Menopause is the physiologic transition every woman inevitably goes through. It’s defined as the cessation of ovulation and menstruation and reduced ovarian endocrine function. All in all – it signifies a lot of change, many of which are reflected in routine tests.

In order to diagnose, we typically base it on age, menstruation history and clinical symptoms. Testing is needed in some situations but not all.

If you’re interested in learning all about menopause, click here.

The following are the conventional lab tests you may order to investigate your reproductive status.

Follicle Stimulating Hormone (FSH) and Menopause

FSH is not required to confirm diagnosis of menopause. It may be indicated for women in perimenopause aged 45 or less.

FSH greater than 25 mlU/ml confirms perimenopause or menopause.

How to measure FSH

• Blood test
• Done on any day you’re not having menses
• If you’re menstruating currently, measure on day 3
• If you’re on the OCP (oral contraceptive pill) and on your placebo week, measure on day 6-7. If >25 mlU/ml, that confirms birth control is no longer needed

Thyroid Stimulating Hormone (TSH) and Menopause

TSH is mainly tested in atypical or young women experiencing menopause type presentation. If it doesn’t make sense you’re experiencing menopause, test thyroid function.

This is also done when vasomotor (hot flash) symptoms are the main issue.

How to measure TSH

• Blood test
• Done on any day
• Consider testing T3, T4, rT3 (which are the main thyroid hormones)

Vaginal pH and Menopause

Vaginal pH is a function of the bacteria population and reflects the overall health of the vagina.

pH greater than 4.5

• Indicates menopause
• If a woman has vaginitis, infection, or is receiving HRT, a pH greater than 4.5 does NOT indicate menopause

pH less than 4.5

• Can be used to monitor for adequate hormone replacement therapy response

How to measure vaginal pH

• pH test strips, not urinary pH strips, but rather, test the discharge preferably from internal exam

Summary

Menopause comes at different ages for every woman, and as menstrual cycles change, and symptoms appear, its helpful to run these basic tests to get a better idea of whether it’s menopause or something else.