What is menopause?

What is menopause?

Menopause is when you have stopped having periods for one year — triggered by a drop in the levels of the hormones oestrogen and progesterone. This means you can no longer get pregnant naturally.

Prior to this, most women go through perimenopause — when your periods become irregular and your flow might become lighter or heavier. Typically, women transition into menopause between 45 and 55 (the UK average is 51). Sometimes this can happen below the age of 40 — early menopause.

Common menopause symptoms

Most women will experience menopausal symptoms — this can begin up to five years before your periods stop. The most common symptoms include:

• hot flushes, night sweats, and flushing
• vaginal dryness and discomfort during sex
• difficulty sleeping
• low mood or anxiety
• reduced sex drive (libido)
• problems with memory and concentration

None of these symptoms are usually anything to worry about but if you’re concerned you should see your GP.

When to do a menopause blood test

Menopause is a completely natural part of ageing and many women ‘self-diagnose’ themselves as their periods become irregular.

However, you might like to see a GP or specialist if:

• your symptoms are bad
• your periods become irregular early

Your periods being absent for a year combined with your age are the main clinical indicators of menopause — so a blood test won’t always be offered. But in some cases, you will be offered one — for example, if you’re under the age of 45.

A blood test can also help rule out other conditions that cause menopause-like symptoms — for example, an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism).

Keep in mind that not all blood tests are diagnostic. Some tests are used to build a picture of what’s going on inside your body.

What’s in a menopause blood test?

Your ovaries' ability to produce hormones gradually declines over time — in particular, the hormone oestrogen. The drop in oestrogen triggers the levels of another hormone, follicle-stimulating hormone (FSH), to rise — a menopause test will usually measure these two hormones to see if they’re in the menopausal range.

A GP will most likely just measure your FSH levels alone. Other tests might be included depending on your symptoms and any current or past medical conditions.

Other things that your doctor might include in your blood test could be:

• thyroid hormones (TSH, T4) — if these are out of range it can mimic menopausal symptoms
• luteinising hormone (LH)

Understanding your menopause blood test results

Your hormones fluctuate a lot, especially leading up to menopause. So it's often recommended that you do a second test, 4-6 weeks later, if your first FSH level is raised — to build a more accurate picture. If your FSH levels are raised in both instances, then it can suggest that you’re menopausal.

Here’s a brief overview of what your results might show.

Thyroid hormones
If your thyroid hormones are out of range it can cause symptoms like irregular periods, weight changes, tiredness, anxiety, and restlessness — similar to menopausal symptoms. So it’s a good idea to rule out a thyroid disorder when doing a menopause test.

FSH
In most cases, your FSH levels are the strongest indicator that you’re perimenopausal or menopausal — especially if it’s combined with missing periods.

Oestrogen
Your oestrogen levels drop as you reach menopause — which is largely responsible for a lot of symptoms associated with menopause.

If your results show low oestrogen levels this can mean that you’re perimenopausal or menopausal.

Luteinising hormone (LH)
Your LH levels increase as you reach menopause. Raised LH levels, combined with your other hormone levels, can indicate that you’re perimenopausal or menopausal.