Confirming Menopause Status : Some Fact about FSH
Perimenopause is a diagnosis that can usually be made by reviewing a woman’s medical history. The most common symptoms women in their 40s notice are changes in menstrual periods and the onset of hot flashes. Menopause is confirmed when a woman has had no menstrual bleeding for 12 consecutive months.
In most cases, hormone tests aren’t helpful because in menstruating women, hormone levels are changing all the time. Sometimes testing is done to check specific hormone levels, especially when fertility is an issue. This can help women make decisions about beginning or adjusting medications. For some women, it may make sense to test for other causes of symptoms that can mimic perimenopause, such as thyroid disease.
Sometimes, elevated follicle-stimulating hormone (FSH) levels are used to confirm menopause. FSH is a hormone produced by the pituitary gland that triggers the ovaries to secrete estrogen. As the ovaries’ production of estrogen declines, the pituitary gland tries to stimulate estrogen production by releasing more FSH into the blood. When a woman’s FSH blood level is consistently elevated to 30 mIU/mL or higher, and she is no longer having menstrual periods, it is generally accepted that she has reached menopause.
However, a single FSH level can be misleading in perimenopause since estrogen production doesn’t fall at a steady rate from day to day. Instead, both estrogen and FSH levels fluctuate from fairly high to fairly low during perimenopause. Therefore, one test with an elevated FSH level is not usually enough to confirm menopause. More important, a low FSH in a woman who is having hot flashes and changing periods does not eliminate the likelihood of perimenopause. Also, if a woman is using certain hormone therapies (such as birth control pills), an FSH test isn’t valid. Some healthcare practitioners recommend testing a woman’s saliva for estrogen levels. There is no conclusive evidence that this test provides accurate information around menopause.
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