1. Rule Out Pregnancy
Even if you're in your 40's and have thought about becoming a grandmother, don't assume that skipped periods are related to menopause. Women in their 40's have a high rate of unintended pregnancy, so rule out pregnancy first with a home pregnancy test (and be sure to use protection if pregnancy is not in your plans).
2. Evaluate Thyroid Levels
The signs of low thyroid can often masquerade as menopause symptoms: hot flashes, heavy periods, irritability, sleep disruptions and heart palpitations. Talk with your doctor about whether a thyroid test is right for you. A simple blood test measures your thyroid stimulating hormone (TSH). If your TSH is high, this may be a sign of an under-active thyroid gland. Your body produces more TSH in an effort to spur the thyroid into action. Sometimes doctors order tests to measure T-4 and T-3 levels, too. These are the thyroid hormones thyroxine (T-4) and triiodothyronine (T-3). Low levels of either of these, combined with a high TSH level, can point to hypothyroidism. While symptoms of menopause and low thyroid may sometimes be confused, it's possible to go through menopause and have an under-active thyroid gland at the same time. One does not cause the other, and they are not related, but sorting out the symptoms can be tricky.
3. Measure FSH and Other Key Hormones
Your doctor may order a simple blood test to measure your level of follicle stimulating hormone, or FSH. This pituitary hormone stimulates the production of egg follicles in the ovaries. When FSH levels are 50 IU/L or greater, this confirms menopause. Doctors sometimes order blood tests to measure estradiol levels, too. Estradiol is a form of estrogen. If your estradiol level is low, 5 to 25 pg/mL, this points to menopause. Estradiol levels have limited usefulness as a menopause test, though, because levels can fluctuate widely.
