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: 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.
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.
Women might want to know if their 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, also known as a vasomotor symptom, 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 women have stopped menstruating for 12 months that they have 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 women who are feeling fine without any menopause symptoms, no matter what their 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, if you have menopause symptoms, see your doctor, because your symptoms can be due to another medical condition. 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.
