Why menopause tests miss the mark: expert insights


How do you find out if you’re pregnant? How do you determine if you have COVID? How do you check your blood glucose levels?

For most of us, the answer is we take a test at home and we get a definitive answer. A line, a plus sign, a number.

These tests are simple and quite accurate. We’ve become used to their convenience.

It’s no surprise that companies are now offering tests that claim to tell you if you’re in menopause, and it’s no surprise women would want the answers those tests promise.

The catch is, menopause experts say these menopause tests don’t work.

The experts

We’ve gathered information from Dr. Jen Gunter’s Substack (The Vagenda), Dr. Ardelle Piper’s fantastically informative Instagram account, and the North American Menopause Society, all of whom offer important insight into the science behind menopause test kits.

As we’ve discussed in previous stories about menopause, this period of life is a gradual transition as the body’s production of estrogen and progesterone – hormones essential for reproduction – starts to fluctuate and eventually decline.

Listen to our conversation with Dr. Jennifer Gunter

Hormone levels, particularly estrogen and follicle-stimulating hormone (FSH), can rise and fall significantly from day to day and even within the same day. Commercial tests which capture a hormone “snapshot” through a blood or saliva test may be inaccurate within a very short time after the test is administered.

Dr. Jen Gunter offers three clear reasons why doctors make a menopause diagnosis clinically – using age, menstrual status, and other symptoms – rather than by using blood, saliva, or urine tests:

1)    Hormone tests are not useful: Because ovarian function declines unpredictably, no single hormone level, including FSH, reliably indicates menopause. While FSH levels may rise before menopause, about 10 percent of people see no significant increase until after their final period.

2)     Hormone tests can be unreliable: Long periods of no bleeding may be followed by ovulation, with the FSH level varying correspondingly. The unpredictability of ovulation underscores the need for a one-year wait without periods to confirm menopause.

3)     Neither hormone levels nor phase of menopause matters: Therapy begins based on symptoms, not hormone levels. If doctors want to evaluate whether bleeding is normal or whether you can stop using contraception, they will assess whether you’ve reached menopause … but they won’t use hormone levels.

Better alternatives

If hormone tests aren’t all they’re cracked up to be, and if you really want to know where you are in your menopause journey, then how do you go about that?

Symptom tracking

In a recent Instagram video on tracking menopause, Dr. Ardelle Piper says, “A symptom tracker is a much better method of gauging where you are in your perimenopause than asking for labs.”

There are plenty of different styles and types of menopause trackers – print, spreadsheets, apps – you can choose the one that’s best for you. These are all from reputable sources:

·        Menopause Symptoms (menopausefoundationcanada.ca)

·        Menstrual calendar (menopause.org)

·        Microsoft Word – Symptom Tracker 2.docx (bywardfht.ca) (Dr. Piper’s tracker)

Visit your doctor

The North American Menopause Society says, “When a woman suspects she’s in perimenopause, it is an excellent time to have a complete medical examination by a qualified healthcare professional.”

And if you’ve been using a symptom tracker, you can definitely bring that to your appointment to help your doctor understand what you’ve been experiencing.

Read about: What does it mean to advocate for yourself in a doctor’s office?

Take a step back

Ask yourself why you want to know. If you have a health concern – for example you think you’re bleeding when you shouldn’t be, or your symptoms are worrying you – fair enough. That seems like a great reason to see your doctor.

Otherwise, though, Dr. Gunter makes a great point: “If you have ovaries and a uterus, at some point, you will start menstruating, and at some point, you will stop menstruating and enter menopause.”

Say you still want to “know,” though. You still want to take a test. You’re willing to pay for it. Is there a problem with that?

Dr. Gunter is concerned that these take-home tests could cause confusion and lead to difficult interactions between patients – thinking they have a definitive result – and their healthcare providers.

The bottom line

If you’re over 40 and you think you might have started your menopause journey… there’s a strong chance you could be right.

And, if you are right, that would make you completely normal.

Menopause experts want you to know you can track your symptoms, you can consult a healthcare provider, and you can make informed choices about how to manage your health – and you don’t have to spend your money on a menopause test.