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Forum Name: Gynecology

Question: Am I Peri-menopausal or in menopause??


 dvskitten - Thu May 07, 2009 11:47 am

Hi, I’m a 40-year-old woman and I had some labs done last week because I have been having some hot flashes at night. I also suffer from anxiety/depression, so to make sure it’s not that or related to my meds, my psychiatrist ordered the following: FSH level, LH, and estradiol. The doctor won’t come to the phone and has the secretary call, so I can’t get a straight answer.

These were my results: FSH: 24.4 (reference range: follicular phase 2.5-10.2; mid-cycle peak 3.1-17.7; luteal phase 1.5-9.1; postmenopausal 23.0-116.3. LH: 11.6 (reference range: follicular phase 1.9 -12.5; mid cycle peak: 8.7-76.3; luteal phase 0.5-16.9; postmenopausal: 5.0-52.3. Estradiol: 68 (reference range: follicular phase 11-212; mid cycle: 18-480; luteal phase < or – 247; postmenopausal < or -27).

Am I in peri-menopause or menopausal??
 Debbie Miller, RN - Tue May 12, 2009 5:46 pm

User avatar Hello,
Menopause is generally diagnosed by the absence of menstruation for a period of one year (consecutively missed monthly flow). You did not mention this detail or whether or not you have had a total hysterectomy. I assume not or you would be in surgical menopause and would not be asking this question. It is also unclear at what point in the cycle you had the test. If you do not have periods, it would not matter, but if you do, the cyclic hormonal fluctuation can cause the changes and must be considered with the results.

If you are still bleeding, you are not in menopause. Perimenopause can last for several years prior to the cessation of periods, hormone levels will be altered and you may have such symptoms. It is not an exact science and lab values can help determine the change in hormones and help with the diagnosis but most commonly it is simply the amenorrhea.

The FSH test does not detect menopause or perimenopause. As you grow older, your FSH levels may rise and fall during your menstrual cycle. While your hormone levels are changing, your ovaries continue to release eggs. The level on a particular day is not a constant but the value can be a clue when considered with the rest of your history and symptoms.

The fluctuation (rising FSH) and symptoms would suggest perimenopause until your periods cease for a year. There are other potential causes though so your doctor is probably ruling out the obvious possibility before going on to a second theory.

Any doctor ordering labs owes you an explanation of the results. I would schedule a face to face appointment for this purpose and not accept the secretary's information alone. Phone calls to the doctor take him/her away from regular scheduled appointments and they could be running behind schedule anyway. He/she should, however, answer the messages at the end of the day when it is convenient if you request that.

Best wishes.

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