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Diagnosing Menopause

Millions of women experience menopause for the first time every year. Misunderstood by the majority of the population, it affects everything from health to personal relationships and is largely unavoidable. It can be a confusing period for women who are going through the initial experience, and often times, they are not even aware of what is causing their symptoms.

HFN 002 Diagnosing 1 21346565Menopause does not simply and suddenly walk through the front door and announce its presence; it usually builds slowly and catches women by surprise when they become aware of multiple symptoms—or one ornery one.  It is preceded by perimenopause, a transitional stage occurring before menopause in which the menstrual cycle becomes irregular—before eventually ceasing altogether—and other symptoms, including hot flashes, may appear. It can be a stressful time, but fortunately there is help, and it starts with an accurate diagnosis.

Loosely defined as the stage of life that occurs after an absence of a menstrual period for 12 months, menopause is the natural, biological process by which a woman reaches the end of fertility. While the average age of women entering menopause is 51, the condition can arise as early as your thirties or as late as your sixties. Irregularities in the menstrual cycle can even occur up to 10 years before a woman enters menopause. Furthermore, menopause has shared symptoms with several other conditions, such as cancer treatment and pregnancy.

Premature Menopause
If you've been experiencing symptoms of menopause, such as hot flashes, mood swings, loss of libido, or night sweats, you could be entering menopause, even if you are under the age of 40. Your symptoms are a sign that your body is producing less estrogen, which isn't always caused by age. Factors such as illness, genetics, and even medical procedures can cause premature menopause. For example, women who have had to undergo chemotherapy or radiation treatment are more likely to experience premature menopause. Additionally, women undergoing an oophorectomy (the surgical removal of both ovaries) will transition into immediate menopause, hot flashes included. The ovaries supply the main source of two female sex hormones—estradiol (a component of estrogen) and progesterone—plus testosterone.  When the ovaries are gone, so is the estrogen.

Diagnosing_MenopauseFSH Levels
If any of this is sounding familiar, it is best to go see your doctor. He or she will likely perform several tests to rule out conditions such as pregnancy or thyroid, but the definitive test will be the FSH (follicle stimulating hormone) test. FSH, produced by the pituitary gland, is responsible for causing your ovaries to create estrogen and helps control your cycle. When your estrogen level drops, FSH levels rise. A high FSH level indicates you are in menopause.

Since women's estrogen levels are irregular during perimenopause, a single FSH test may not be definitive for a diagnosis.  For women who still menstruate, the test should be on day 3 of your period. When your test reveals FSH levels more than 10-12 mlu/ml, you're likely in perimenopause. You can test much higher, even in the menopause range, and still be having periods. Many physicians will also want to measure your estradiol, the main component of estrogen, to have a better sense of where you are on the menopause continuum.

There can be many health concerns associated with low estrogen levels, such as osteoporosis (the thinning of the bones), cataract formation, cancer, and more. Women who enter menopause prematurely spend a longer portion of their lives at risk, which is why an early diagnosis is important.

Take the first step in realizing what you're going through. Once you understand your situation, the sooner you can learn to manage your menopause and its symptoms and start to get your life back. ♀

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