Are Lab Tests Accurate in Detecting Perimenopause?

In Western medicine lab work is king. Blood work can tell you if you’re pregnant or if you’re not. You can determine if you’re diabetic or have kidney disease. If you have an infection, a high white blood cell count will tell all. And if law enforcement authorities want to determine if you are legally drunk, blood-alcohol levels can also send you to jail.

So, surely if you’re beginning to exhibit classic symptoms of perimenopause such as erratic menstrual cycles, hot flashes, night sweats, mood swings and insomnia, lab tests will confirm it, right? Wrong.

In fact, a lab test alone is probably the least dependable barometer of the onset of perimenopause. Yet, physicians continue to use them to dismiss women who believe they are in perimenopause because the results say their blood work is “normal.” So, what’s a girl to do?

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 that is secreted by your pituitary gland called FSH. FSH or follicle stimulating hormone, is a hormone that is secreted by your body in response to low estrogen levels.

When a woman is in perimenopause, it is assumed she will have low estrogen and progesterone levels and hence, there will a higher presence of FSH in her blood. While FSH levels are certainly an indicator of whether you are in perimenopause or not, it should not be presumed that you are or are not based primarily on high or low FSH levels.

Why Are Lab Tests Alone Not Reliable in Detecting Perimenopause?

Think of lab tests and blood work like a camera. They provide a snapshot of your physiological health at a given point and time. Depending on when the lab tests are taken, you could have several different results.

For example, let’s say you’ve been cycling normally and you begin to enter a rough patch of life and are under a lot of stress. You’re not eating right, sleeping right and perhaps even drinking a little too much alcohol to help you relax. As a result, you may not cycle normally. You could even skip a couple of periods.

If you had blood work tested during that time your FSH levels would be high as your body tried to stimulate ovulation. The high FSH levels could indicate perimenopause.

Then, let’s say that period of stress passes and you begin to relax, eat and sleep better, and your cycles return to normal again. However, your estrogen and progesterone could still be out of balance. You may even experience hot flashes and night sweats. In this scenario, you could be exhibiting classic symptoms of perimenopause and have normal FSH levels because you are cycling normally.

So while lab tests can be an excellent tool to help your physician determine if you are entering perimenopause, because of the variations that can occur at different times, they should not be used exclusively.

How Do I know If I’m in Perimenopause?

If you are in your mid to late 40s, perhaps even your late 30s and you begin to exhibit what you think are perimenopause symptoms, definitely see your doctor for the appropriate lab tests.

However, be mindful that you will need to have more lab tests taken over a period of time, also known as a “panel of lab tests” in order to get a more accurate picture of your hormone levels.

If your physician will not provide that for you seek the opinion of a second or third physician if necessary. Remember, you are the best barometer for how you feel. If your instincts tell you that you might be in perimenopause, trust yourself.




John Lee

The Perimenopause


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