Testing and Diagnosing Menopause

Menopause is a natural part of getting older for people with ovaries. It marks the end of the time when a person can get pregnant. This change can feel like a big shift in your life. You might have many questions about how doctors find out if you are in menopause.¹

You do not need an official test to diagnose menopause. However, there are certain tests and steps available that can help you feel more in control of your health, and if you have specific questions. This article explains the specific steps and tests doctors use that can help with diagnosing menopause.

A full year without a period

The most common way to know you have reached menopause is by looking at your menstrual cycle. Menopause is defined as the point in time after you have gone 12 months in a row without a period. This means you have not had any bleeding or spotting for 1 full year.^1,2

During the years leading up to this, your periods may become irregular. This time is called perimenopause. You might skip a month or have a period that is lighter than usual. These changes happen because your body is making less estrogen.^1,2

Once you hit the 12-month mark without a period, you are officially in postmenopause. Tracking your period on a calendar or an app is a great way to help you and your doctor understand where you are in this process.^1,2

The physical exam

If you think you are starting menopause, your doctor will likely start with a physical exam. They will talk to you about your health history. They will ask about your symptoms. Common menopause symptoms include hot flashes, trouble sleeping, and mood changes.^1,2

If your symptoms include vaginal dryness, pain with sex, or urinary symptoms, your doctor may also perform a pelvic exam. This helps them check the health of your reproductive organs. They will look for signs like thinning of the vaginal walls. This thinning is a common sign of lower estrogen levels. A physical exam is a simple and safe way for your doctor to gather clues about your body's changes. It is also a good time for you to share any concerns you have about how you feel.^1,2

Blood tests

Sometimes a doctor will order a blood test to help with a menopause diagnosis. One common test measures the level of estradiol in your blood. Estradiol is the main type of estrogen made by the ovaries. As you move toward menopause, your estradiol levels will naturally go down. A blood test can show if these levels are lower than they used to be.^1,2

Doctors may also test for follicle-stimulating hormone (FSH). FSH is a hormone created by the brain that tells the ovaries to prepare an egg for ovulation. When ovaries start to slow down, FSH levels usually go up because the brain is trying harder to talk to the ovaries. You may find home FSH tests, but these may not be reliable.^1-3

However, hormone levels can change a lot from day to day during perimenopause. Because of this, a single blood test may not give a perfect answer. Your doctor will look at the test results along with your symptoms and period history to make a final decision.^1-3

Your doctor may also use blood tests, such as thyroid hormone levels, to ensure that your menopause symptoms are not caused by another diagnosis. This is especially important if you are experiencing irregular periods or other menopause symptoms before age 45.¹

Treating symptoms without a formal diagnosis

You do not need a formal menopause diagnosis from a doctor to start treating your symptoms. Many people start to feel the effects of menopause long before their periods stop for a full year. If hot flashes or night sweats are making your life difficult, you can seek help right away.^1-3

There are many ways to manage these changes. You might try lifestyle changes, such as dressing in layers, keeping your home cool, or avoiding spicy foods. There are also over-the-counter options and prescription treatments available. Talk to a healthcare provider about your symptoms as soon as they start. You do not have to wait for a specific test result to find relief and support.

Your symptoms are valid

Menopause is a journey that every person experiences differently. One of the earliest signs is irregular periods after age 45. While physical exams and blood tests are necessary to diagnose perimenopause, doctors may use them to gain more information for your knowledge and peace of mind. Remember that your symptoms are valid and are treatable.^1-3