To test or not to test: how do you know if you're in menopause?

If you want to know whether you're in menopause, you can get tested with a self-test or through your GP. These tests measure your hormone levels. A home test only measures the FSH hormone, while a GP can also assess other hormones, such as LH, oestrogen, and progesterone. These are the hormone levels involved:

• Follicle-stimulating hormone (FSH): stimulates egg maturation and oestrogen production in the ovaries.
• Luteinising hormone (LH): stimulates ovulation.
• Oestrogen: produced in the ovaries and stimulates, among other things, the growth of the uterine lining.
• Progesterone: formed after ovulation and stabilises the uterine lining. Important to note: if you don't ovulate during menopause, your body also stops producing progesterone.

A test can measure the levels of FSH, LH, and/or oestrogen in your body. However, a test only shows your hormone levels at that specific moment. It doesn't definitively indicate whether you're in menopause.

Around the age of 40, the maturation of the available eggs in a woman's body becomes increasingly difficult. During this period, your fertility gradually declines. This is a natural process that every woman's body goes through.

Your body responds to this change by trying to stimulate fertility. It does so by increasing FSH and LH levels (the hormones that stimulate egg maturation and ovulation).

This happens because your ovaries send a signal to the pituitary gland (a small organ beneath the brain that regulates the function of several hormone-producing glands). The pituitary gland detects that egg maturation isn't occurring and tries to boost fertility by sending extra FSH and LH to the ovaries.

Additionally, progesterone levels initially drop because egg maturation becomes increasingly difficult or ceases altogether. This leads to oestrogen dominance in the body (and any associated symptoms). Later in menopause, oestrogen levels also decline (which may bring about other symptoms).

This creates a temporary imbalance in the hormonal system, which can cause withdrawal-like symptoms. Your body suddenly has to function with fewer hormones than before, requiring some adjustment. Fortunately, our bodies are adaptable and will naturally seek a new balance.

Hormonal fluctuations make it difficult to determine through a test whether a woman is in menopause. During menopause, your hormones fluctuate. One month, you might ovulate and produce oestrogen (so your body doesn't produce extra LH and FSH), while the next month, this might not happen (and your body does produce extra LH and FSH).

This means that a test in the first month might indicate that you're not in menopause, while the same test the following month might show that you are. A single test at the GP's surgery is therefore essentially pointless.

A more reliable option is a self-test that you perform multiple times. The test checks for an increase in FSH levels. By testing several times, you get a more realistic picture of what's happening in your body. You can purchase a self-test through SeeMe-nopause and have it delivered to your home.

It's important to note that the level of FSH doesn't indicate the severity of your symptoms. A slight drop in oestrogen, and thus a slight increase in FSH, may cause significant symptoms in one woman and minimal or no symptoms in another.

If menopause begins before the age of 40, it is referred to as early menopause, also known as POI (primary ovarian insufficiency). One per cent of all women experience this.

Because a woman under 40 generally doesn't have elevated FSH and oestrogen levels, an increase in these levels at this age is particularly significant. In such cases, both a self-test and a test at the GP's surgery can determine whether you're in menopause. However, this only applies to women experiencing early menopause.

Even before perimenopause, your hormones begin to fluctuate. Changes in your body may already manifest as symptoms, often caused by oestrogen dominance. You may notice that menopause is approaching.

One of the first signs that perimenopause (the first phase of menopause) is beginning is a change in your menstrual pattern. Your cycles may become shorter or longer. You might also notice that the amount of blood loss decreases or increases. These changes gradually progress until menstruation stops altogether: menopause.

How this process unfolds is entirely different for every woman. There’s no way to predict it, but generally speaking, every woman over the age of 45 is in menopause.

Finally, here's a fact that might provide some guidance. Research shows that the age at which your mother reached menopause can give some indication of your own timing, but it’s not a certainty. Various factors can influence this, such as:

• lifestyle, for example, smoking or prolonged stress;
• medical treatments, such as chemotherapy or surgeries on the ovaries;
• use of hormonal contraception (you might already be in menopause, but the pill masks the signs).

If you stop taking the pill around the age of 50, it may seem like you're suddenly entering menopause, even though the process was already underway. Without the pill, it might appear to start later.

However, your mother's symptom pattern says nothing about yours. What you experience largely depends on your personal situation, lifestyle, and health.