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Menopause

Menopause is the time in a woman’s life when her normal menstrual periods stop and she can no longer become pregnant. Menopause can occur anytime after the age of 35, but the typical age of onset is in the late 40s. A woman’s ovaries, the organs that produce eggs, stop making them and female hormones at this time.

Two important hormones, estradiol and progesterone, are made by the ovaries in a cyclical fashion and help to maintain a normal menstrual cycle. When a woman approaches menopause, cyclical hormone production from the ovaries stops, leading to a cessation in monthly menstrual periods.

The menopausal change is slow and usually takes two to five years to complete. During the so-called peri-menopausal period, hormone levels can fluctuate from high to low from one month to the next. Some months a woman may have a period but then go for several months without a period. It is important to note that during this time, a woman may still be able to get pregnant.

Menopause happens naturally as a woman ages. However, menopause can also occur for other reasons, including the removal of the ovaries for cancer or other medical reasons like endometriosis, excessive exposure to radiation or chemotherapy, pituitary gland disorders, or very poor health.

Symptoms
A woman’s body goes through several changes during menopause. Some of the more common symptoms of menopause occur when estrogen levels start to drop. Women may experience:

hot flashes;
rapid mood swings ranging from depression to euphoria;
decreased libido and sex drive;
increased frequency or sudden urge to urinate;
vaginal dryness with pain during intercourse;
excessive bone loss, leading to a higher incidence of fractures of the hip and spinal column; and a
higher risk for heart disease (because the levels of LDL “bad” cholesterol in the blood may rise).

Tests
A woman of menopausal age might have the following tests ordered:

Follicle-stimulating hormone (FSH): to learn whether she is approaching or has gone through menopause;
Estradiol: to measure ovarian production of estrogen and to evaluate whether the menstrual cycle is normal and if she is fertile;
Thyroid function testing (free T4 and TSH): to test the function of the thyroid gland, which can slow with age;
Lipid profile: to test for triglycerides and the good (HDL) and bad (LDL) cholesterol levels in the blood to assess for cardiovascular disease;
Complete blood count (CBC): to determine the adequacy of the number of red and white blood cells in the blood;
Chemistry tests for liver and kidney function: to see if she can tolerate hormone replacement therapy; and
Blood pressure check.
If a woman has risk factors or symptoms of diabetes, her doctor may also order a glucose test to learn whether the sugar levels in the blood are too high.

As estrogen levels drop, bones can get weaker. For guidelines on bone density testing, see the National Osteoporosis Foundation.

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"Menopause." Lab Tests Online. 4/15/11. Lab Tests Online, Web. 9/2/11.
Services not available in MD, NJ, NY and RI. 

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