to clinical practice. The five quality statements that make up NICE QS143 are listed in Table 1 and discussed in detail below.
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Is This A Menopause Home Test Or Menopause Self
Menopause is typically diagnosed based on consideration of a number of factors like age and menopause symptoms, and laboratory test results alone cannot diagnose menopause. Instead, this test is meant for women who are still having menstrual periods, but may have begun to experience fewer menstrual periods and/or are experiencing perimenopause symptoms. The results of this test allow you to explore changes in key hormone levels as you go through the menopause transition. Shifting hormones may be contributing to symptoms you are experiencing and measuring your hormone levels can help start a conversation with your healthcare provider about next steps.
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.
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Best For Providing Personalized Reports: Everlywell Perimenopause Test
- Collection method: finger prick
- Results: within a few days
Estradiol thickens the uterus lining so that eggs can implant into the lining to grow. When a person goes through menopause, estradiol levels in the body can decrease.
LH helps release eggs from the ovaries, and its level increases during menopause.
Everlywell claims that it works with labs with a certification. This means that the labs Everlywell use are regulated, possess state and federal certifications, and are open to regular inspections.
In addition, Everlywell states that its independent board certified doctors review and approve its customers tests.
To complete an Everlywell test, a person must first order a test, register their test kit online, collect their sample and then mail it to the lab for analysis.
Everlywell states that a person can receive their results within a few days. It also recommends that customers discuss their results with a doctor.
Everlywell provides personalized reports with results. Its test may be a good purchase for persons who wish to receive more helpful resources. Then, they can share them with their doctor.
This kit uses a finger prick test to collect the necessary blood sample.
Pros and cons
Some pros of Everlywells test include:
- CLIA certified labs
- health tips included with results
- encrypted information
What To Look For In A Home Menopause Test
People may wish to consider the following when choosing a menopause test:
- Certifications: People may wish to check that the company works with CLIA certified labs to ensure they are in line with federal standards and undergo regular inspections.
- Results: Some individuals may prefer to opt for a test that has results available within a few days.
- Sample collection: Some tests require a blood or saliva sample or even both. People may prefer to opt for a saliva test if they have a fear of needles.
- Doctor consultations: Some companies offer free doctor consultations, either with or without a positive test result. People may prefer to opt for a company that offers a consultation if they wish for more immediate medical advice.
A person may wish to contact a doctor if they are experiencing symptoms of menopause.
Doctors can evaluate a persons symptoms and ask about their family history. This helps determine if their symptoms suggest they are experiencing menopause.
A doctor may suggest a person has additional tests or treatment to help them understand their symptoms more.
Anyone who is interested in buying a menopause home test kit, who wants to learn more about them, check whether it would be useful for them, or to discuss the results might wish to talk with a doctor or another healthcare professional.
These are some frequently asked questions about menopause home tests:
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What Is The Guidance Around A Menopause Test
NICE guidance recommends not to test women over the age of 45 for hormone tests, such as FSH, anti-Mullerian hormone, inhibin A, inhibin B and oestradiol. This is because these hormones can fluctuate so much for many different reasons, not only due to your body going through perimenopause. Therefore results can be misleading and inconclusive. Its just not simple when it comes to a menopause test.
Are You Starting To Notice Changes In How You Feel As You Age
Having occasional hot flashes or night sweats? Perhaps you are approaching menopause and want to better understand your hormone levels during this change? Testing hormones with our perimenopause test kit is a step toward better understanding your reproductive and general health. Libido, menstruation, body thermoregulation, and metabolism can be impacted by your hormone levels.
The Everlywell Perimenopause home test for women provides a quick assessment for those who are looking for more information about hormone levels that may indicate a perimenopausal state.
This easy-to-use perimenopause blood test checks if your hormone level is within normal range for 3 key hormones involved in the menopausal transition. If hormone testing with this test reveals a possible hormone imbalance, you can share your results with your healthcare provider to better understand if you are entering menopause. If you are transitioning into menopause and are experiencing symptoms, your healthcare provider may recommend medication, menopausal hormone therapy, or other options for menopause symptom management.
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Menopause Blood Test What Is It
As a woman ages, her reproductive system begins to produce fewer hormones as well as less of those hormones, especially estrogen. Because of this, your body is signaled to begin producing more FSH . The blood test will measure both of these levels against each other, as well as individually.
If you have multiple symptoms, this test alone may not be able to come to a definitive conclusion, so your doctor may require further tests. Along with the tests for these two hormones, there may be other parameters that need to be checked.
We are referring to things like the TSH and T4 hormones, which are produced by your thyroid. When out of whack, these hormones can also be a key sign that menopause has begun. Along with this, your physician may also ask for your LH levels to be checked. This hormone helps stimulate the reproductive systems and is created in the pituitary gland.
