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Author: Forth
June 1, 2023
Female health
First of all, perimenopause and menopause are two distinct stages in a woman’s reproductive life. There are 3 main reasons to test your female hormones at this stage in life; to find out if you have entered perimenopause, to track the transition to menopause to judge when is the right time to consider HRT, and whilst on HRT to check if the dosage is right for you.
Perimenopause refers to the transitional period leading up to menopause, usually starting in a woman’s 40s and occasionally can happen earlier. During perimenopause, hormone levels, particularly oestrogen and progesterone, begin to fluctuate, leading to irregular menstrual cycles, low mood, hot flashes, and many other symptoms. It is still possible for women to conceive during perimenopause, although fertility decreases.
Menopause, on the other hand, marks the end of reproductive years and is defined as the absence of menstrual periods for 12 consecutive months. Oestrogen levels decline significantly, resulting in various physical and emotional changes such as vaginal dryness, night sweats, and mood disturbances.
Menopause is a natural biological process that signifies the end of fertility, while perimenopause represents the transition into this phase.
Urine tests usually measure the amount of follicle-stimulating hormone (FSH) in your urine, which increases during menopause as the ovaries produce less oestrogen. However, as urine is a waste product, this type of sample is not as accurate as a blood test and usually only measure 1 hormone (FSH) rather than all 4 sex hormones. They are therefore a poor indicator of perimenopause. Other factors such as pregnancy, certain medications, and medical conditions can also affect the results.
Dr Thom says: Urinary menopause tests are not an effective means of identifying menopause or perimenopause. These tests have limitations because they solely measure Follicle Stimulating Hormone (FSH), without considering the broader clinical context. FSH levels vary throughout the menstrual cycle and during the menopausal transition. Although heightened FSH levels may suggest perimenopause or menopause, a negative test result for elevated FSH levels does not necessarily mean that an individual is not experiencing menopause or perimenopause. Moreover, if hormonal contraception is being used, these tests hold no value as they function by suppressing FSH production.
Saliva tests use a swab to collect hormone levels from your saliva. However, the outcome of a saliva test can be highly variable, depending on time of day, your diet and hydration, making them unreliable and inaccurate. Because of this, you may need to redo tests multiple times over the course of a few weeks.
Dr Thom says: There is not enough research to show that salivary testing for menopause improves diagnosis or health outcomes for people. The current clinical practice guidelines do not recommend salivary hormone testing for menopause.
Alongside symptoms, blood tests are the best way to help diagnose perimenopause. Although they are more accurate than urine tests, blood tests that only measure a sample from a single day are still not an effective way to diagnose perimenopause, as your hormones fluctuate over the course of your menstrual cycle.
Dr Thom says: Although more accurate than urinary or salivary testing, a single time point blood test does not account for the cyclical release of hormones during the menstrual cycle. It can provide false reassurance especially if a woman’s cycle is irregular or they are taking hormonal contraceptive products.
MyFORM® is our groundbreaking perimenopause test. It works by checking 2 samples of blood from day 14 and day 21 of your menstrual cycle, rather than a single day. By applying sophisticated mathematical algorithms we are able to map if your hormones are fluctuating in the correct pattern across your full cycle, or if your ovarian response has started to decline indicating perimenopause.
Unlike urine tests and some single day blood tests, it checks all of the important hormones related to perimenopause – Oestradiol (Oestrogen), Progesterone, Luteinising Hormone (LH) and Follicle-Stimulating Hormone (FSH).
Dr Thom says: Using our world leading AI algorithm looking at the four menstrual hormones gives you an in-depth analysis of your personal hormone network and how it is functioning. We are able to identify perimenopausal hormone changes earlier with more certainty and allow you to make more informed decisions about your health.
Choosing the best menopause test for you might seem challenging. The main consideration should be accuracy, as you may end up wasting money on tests that don’t help you test or track the right hormones in the right way. Although saliva and urine tests may seem inexpensive, they won’t be able to provide you with the insights you need to understand your hormones and manage symptoms of perimenopause.
We recommend trying our MyFORM® Perimenopause test for the most accurate results. We’ve put together a perimenopause symptoms quiz – completing the quiz will unlock 15% off our MyFORM perimenopause blood test to help you get started.
Most women begin to experience symptoms of perimenopause in their 40s. Irregular periods is one of the key tell-tale signs of perimenopause but if you are experiencing other symptoms such as hot flashes, mood swings and vaginal dryness, you may also consider testing for perimenopause.
Once you have received your test results, it is important to understand what they mean and how they can affect your health. Our doctors will interpret your results and provide feedback to help you understand what your hormone levels mean for you and what to do next.
If you decide to discuss your menopause test results with your doctor, it is important to be open and honest about your symptoms and concerns. They can help you navigate the various treatment options available to manage your symptoms.
Hormone replacement therapy is a common treatment for menopause symptoms. This involves taking oestrogen and progesterone to replace the hormones that your body is no longer producing. Hormone therapy can be taken in various forms, including pills, patches, gels, and creams.
Menopause testing can benefit you in various ways. It can provide clarity and peace of mind about if you are entering perimenopause or not. It can also help you manage your symptoms more effectively. Knowing your hormone levels can help you and your healthcare provider make informed decisions about the best treatment options for you. Thirdly, menopause testing can help detect other medical conditions that may cause similar symptoms. Early detection can lead to early intervention and better outcomes.
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Thom works in NHS general practice and has a decade of experience working in both male and female elite sport. He has a background in exercise physiology and has published research into fatigue biomarkers.
Dr Thom Phillips
Head of Clinical Services
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