Menopause is a natural process when women’s reproductive age ends. During this period, important hormonal changes occur in the body and various hormone tests are performed to understand these changes. As a gynecologist, I will discuss the hormone tests required during menopause in detail in this article.
Menopause is the period when a woman’s menstrual cycle permanently ends, and her natural fertility ability is lost. This process usually occurs between the ages of 45-55. Menopause is usually defined with the absence of menstruation for 12 months. Hormonal changes during this period can cause various symptoms in the body.
– Menstrual irregularities or complete cessation of menstruation
– Hot flushes and night sweats
– Vaginal dryness and decreased sexual desire
– Sleep disorders
– Mood changes, depression and anxiety
– Weight gain and slowing of metabolism
– Dryness of hair and skin
– Susceptibility to urinary tract infections
Various hormone tests are used to diagnose menopause and manage the process. These tests allow us to objectively measure changes in hormonal balance.
The FSH test is one of the most commonly used tests in the diagnosis of menopause. It is used to evaluate the function of the ovaries.
Normal Values:
– In reproductive age: 5-20 mIU/mL
– Pre-menopause (perimenopause): 20-30 mIU/mL
– Post-menopause: 30 mIU/mL and above
LH levels also increase during menopause, but not as markedly as FSH. Therefore, the LH test alone is not sufficient to diagnose menopause, but may be useful in combination with other tests
Values:
– In reproductive age: 5-20 mIU/mL
– In menopause: 20 mIU/mL and above
Estrogen is known as the female hormone and is produced by the ovaries. Estrogen levels fall during menopause. Low estrogen levels can lead to symptoms such as hot flushes, vaginal dryness and decreased bone density. An estrogen test on day 3 of the menstrual cycle can help diagnose menopause
Reference Intervals:
– In reproductive age: 30-400 pg/mL
– In menopause: <30 pg/mL
AMH is a hormone used to assess the ovarian reserve. AMH levels decrease within age and fall considerably during menopause. The AMH test can be used to assess the risk of early menopause in particular.
Values:
– Above 1.5 ng/mL: Normal ovarian reserve
– 1.0-1.5 ng/mL: Low reserve
– Below 0.5 ng/mL: Very low reserve
– In menopause: Usually below 0.1 ng/mL
Progesterone is a hormone that increases in the second half of the menstrual cycle. During menopause, progesterone levels fall. Low progesterone levels can cause menstrual irregularities and sleep disorders. However, a progesterone test alone is not enough to diagnose menopause.
Testosterone is a hormone also found in women and can have an effect on sexual desire, energy levels and muscle mass. During the menopause, testosterone levels may decrease, which can lead to decreased libido and low energy.
Inhibin B is a hormone secreted by the ovaries that regulates FSH production. Inhibin B levels decrease during menopause. This decrease contributes to increased FSH levels. The Inhibin B test can be helpful in diagnosing menopause but is not routinely used.
Thyroid hormones regulate the body’s metabolism. Disorders in thyroid functions can cause symptoms similar to those of menopause. It is therefore important to assess thyroid hormones.
Timing is very important for hormone tests to give accurate results:
– 3rd day of menstruation: It is the ideal time for FSH, LH, and estradiol tests.
– AMH test: It can be done on any day of the menstrual cycle.
– Progesterone test: It is performed on the 21st day of menstruation (28-day cycle).
Things to consider when interpreting test results:
In addition to hormone tests, other tests are recommended during the menopause:
– Bone density measurement (DEXA): To assess the risk of osteoporosis.
– Lipid profile: to check cardiovascular health.
– Mammography: For breast cancer screening.
– Pap smear test: For cervical cancer screening.
– Vitamin D level: Important for bone health.
Hormone test results are guiding when deciding on hormone replacement therapy. Treatment planning:
– General health status of the individual
– Family history
– Risk factors
– The person’s expectations and quality of life are assessed together. Hormone replacement therapy should be planned individually.
Most hormone tests do not require fasting. However, if blood glucose or lipid profile is to be analysed, fasting for 8-12 hours may be required.
The 3rd day of menstruation is the ideal time for FSH, LH and estradiol tests, and morning hours are preferred for blood tests. The AMH test can be performed on any day of the menstrual cycle.
There are FSH tests in urine performed at home. However, these tests are not sufficient for a definitive diagnosis. A doctor’s evaluation and laboratory tests are required.
Hormone tests alone do not make a diagnosis. It should be evaluated together with clinical symptoms and a history of absence of menstruation for at least 12 months.
A test can be performed between the ages of 45-55 when menopausal symptoms begin. Under 40 years of age, if symptoms are present, evaluation for early menopause is required.
Low AMH levels indicate decreased ovarian reserve, but it does not diagnose menopause alone. It should be evaluated together with other tests and clinical findings.
You should consult a gynaecologist. If necessary, you may also be referred to an endocrinologist.
It is important to have a balanced and healthy diet during menopause. Consuming foods rich in calcium and vitamin D supports bone health. It is also important to consume fibre-rich foods and plenty of water.
Menopause is a natural transition in every woman’s life, and the correct management of the physical and psychological changes experienced during this period is of great importance in improving quality of life. Hormone tests not only determine the stage of menopause, but also enable the development of a specialized approach to the needs of the individual. Tests such as FSH, estrogen, LH, AMH, etc. clarify the diagnostic process and, if necessary, supportive interventions such as hormone therapy can be started on time.
If you are experiencing menopausal symptoms such as menstrual irregularities, hot flashes, sleep disorders and want to manage this process in a healthy way, you should definitely consult a gynaecologist. Prof. Dr. Şadıman Kıykaç Altınbaş, who serves with a patient-oriented and scientific approach in her practice in Ankara, can support you to provide a more comfortable transition by drawing a special road map for your menopause process. Remember, healthy aging process starts with conscious steps. You can contact us for detailed information and appointment.
Kızılırmak, Dumlupınar Blv. No: 3 Next Level Ofis A Blok Kat: 14, No: 69, 06510 Çankaya/Ankara
Klinik: +90 538 430 32 10
