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Q&A from Mandurah Forum 9th June 2023

No, blood test are not necessary.

However, blood tests may be necessary in the following scenarios.

1. If a woman is <45yrs old with no period for 6 months and pregnancy has been ruled out she may benefit from FSH. Estrogen is generally not a very useful test.

2. If a woman is on HRT but is still experiencing signficant menopausal symptoms. In this case, an Estrogen test can be done to assess the absorption of Estrogen into the blood.

3. In some cases a woman who has had a hysterectomy may want to know if she's menopausal. In this case, the FSH test may be done, but remember FSH is not an accurate test for a firm diagnosis of menopause, the normal practice would be, to repeat FSH 6 weeks apart. However, the fundamental question is, " will the diagnosis of menopause change the management plan?" Not really. The reason for this is, menopause is successfully diagnosed by having menopause symptoms. With a trial of therapy for 3 months, most menopausal symptoms fully resolve.

I use the AMS symptoms score.

At 6 weeks, a woman should be scoring half of what she scored at the first consultation. At 12 weeks, a woman should be scoring less than 5. If not, I start asking questions and look for other causes of her symptoms. If necessary, I usually adjust estrogen dose at 6 weeks and again at 3 months. However, I find that if estrogen is adjusted at 6 weeks, by 3 months, most women are on the right level of estrogen.

(Remember, blood tests are not necessary to diagnose perimenopause or menopause)

Typically the usual Blood test requested by GPs for perimenopause and menopause include:

#1 Follicle-Stimulating Hormone (FSH)

FSH is like a messenger in your body that helps with making babies.In women, FSH tells the ovaries to grow eggs and make hormones that are important for the menstrual cycle and fertility.

#2 Estrogen

Here are some of the primary effects of Estrogen in different parts of the body:

Ovaries: Estrogen helps regulate the menstrual cycle, stimulates the growth of ovarian follicles, and supports egg maturation.

Uterus: It promotes the thickening of the uterine lining in preparation for pregnancy.

Breasts: Estrogen is responsible for breast development during puberty and maintains breast health.

Cardiovascular System: Estrogen can have a protective effect on the heart and blood vessels by helping maintain healthy cholesterol levels and promoting proper blood vessel function.

Bone Health: Estrogen helps maintain strong bones by regulating bone density and preventing excessive bone loss. Low estrogen levels can lead to an increased risk of osteoporosis.

Skin and Hair:Estrogen contributes to the maintenance of skin elasticity and thickness and promotes hair growth.

Mood and Cognitive Function: Estrogen can influence mood and cognitive function. Changes in estrogen levels are associated with mood swings, anxiety, and cognitive changes, especially during the menstrual cycle and menopause.

Metabolism: Estrogen can affect metabolism, including body fat distribution. It tends to promote fat storage in the hips and thighs.

Sexual Function: Estrogen is essential for maintaining vaginal health and lubrication. It also contributes to sexual desire and function.

Immune system: Estrogen affects the immune system positively. During the height of Covid In the U.K. there was no woman on HRT Who had needed ICU.

Anti inflammatory:Estrogen is a natural anti inflammatory. Your aches and pains will completely resolve or significantly improve on Estrogen. Most minor aches and pains resolve by 6 weeks. However, if you've got long standing back pain, joint pain or muscle pain, it takes about 6-9 months to get Togo's improvement.

#3 Testosterone

During their reproductive health, women produce 3 times more testosterone than estrogen. It plays a crucial role in a variety of functions in the body. Here are some of the key actions and effects of testosterone:

Muscle and Bone Health: Testosterone helps increase muscle mass and strength by promoting muscle protein synthesis. It also contributes to bone density, maintaining strong bones.

Libido and Sexual Function: Testosterone plays a significant role in regulating sexual desire (libido) and overall sexual function in both men and women.

Mood and Cognitive Function: Testosterone can influence mood and cognitive function, including mental clarity, motivation, and confidence.

Red Blood Cell Production: It stimulates the production of red blood cells, which are responsible for carrying oxygen throughout the body.

Metabolism: Testosterone can affect fat distribution in the body, potentially leading to a more muscular and lean physique.

Skin Health: Testosterone helps maintain skin health and can influence skin thickness.

Immune System: Testosterone can influence the immune system, potentially affecting a person's susceptibility to certain diseases.

Look out for more Q&A in future blogs

By Dr Purity Carr

GP & Menopause Doctor

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Unknown member
Oct 17, 2023

Informative article. Thank you Dr. Carr

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