You and your doctor can tell whether
you are in
perimenopause based on your age, your history of
menstrual periods, your symptoms, and the results of your
pelvic exam. If possible, bring a calendar or journal
of your menstrual period and symptoms.
If you have severe symptoms
before or after menopause, if your doctor suspects another medical condition,
or if you have a medical condition that makes a diagnosis difficult, your
doctor may do one or more of the following tests:
Menopause symptoms, like hot flashes and drop in sex drive, haven't changed. But the way women deal with menopause has.
"Women are becoming more accepting of the physical and emotional challenges that are associated with menopause and accepting them as natural, transitional changes," says Karen Giblin. She's the founder of Red Hot Mamas, a national menopause education program. "They're focusing on feeling good and looking at menopause more positively."
If you have had no menstrual periods for 1 year, you have
reached menopause and are in
postmenopause. This is a good time to have a full
physical exam, with particular focus on your heart health and risk factors for
osteoporosis. Be sure to report to your doctor any
unexpected vaginal bleeding.
Unexpected vaginal or menstrual bleeding
If you have irregular bleeding during
perimenopause or you are taking continuous
hormone therapy and have vaginal bleeding after 6 to
12 months of treatment, your doctor may use one or more additional tests to
rule out serious causes of the bleeding. These tests may include:
United States Preventive Services Task Force
(USPSTF) recommends that all women age 65 and older routinely have a
bone mineral density test to screen for osteoporosis.
If you are at increased risk for fractures caused by osteoporosis, routine
screening should start sooner.4 If you
have stopped hormone therapy, it is very important to discuss osteoporosis
screening with your doctor. This is because you no longer have the extra bone
protection from extra estrogen. USPSTF recommends that you and your doctor check your fracture risk using a tool such as FRAX to help decide whether you should be screened for osteoporosis. Talk to your doctor about your risk factors and when to start bone mineral density screening.
The FRAX tool was developed by the World Health Organization to help predict your risk of having a fracture related to osteoporosis in the next 10 years. You can use this tool. Go to the website at www.sheffield.ac.uk/FRAX, and click on Calculation Tool. If you have had a bone mineral density test (BMD) on your hip, you can type in your score. If you have not had that test, you can leave the score blank.
Most experts say that the decision
to screen younger women should be made on an individual basis. This
decision depends on your risk for developing osteoporosis and whether the test
results could help with treatment decisions. For more information, see the