Menopause Diagnosis and Testing

If your periods have stopped sooner than they would naturally due to breast cancer treatments you may wonder if they will return. Your doctor may order menopause tests to check the hormone levels in your body.

Still, it’s important to remember that these tests won’t give you a definitive answer about menopause. The conclusive result is not having a period for a year.

It’s also important to know that figuring out menopausal status is harder in women who have a menstrual cycle disorder, like polycystic ovarian syndrome, and in women taking oral birth control.

If you’re in peri-menopause and still having periods, but not every month, and have been diagnosed with early-stage, hormone receptor-positive breast cancer, your doctor may do a menopause test to help make decisions about hormonal therapy. Aromatase inhibitors are usually recommended for post-menopausal women, while tamoxifen can be taken by both pre-menopausal and post-menopausal women.

There are three tests that can help figure out if you’re in menopause.

FSH is a hormone made by the brain that tells your ovaries to release an egg. FSH levels are highest just before an egg is released. 

An FSH test is done on a blood sample taken in your doctor’s office.

If you’re in menopause, your ovaries no longer respond to FSH and your brain reacts by making even more hormone. FSH levels can vary widely from day to day, so tracking levels over time is important when figuring out menopausal status. A persistently high level can mean that menopause is permanent.

One high FSH level is not enough to diagnose menopause because levels of this hormone vary widely during the menopausal transition. FSH levels are consistently high around the time of your final menstrual period. But it’s hard to predict when this final menstrual period will happen.

FSH works closely with another hormone, luteinizing hormone, to help control the menstrual cycle.

Luteinizing hormone is made by the pituitary gland, a small gland that is just underneath the brain.

A luteinizing hormone level test is also done on a blood sample taken in your doctor’s office. There are at-home tests that use urine samples, but there are concerns that the results of these at-home tests aren’t always accurate. 

If you’re in menopause, your ovaries no longer respond to luteinizing hormone and your pituitary gland reacts by making even more hormone. Like FSH levels, luteinizing hormone levels can vary widely from day to day, so tracking levels over time is important when figuring out menopausal status. A persistently high level can mean that menopause is permanent.

Still, some doctors feel luteinizing hormone levels are not as helpful as FSH levels when trying to figure out menopausal status.

An estrogen level test is usually done on a blood sample in your doctor’s office, but can also be done on a urine sample. Estradiol is the main form of estrogen found in pre-menopausal women. There are at-home tests that use saliva samples, but there are concerns that the results of these at-home tests aren’t always accurate. 

Low estrogen levels may mean you’re in menopause, but there are other things to consider. If you’re taking tamoxifen, you may skip periods or they may stop altogether, but your estrogen levels may be higher than normal. Doctors aren’t exactly sure why this happens. One possible reason is that although tamoxifen stops estrogen from affecting breast tissue, it acts like estrogen in other tissues. 

You may see other menopause tests that you can do at home, on your own, using urine or saliva. However, these tests aren’t considered reliable, especially tests that use saliva. If you’re interested in testing, be sure to discuss it with your doctor.

 

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