Menopause is a natural life stage that all women who have periods will go through. However, that doesn’t mean that the changes that occur are easy to navigate or that you won’t worry about the physical and emotional symptoms you are experiencing.
It usually occurs between the ages of 45 and 55 and menopause can normally be diagnosed through symptoms alone. Receiving a menopause diagnosis from a doctor can help give you peace of mind by confirming what’s going on in your body and ruling out other underlying issues. What’s more, it gives you the opportunity to discuss treatment options if your symptoms are affecting your life and well-being.
How do you know if you’re entering menopause?
While menopause is reached after a year without menstrual periods, this phase of midlife is often discussed in terms of stages: perimenopause, menopause and postmenopause.
Perimenopause is when your ovaries gradually stop working and start to produce fluctuating and declining amounts of oestrogen and progesterone. This can trigger the onset of menopause symptoms, but you may still have periods, which may start to change or become irregular, and you can still potentially get pregnant.
Symptoms of perimenopause and menopause include:
- Hot flushes
- Night sweats
- Heart palpitations
- Weight changes
- Low mood, including anxiety and depression
- Irritability
- Sleep disturbances
- Poor concentration
- Difficulty focusing
- Memory issues
- Vaginal dryness, burning or itching
- Discomfort during sex
- Reduced libido
- Increased urinary urgency or frequency
- Recurrent urinary tract infections (UTI)
- Loss of confidence
- Fatigue or low energy
If you are experiencing some, or all these symptoms but are still having menstrual periods, you may have entered perimenopause. However, some women can be menopausal without these symptoms and these symptoms can also be indicative of other health issues.
If you’re using hormonal contraception, such as the pill, implant or injection, it may also be harder to tell if you’ve reached menopause as the hormones in these medications can affect your periods.
How is menopause diagnosed?
Menopause is officially diagnosed when a woman has gone without a menstrual period, vaginal bleeding or spotting for 12 consecutive months, so your medical history is crucial to the diagnosis.
Current UK guidelines don’t recommend blood tests to confirm menopause in people over the age of 45 years with typical symptoms. If your doctor is concerned, there may be other conditions underlying your symptoms, they may conduct other investigations to exclude possible causes.
In people between 40 and 45 years old, blood tests may be carried out to check their hormone levels and exclude other causes of any symptoms.
These blood tests usually include:
- Hormone level testing of follicle-stimulating hormone (FSH) and oestrogen. FSH levels are typically (but not always) high in menopause and oestrogen levels are usually low (but not always). Blood tests are notoriously unreliable at diagnosing perimenopause.
- General health screening blood test. These are carried out to exclude other causes for symptoms and may include thyroid function tests, vitamin D, vitamin B12, folate, ferritin, full blood count, kidney, bone and liver function, cholesterol, and HbA1c to check for diabetes and blood sugar control.
If you are under the age of 40, you may be required to have more extensive blood tests to diagnose suspected premature menopause or premature ovarian insufficiency (POI). If you think you may be reaching menopause earlier than expected, you should talk to your GP.
What is not required?
Complex tests to diagnose menopause (including urine hormone tests, over-the-counter tests and saliva tests) are not required or recommended by the British Menopause Society. Contrary to what you may have seen in adverts, the reason they are not recommended is not because they are expensive (although they are), it is because they have not been validated independently nor do they add value towards making a diagnosis. These tests may be misleading and delay options for a trial of treatment.
How can I get a menopause diagnosis?
Diagnosing perimenopause or menopause can be done by your GP on evaluation of your symptoms, menstrual history, and sometimes, blood tests. However, seeing a menopause specialist can help you understand your symptoms in more detail and arm you with a range of management techniques, such as hormone replacement therapy (HRT), holistic therapies, herbal remedies for menopause, and simple lifestyle changes.
When seeking a menopause diagnosis from Menopause Care, you can expect a consultant who listens to your experiences and provides you with personalised care and advice.
During your initial consultation, be open and honest with your doctor about your symptoms and concerns. Be sure to discuss your medical history including any family history of early menopause or related conditions.
Your doctor or menopause specialist will tailor their approach based on your individual needs and preferences. Treatment options will be discussed if necessary, such as HRT, other medication, and/or lifestyle changes.
Your care won’t end there. Regular follow-up appointments will be scheduled to monitor your symptoms and adjust your treatment plan if needed.
Remember, menopause is a natural phase of life, and managing its symptoms is possible with the right support and guidance. If you’d like some help, book a consultation with a menopause doctor.
¹
