In our series this Menopause Awareness Month, we’re asking the questions you may have been wanting to ask your GP. On Menopause Awareness Day, we are looking at the subject of blood tests and how the results can cause confusion when it comes to menopause with our Group Medical Director and practicing GP Dr Rebecca Brady.
Q: My blood tests are normal, does that mean I’m not in perimenopause?
I get a lot of questions and comments from my patients around this theme. Patients come to me with what are considered ‘normal’ blood test results or have been told they can’t have a blood test despite experiencing other (pre)menopausal symptoms. This often leads to confusion for the patient – are in the perimenopause or not? It is a confusing area and not often very well explained! So let me tell you how I explain it.
In answering a previous question on the menopause, I mentioned that the menopausal transition is very variable. But women in their 40s experiencing menopause-like symptoms, should have these symptoms managed as such.
You may have heard of blood tests such as follicle-stimulating hormone (FSH) measures to diagnose the perimenopause or menopause. This detects elevated levels of FSH in the the blood which can help diagnose the menopause in younger women.
But blood tests aren’t always the most useful way of detecting the menopausal transition for most individuals. This is because hormone levels can fluctuate or remain normal on a blood test on any given day, even if people are experiencing severe symptoms.
Many labs will not routinely use blood tests to check hormones above the age of 45 unless there is a good reason to do so, such as if the person is having other treatment like pelvic organ prolapse treatment or use of the Mirena coil, where periods have stopped artificially.
The more I speak to women in my clinic, the more I find there are a lot of women in their 30s and 40s who are experiencing transitional symptoms but are still having periods. Despite still having periods, this could be the perimenopause and therefore they may want to try HRT to see if this alleviates symptoms. There are caveats where certain health conditions such as active breast cancer mean HRT is not appropriate.
It may be that blood tests can be done to exclude other causes of these transitional symptoms e.g., anaemia, thyroid disturbance, vitamin D deficiency, as well as looking at an individual’s general health risk factors, such as diabetes and cholesterol.
If you’re concerned about symptoms or need help and advice, talk to your GP.
If you’re an employer looking to provide menopause support as part of your employee health and wellbeing strategy, speak to one of our experts who will be happy to help. If you’re an employee who would like to see your workplace provide menopause support, let us know!