TESTING FOR PERIMENOPAUSE
How exactly does a doctor determine that a woman’s symptoms are due to unopposed estrogen instead of something else? Dr Steven R. Goldstein, a Perimenopause Specialist in NYC, and past President of the International Menopause Society and a Certified Menopause Practitioner says that the first place to begin is with menstrual history, which is why it is very important for women to keep a good calendar. In addition, the doctor inquires about subtle symptoms such as mood changes (depression), free-floating anxiety, sleep disturbances, forgetfulness, changes in libido, difficulty concentrating etc. Doctors can also do blood tests to verify this transition. One test measures the level of estradiol in the blood. Estrogen isn’t really one hormone, but three – estrone, estradiol, and estriol. Estradiol is the predominant estrogen in terms of potency. Estradiol comes mainly from the ovaries, which is why this is the type of estrogen your gynecologist is most interested in. The second test is for FSH (follicle stimulating hormone) level. FSH is the hormone that tells the ovary to release an egg. It will also appear in your blood. Sometimes, however, these blood tests can give confusing results. Many patients have estrogen levels that are not in the menopausal range (in other words they are still making estrogen), but their FSH levels have started to rise (greater than 30, which is