Confirming Menopause

Step One: Get to Perimenopause

     Physical signs of menopause begin many years before the final menstrual period. This menopause transition phase is called perimenopause (literally meaning “around menopause”). It can last 6 years or more, and by definition, ends 1 year after the final menstrual period.

     Perimenopausal changes are brought on by changing levels of ovarian hormones such as estrogen. During this transition time, estrogen levels gradually decline, but they do so in an erratic fashion. Sometimes they can even be higher than during the reproductive years. Irregular menstrual periods, hot flashes, sleep disturbances, and mood swings are common, normal signs of perimenopause. Some women experience low libido (sex drive) and/or vaginal dryness.

     During perimenopause, a woman may be able to conceive, although fertility is very low. If pregnancy is not desired, contraception is necessary until menopause is reached.

Step Two: Get Past Perimenopause

     When a woman suspects she is experiencing perimenopause, it is an excellent time to come in for a complete medical examination. The diagnosis of perimenopause can usually be made by reviewing a woman’s medical history, her menstrual history, and her signs and symptoms.

    Testing hormonal blood levels is not always recommended because in menstruating women, hormone levels are changing all the time. However, in younger women (below 40) menstrual irregularity is infrequently a sign of menopause, so hormone testing may be a useful tool to test whether menopause has occurred.

    Testing blood hormone levels can also be helpful in assessing a woman’s fertility and potential for pregnancy. Results can help women make decisions about beginning or adjusting medications and help them understand their personal biological clock.

    For some women, it may make sense to test for other causes of symptoms that can mimic perimenopause, such as thyroid disease. Also, if a woman is using certain hormone therapies (such as birth control pills), an FSH test is not valid.

     So, check your calendar, schedule an appointment, and talk to me, Kathleen … I am a Menopause Clinician. I’ve survived my own menopause and learned a lot!

     Welcome to the club!