Q. To Ms Sandra Villella. Do you encourage the use of saliva testing for measuring hormone levels, Vs measuring hormone levels by blood tests.

Saliva tests are not as accurate as blood tests. In many cases, it’s a woman’s symptoms that are the most reliable indicator of whether or not a woman is entering the menopausal transition.

Q. I am perimenopausal and experience symptoms of being very very cold; night sweats that wet all the bed sheets; a feeling of burning up and nothing cools me down. I go through cycles of waking up sweating and cooling and thus poor sleep. After many trials, I now eat soy products, double doses of Remifemin and valerian to sleep. Is being freezing cold or unremitting burning up (without sweating) part of the normal experience of perimenopause?

Some women who are going through menopausal transition experience a feeling of being very cold usually after they have had a hot flush or night sweat and have peeled off some of their clothing or bed clothes! However, feeling very cold and then very hot can also be caused by a number of medical conditions and it is worth consulting your GP to ensure there is nothing else that’s causing this like thyroid problems.

Q. Does our menstrual history eg, easy time, difficult times play any part in the symptoms ?
Q. Is there a correlation between when you start your periods as a teenager and when you reach menopause?
Q. Do you go into menopause early if you got your period early in life?

There is not necessarily a correlation between menstrual history and menopause.

Q. What is tested for in blood tests to see if one is experiencing menopause or not?
Q. I had some surgery some 3 years ago for fibroids which resulted in a diminishing of the lining of the uterus and meant that my periods ceased. How can I find out whether I am post menopausal or not. I am 55 years of age.
Q. Is there a sure way of knowing that menopause has finished for example by a simple blood test.

The diagnosis of menopause is usually made on the basis of no periods for more than twelve months where another diagnosis does not apply (eg . pregnancy, anorexia nervosa). There are often symptoms affecting well-being, the most common being hot flushes and disturbed sleep.

In a woman in her mid-late forties or older, especially if accompanied by hot flushes, a blood test will not usually be performed.  If the diagnosis of menopause is in doubt, such as in a younger woman, measuring a hormone called FSH may be helpful.  However FSH levels can vary from day to day, so the blood test may not give an accurate answer.  Tests measuring hormones in saliva are unreliable and not recommended.

A space of 6 months between periods in a woman in mid 40s-50s is a common sign of menopause approaching, and of no concern.  However infrequent periods in a younger woman could be due to a number of conditions and should be checked out with a doctor. 

Q. Does family history play any part in our menopausal experience?
Q. Does family history play any part? ie like mother, like daughter. Do symptoms follow in generations?
Q. Is it likely that you may go thru' menopause at a similar age as your mother, or sisters?
Q. Do the experiences of sisters tend to be similar in regard to length and severity of symptoms and age of menopause?

Family history does not usually play a part in the experience of menopause, but may be relevant for women experiencing early menopause.

Q. I am surprised to see that menopause is depicted as a disease. Is this how you see it?

Menopause is the phase of a woman’s life where the ovaries stop producing hormones and eggs. In some women the only change noticed is that her periods cease. However 80% of women notice some symptoms varying from mild to disabling. Treatments including lifestyle changes and medications, may be advised if the symptoms are significant.

Q. Will endometriosis make menopause worse?

Endometriosis will not make menopause worse. Once menopause has occurred and periods cease the pains of endometriosis will settle.

Q. Can you fall pregnant if you are going through menopause?
Q. I am 40 years old and going through menopause will I get pregnant?

Once menopause has occurred (i.e. last period more than 12 months ago) pregnancy is not possible. However, during the phase leading up to menopause, namely the “peri-menopause”, pregnancy may occur. A woman in her forties may not yet have actually reached menopause and should therefore use contraception if she wishes to avoid pregnancy. It is important to note than HRT is not contraceptive.

Q. Would you be concerned if space between periods was 6 months?

A space of 6 months between periods in a woman in her mid 40s-50s is a common sign of menopause approaching, and of no concern. However infrequent periods in a younger woman could be due to a number of conditions, and should be checked out with a doctor.

Q. Can menopause affect blood pressure and blood sugar levels when there is no other known reason for these changes

Blood pressure and sugar can rise as we get older, rather than specifically being associated with menopause.

Q. Does the existance of fibroids in the uterus influence the way a woman experiences menopause?

Fibroids can cause heavy periods which may worsen in the months leading up to menopause. Iron deficiency is a possible consequence if the blood loss is significant.  Fibroids will not impact on other aspects of the menopause.

Q. What do you call post menopausal?

Post menopause means “after” namely once the menopause has occurred and periods have ceased for at least 12 months..

Q. Is there any specific treatment for women who have gone into menopause early due to cancer treatment? Do these women experience a longer menopause?

Early menopause, especially due to cancer treatment, can be a difficult experience. There are a variety of options available depending on the type of cancer and the woman’s symptoms. It would be important to discuss this with a doctor to get individualized advice.

Q. How does menopause affect women who have poly-cystic ovaries?

Poly-cystic ovaries do not have an impact on the experience of menopause. It would be important to keep a check on weight and cholesterol and glucose levels for diabetes.

Q. Will menopause affect hypertension medications?

Menopause will not affect medications for hypertension.

Q. Will falling pregnant in your early forties stave of menopause?

Menopause occurs because the ovaries have run out of eggs and therefore pregnancy is no longer possible. The timing of this is not affected by falling or not falling pregnant.  During the phase leading up to menopause, namely “peri-menopause”, pregnancy may occur, although it is less likely than in a younger woman. On average, a woman’s chance of becoming pregnant decreases markedly after the age of 37.  A woman in her forties may have irregular periods but not yet have actually reached menopause and should therefore use contraception if she wishes to avoid pregnancy.  It is important to note that HRT is not a contraceptive.

Q. Is it beneficial for women to have their hormone levels tested prior to reaching menopause so that they have a baseline for the correct dosages of HRT prescribed if/when needed?

The diagnosis of menopause is usually made on the basis of symptoms, in particular no periods for more than 12 months where another diagnosis does not apply (e.g. pregnancy,
anorexia nervosa). In a woman in her mid-late forties, especially if accompanied by hot flushes, a blood test will not usually be performed. If the diagnosis of menopause is in doubt such as in a younger woman, measuring a hormone called FSH may be helpful.  However FSH levels can vary from day to day, so the blood test may not give an accurate answer.  Hormone levels are not usually measured when on treatment because they are not accurate.  The way a woman feels is a much more important way to gauge whether she is on the best type and dose of HRT.

Q. Is there a test to have to confirm that you are approaching menopause? I am 36 and am experiencing many of the symptoms that you listed earlier.

The diagnosis of menopause is usually made on the basis of no periods for more than 12 months where another diagnosis does not apply (e.g. pregnancy, anorexia nervosa). There are often symptoms affecting well-being, the most common being hot flushes and disturbed sleep.  Thirty-six is much earlier than the age most women experience menopause (average age is 51).  If the diagnosis of menopause is in doubt, measuring a hormone called FSH may be helpful.  However FSH levels can vary from day to day, so the blood test may not give an accurate answer.  Tests measuring hormones in saliva are unreliable and not recommended. It would be important to consult your doctor as you should get advice on symptoms relief as well as the effect on your bones and heart -  HRT is usually recommended at least until you reach 50 to reduce the risk of osteoporosis and cardiovascular disease.

Content updated April 23, 2008