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"Diagnosing" menopause

Menopause is not a medical condition - it's a natural part of aging for women. So it doesn't need a 'diagnosis' as such. But if you are wondering about how doctors identify menopause we explain that here. We've broken it down by age, as this plays a big part in how doctors assess menopause.

If you're over 45 and having symptoms...

Firstly, your doctor will take a full medical history - including family history and current symptoms. This information, combined with age will inform whether symptoms are considered menopausal or not.

Expect the medical history to cover:

  • Current symptoms
  • Family history of major disease
  • Discussion of changes to periods (frequency and flow)
  • Gynaecological history (including past infections, operations and children)
  • Health behaviours that can impact health risks (including drinking, smoking and weight)
  • Blood pressure
  • Risk factors for long term diseases (including osteoporosis and heart disease).
  • They'll only do a physical exam of the breasts and abdomen if it's needed because of your specific symptoms.

If you have symptoms, and the doctor does not suspect other causes then they'll most likely conclude that your menopausal. No blood tests are needed for 'diagnosis'.

If you're between 40 and 45 and having symptoms...

If you're a bit younger, then the approach will be similar to the above. Changes to your periods and your current symptoms will be the leading factors used to identify menopause. When you are younger, the doctor may also order blood tests to confirm hormone changes - but not always. If ordered, the blood test would be for follicle stimulating hormone (FSH). FSH rises as you approach menopause, and raised levels can be an indicator. Sometimes your doctor will test for thyroid function too - as your thyroid function can impact your periods. Whether a doctor does a blood test will depend on your symptoms and family history.

If you are under 40 and having symptoms...

The doctor will run a blood test for FSH check for premature ovarian insufficiency (POI). They'll run this twice over a 6-8 week period to confirm your levels - as hormones fluctuate a lot during the lead up to menopouse. Two high FSH results suggest that your symptoms are due to hormonal changes that arise as you approach menopause.

When you are under 40 with symptoms, doctors will probably run other blood tests to rule out other potential causes. These will likely include a check on your thyroid, full blood count and a check for autoimmune antibodies.

If menopause is suspected then your doctor should talk you through the different treatment options. This should include discussing HRT and other lifestyle based ways to manage symptoms.

The reason for the slightly different approaches are that with early menopause, or POI there are more longer term health risks. Therefore, your doctor needs to be sure of menopause to advise you of any preventative actions you need to take to reduce these longer term risks.

Wondering where you might be?

Take our assessment

Our assessment is designed to be the first step in helping youn understand where you're at with respect to menopause. It's an educational, free tool which you can complete at home in less that 5 minutes.

References:

1 Hillard T., et al. (2017). Management of the menopause. 6th edn. British Menopause Society. UK.

2 National Health Services Website (2018). *Overview - menopause * Retrieved 16 October 2019 from [https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/].

3 National Health Services (2018). Health A-Z: Menopause. Retrieved 15 October 2019 from [https://www.nhs.uk/conditions/menopause/]