Is There More Blood Work To Check Your Hormones
When I first began studying neuro-immune-endocrinology, I played around with lots of different laboratory tests to try to determine what would confirm or deny what I was seeing in my patients. I did 24-hour urine tests, salivary tests, and blood tests. Urine reveals hormone metabolites, while saliva can indicate hormones at the tissue level. Blood reveals what hormones are available in the body. None of these tests truly tell us exactly whats going on with your hormones, which is why its more important to assess the signs and symptoms of hormonal imbalance, and use the lab tests to confirm.
I know this is a lot of complicated information, which is why you should sign up for my free Hormone Reboot Training. Here youll get exclusive access to the same education I give to my patients I help them interpret their results.
Hope to see you there!
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How To Understand Your Menopause Blood Test
Once the menopause blood test results come back, that is when most people begin to get lost. After all, the results are full of medical jargon and acronyms you may have never heard of. When broken down, the test becomes much easier to read and understand.
Because your bodys hormones fluctuate regularly, your physician may want to take two separate tests about a month to a month and a half apart to compare the two. That being said, lets take a look at each of the hormones that are looked at in these tests.
Will My Hot Flashes Stop After Menopause
Some people still experience hot flashes after menopause. Postmenopausal hot flashes are caused by decreased estrogen levels. It is not uncommon to experience a random hot flash for years after menopause. If your hot flashes are bothersome or intensify, speak with your healthcare provider to rule out other causes.
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Cardiovascular Issues And Menopause
Coronary artery disease is the leading cause of morbidity and mortality in men and postmenopausal women. Menopause increases the risk for women still further, independent of age. Before menopause, the risk of CAD for women lags behind the risk for men by approximately 10 years after menopause, it catches up. As a result, mortality from CAD is increasing in women. The Framingham study was pivotal in showing the relation between menopause and increased cardiovascular mortality.
The Womens Health Initiative was a randomized, controlled trial that addressed the issue of whether postmenopausal women should take hormone therapy or estrogen therapy for prevention of CAD more than 27,000 healthy women participated in the trial. The investigators concluded that hormone therapy and estrogen therapy are not indicated for the prevention of CAD.
Emerging analyses of WHI data from the Estrogen-Alone Triala double-blind, placebo-controlled, randomized clinical trial evaluating the effects of conjugated equine estrogens on chronic disease incidence among postmenopausal women with prior hysterectomy and after a mean of 7.1 years of follow-upsuggested that treatment effects differ by age. Compared with older women, younger women receiving CEE had a lower risk of CAD.
Other Causes Of Absent Or Irregular Periods
Very early menopause is called premature ovarian failure. This can be due to genetic causes such as Turners syndrome, chemo- or radiotherapy, or an autoimmune process affecting the ovaries themselves or sometimes other endocrine organs. There may also be other possible causes of irregular or absent menstrual periods such as pregnancy, increased prolactin levels, polycystic ovarian syndrome and thyroid disease.
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Table : Nice Quality Standard For Menopauselist Of Quality Statements4
Women with premature ovarian insufficiency are offered HRT or a combined hormonal contraceptive.
Women having treatment for menopausal symptoms have a review 3 months after starting each treatment and then at least annually.
Women who are likely to go through menopause as a result of medical or surgical treatment are given information about menopause and fertility before they have their treatment.
FSH=follicle stimulating hormone HRT=hormone replacement therapy
National Institute for Health and Care Excellence. Menopause. Quality Standard 143. NICE, 2017. Available from: www.nice.org.uk/qs143
NICE has not checked the use of its content in this article to confirm that it accurately reflects the NICE publication from which it is taken
Why Do I Need An Estrogen Test
You may need an estradiol test or an estrone test if you:
- Are having trouble getting pregnant
- Are a woman of childbearing age who is not having periods or having abnormal periods
- Are a girl with early or delayed puberty
- Have symptoms of menopause, including hot flashes and/or night sweats
- Have vaginal bleeding after menopause
- Are a boy with delayed puberty
- Are a man showing female characteristics, such as the growth of breasts
If you are pregnant, your health care provider may order an estriol test between the 15th and 20th week of pregnancy as part of a prenatal test called a triple screen test. It can find out if your baby is at risk for a genetic birth defect such as Down syndrome. Not all pregnant women need to get an estriol test, but it is recommended for women who have a higher risk of having a baby with a birth defect. You may be at a higher risk if you:
- Have a family history of birth defects
- Are age 35 or older
- Have a viral infection during pregnancy
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Follicle Stimulating Hormone Test
Follicle stimulating hormone is produced by the pituitary gland, and its levels increase temporarily each month to stimulate ovaries to mature eggs. FSH levels during menopause tend to increase in attempt to make the ovaries produce more estrogen.
Nevertheless, keep in mind that one high FSH reading is not enough to indicate that a woman has entered menopause because hormones can fluctuate dramatically on a daily basis.
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.
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