How Menopause Is Diagnosed

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Most women won't know for sure that they've reached menopause—the point at which the ovaries no longer produce estrogen and progesterone—until at least a year after they get there. Until that point, a woman can still get pregnant. Doctors can diagnose menopause based on your menstruation and overall patient history, but may use lab tests that measure specific hormones to confirm a diagnosis, if needed.

Self-Checks/At-Home Testing

Strictly speaking, a woman has reached menopause when she has gone an entire year without having a period. But unless you have a surgical procedure that will cause your periods to stop immediately, such as a hysterectomy, there's no way to know ahead of time when that will happen. In fact, you'll only know that menopause has occurred for sure if you note each time you menstruate and then notice when a year or more goes by that you haven't had a period.

Some turn to home lab kits to measure follicle-stimulating hormone (FSH) in urine to help determine this; FSH levels rise during perimenopause and menopause. These tests are usually consistent with lab tests that measure FSH in the blood.

But elevated levels detected with an FSH home test aren't a guarantee that you've reached menopause. This is because FSH levels can vary during this time. While yours may be high on the day you measure it, it's possible that you are still menstruating.​​

Even if you've gone several months without menstruating, until an entire year goes by there's always a chance you'll have another period. In that case, you'll have to start the countdown all over again.

Timing and Terminology

The words used to explain menopause are part of what makes understanding the timing of it so confusing. Often you'll hear someone say she's "in menopause," or she's "going through menopause," or she's "menopausal." But this rarely means a woman actually reached menopause. Most likely, she's experiencing perimenopause—the period of time leading up to menopause. This is when symptoms such as hot flashes, irregular periods, and so forth occur.

Labs and Tests

Menopause is diagnosed based on your age, clinical history, and a year having passed since your last menstrual period (unless your menopause was surgically induced).

In cases in which it's not clear if a woman has reached menopause, there are lab tests that can confirm the diagnosis. These measure amounts of certain reproductive hormones in the body that fluctuate during the menstrual cycle.

These are the specific hormones that may be tested for and why:

  • Estradiol: This is one of three types of estrogen and is the type most often evaluated when testing for menopause.
  • Follicle-stimulating hormone (FSH): This hormone is released by the pituitary gland. Since the levels of FSH in the blood rise dramatically after menopause, it is a good indicator of the diagnosis (with the above caveats considered).
  • Thyroid stimulating hormone (TSH): Sometimes a thyroid problem can cause symptoms that mimic menopause. Especially in the case of someone who seems to have reached premature menopause (symptoms begin to appear before age 40), it may be important to test levels of TSH to rule out a condition other than menopause.

Imaging

Ultrasound can show details of follicle counts and ovarian volume to help determine whether menopause has occurred, but it is rare that imaging studies are used in the diagnosis of menopause.

You should continue with your regular imaging health screens when you reach perimenopause and menopause. These include mammograms to screen for breast cancer. It also is often a time when you will have your first colonoscopy to screen for colon cancer.

Differential Diagnoses

Some illnesses have symptoms similar to those often attributed to menopause. Be sure to discuss any symptoms with your doctor so nothing is overlooked.

Perimenopausal symptoms, including sweating, mood changes, and menstrual irregularities, can be seen in hyperthyroidism. You might also stop menstruating due to pregnancy, thyroid disease, or hyperprolactinemia (which may be caused by a pituitary tumor).

If you begin hormone replacement therapy for menopause, be sure to talk to your doctor if your symptoms are not getting better or are getting worse.

A Word From Verywell

Menopause is often an "am I or aren't I?" proposition. You may have been period-free from months and then have spotting or a light period, resetting the countdown until you are sure you are postmenopausal. While menopause means you don't have to use birth control to prevent pregnancy, remember that you still need to practice safe sex to prevent sexually transmitted diseases.

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Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Collaborating Centre for Women's and Children's Health (UK). Diagnosis of perimenopause and menopause. In: Menopause: Full Guideline. London: National Institute for Health and Care Excellence (UK); 2015.


  2. National Institute on Aging. What Is Menopause? Updated June 27, 2017.


  3. Rao SS, Singh M, Parkar M, Sugumaran R. Health maintenance for postmenopausal women. Am Fam Physician. 2008;78(5):583-91.


  4. Klein DA, Poth MA. Amenorrhea: an approach to diagnosis and management. Am Fam Physician. 2013;87(11):781-8.


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