You may have heard about a kit you can use at home to see if you are in menopause. It tests urine for the presence of FSH, or follicle-stimulating hormone.
Fine, but here's the first potential trap: Just because the results of a home urine test agree with the results of a lab blood test does not make the home test reliable. In fact, levels of FSH in the blood correlate poorly with menopausal symptoms. So, if a blood test that looks for FSH isn't a reliable marker, neither is the urine test.
It was the summer of 2002 when the news about hormone replacement therapy
(HRT) shook us to the core.
In what felt like a bomb dropped on all womankind, the U.S. federal
government halted the hormone trial of the Women's Health Initiative early – a
study designed to evaluate the risks and benefits of hormone replacement
therapy on disease prevention.
The reason: Not only had HRT failed to be the protective fountain of youth
doctors and women had long since believed, evidence was mounting...
As disappointing and surprising as it may seem, many aspects of the menopause process remain a mystery to medical science. The medical definition of menopause is when menstrual periods stop for 12 months as a consequence of the ovaries shutting down. Menopause is not defined by a blood test, or a urine test, or any lab test for that matter.
A woman might want to know if her symptoms are a result of menopause, so would FSH testing meet that need? Well, women can have terrible menopause symptoms and yet their FSH level may remain in the "premenopausal" range. Conversely, women without symptoms such as hot flashes may have an FSH level in the "menopausal range."
To further complicate matters, the FSH test is highly variable during the time when periods are irregular. For example, a woman might skip three periods, and then have periods for a few months, and then skip several periods again. During this time of irregular periods -- before periods stop altogether -- the FSH level can fluctuate dramatically. It isn't until a woman has stopped menstruating for 12 months that she is considered menopausal. So, what's the point of the FSH test?
For all of these reasons, FSH testing is not suited as a routine test (like cholesterol screening, say) for every woman around the age of menopause. Encouraging women without any menopausal symptoms to check their FSH levels is not doing them any service.
If women don't have menopause symptoms, they don't need to have any menopause tests (even if the FSH were a perfect marker of menopause, which it isn't). Doctors are not going to prescribe therapy to a woman who is feeling fine without any menopause symptoms, no matter what her FSH levels are. The FSH test only tells you if you have a high FSH level. It doesn't tell you if you are definitely in menopause (or premenopausal or perimenopausal).
The bottom line is that, if you have menopause symptoms, see your doctor, because even if your FSH level is not in the menopausal range, your symptoms can be due to menopause. And if you don't have symptoms, just sit back and don't worry about FSH tests. And by all means, do not use your home menopause test kit to make decisions about your fertility or your need to use contraception.