Menopause means that the levels of the sex hormones progesterone and oestrogen slowly decrease and eventually settle at a stable low level. Menstruation stops and it is no longer possible to get pregnant. There is a whole range of symptoms that can occur, from heavy bleeding, depression and hot flushes to dry mucous membranes.
How do I know if I'm in the menopause?
You'll know you're in the menopause when you haven't had your period for a year. It usually occurs in your 50s but can come later or earlier. Read more about the first symptoms here.
Menopause is usually divided into the following stages:
1. Perimenopause: Hormones start running amok, your periods become irregular (see picture below).
2. Menopause: your last period. Unfortunately, you won't know if it's your last period until you've been period-free for 12 months.
3. Post-menopause: the time after your last period (for the rest of your life).
But if, for example, you feel unreasonably tired or depressed and are in your 40s, how do you know if your symptoms are caused by menopause or something else, such as iron deficiency? Knowing whether you have reached the menopause can be important and you may want to take a test before contacting your health centre. There is a wide range of tests available, both free tests and tests that cost money. However, it is important to realise that none of the hormone tests can give an answer with 100% certainty. This is because we all have different hormone balance and hormone levels, so it is very individual how the hormones vary in the body during the menopause and difficult to get a fair picture from a simple test.
Common tests for menopause
Here are some suggestions for common tests to see if you are in the menopause:
- Menopause rating scale: A free test where you can estimate how severe your various menopausal symptoms are on a scale of 1 (none) to 5 (very severe). It does not provide a diagnosis, but if you have high values for several of the symptoms, you can probably be pretty sure that you are in the menopause. It may be a good idea to take the test before contacting your health care provider.
- Oestrogen/progesterone levels: A blood or saliva test can measure levels of the hormones progesterone, oestrogen or the balance between them. Low levels of progesterone or the ratio of progesterone to oestrogen can show if you are in the menopause. You buy a hormone test online and either get an appointment for a blood test at your home or send a saliva sample to a lab. Of course, it is not advisable to test hormone levels if you are taking contraceptive pills or hormone replacement therapy.
- FSH level: A simple urine test that you read at home. It measures Follicle Stimulating Hormone (FSH), a hormone that stimulates egg cells to produce oestrogen. Oestrogen in turn inhibits the production of FSH, so FSH levels increase during the menopause as your oestrogen levels fall. High levels of FSH can be a sign that you are in menopause.
- AMH test: Anti-Müllerian Hormone, is a sex hormone. The level of AMH in the blood can indicate how many egg follicles a woman has left. During menopause, AMH levels drop too low to be measured. AMH is usually performed in combination with other tests when investigating why a woman cannot have children. It is not normally a test you need to use to see if you are in the menopause.