Menopause

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How Accurate are Lab Tests in Diagnosing Perimenopause?

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In Western medicine lab work is the go-to diagnostic tool, helping physicians diagnose a wide variety of physical conditions. Pregnancy, diabetes,  heart disease, and even kidney disease, can all be confirmed or denied by a simple blood test. But when it comes to diagnosing perimenopause, lab tests are probably the least accurate tool used by physicians.

Every day, countless women exhibiting classic symptoms of perimenopause, are routinely misdiagnosed or worse, outright dismissed by their physicians, who insist they couldn’t possibly be in perimenopause because their blood work says their hormone levels are “normal.”  Frustrated and confused, women either delay or never receive the proper treatment for their symptoms, because the almighty “lab test” has declared they are not in perimenopause.

What Do Lab Tests Look For in Perimenopause?

When your physician administers a blood test to determine if you are in perimenopause, he or she is looking for a hormone secreted by your pituitary gland called FSH.  FSH or follicle stimulating hormone, is a hormone secreted by your body in response to low estrogen levels. 

Why Lab Tests Alone Are Not Reliable in Diagnosing Perimenopause

When a woman is in perimenopause, it is assumed she will have low estrogen and progesterone levels, and as a result, there will a higher presence of FSH in her blood. While high FSH levels are certainly an indicator of whether a woman is in perimenopause, they should not be the only measure for diagnosis. Depending on when the lab work is done, each test could reveal an entirely different result.

For example, say you have been under a lot of stress, you are not eating well or sleeping well, and perhaps you have been drinking more alcohol than you should. It is possible that you could miss a normal period, maybe even two, due entirely to the stress.  

If you were to have your FSH levels tested at this time, chances are they would be very high since your body would be responding to low estrogen levels due to the missed periods, and therefore, trying to stimulate ovulation. Depending on your age, your physician may conclude based on the high FSH levels alone that you are in perimenopause, when in actuality you are not.  

Then, let’s say that the period of stress passes, and your cycles return to normal again, though due to the missed periods, your estrogen and progesterone levels could be out of balance. As a result, you may also experience hot flashes and night sweats. In this scenario, hot flashes and night sweats are classic symptoms of perimenopause, yet if you were to have your FSH levels tested, they could be normal, because you have been cycling regularly.

So while lab tests are certainly an excellent tool for your physician to use in diagnosing perimenopause, given the variety of variables that can affect their outcome, they should not be used exclusively.  

How do I know if I’m in Perimenopause?

If you are in your mid to late 40s, or even your late 30s and are experiencing what you think are perimenopause symptoms, then by all means, see your physician for the appropriate lab tests. 

But it is important to understand, you may need several lab tests taken over a period of time in order to get an accurate picture of your hormone levels for a proper diagnosis.

And remember, you are the best barometer for how you feel. Regardless of the results of any lab tests, if your instincts tell you that you might be in perimenopause, trust yourself.  Do not be afraid to seek a second or even a third opinion if necessary.  It’s your hormone health and your body, get in the driver’s seat.  

Magnolia Miller is a freelance women’s health writer and blogger at The Perimenopause Blog

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About the Author

Magnolia is dedicated to empowering women to take responsibility for their own health.

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