Menopause - Do we need to monitor our FSH? (Follicle Stimulating Hormone)
That is the question of the day.
Since Clear Blue has a commercial telling us we need to monitor our FSH, and many women will spend their hard earned money on this useless test, I thought we should investigate this more and find out why, and if, it is necessary.
In my opinion, after reading these articles, is yes to test when you are in perimenopause and no, once you have hit menopause. But you should test with your doctor, not some over the counter expensive bullshit test. Keep reading for why.
First, what is the Follicle Stimulating Hormone? I googled that question and came up with this from the Cleveland Clinic:
https://my.clevelandclinic.org/health/articles/24638-follicle-stimulating-hormone-fsh
“Follicle-stimulating hormone (FSH) is a hormone that plays a significant role in sexual development and reproduction by affecting the function of the ovaries and testes. It works alongside luteinizing hormone (LH).”
ME: So both men and women have this hormone.
“Follicle-stimulating hormone (FSH) is an important hormone that has a powerful effect on sexual development and fertility. Since FSH is part of a complex web of other hormones and glands, it’s not uncommon to have irregular FSH levels...”
Normal FSH levels in women or people assigned female at birth (AFAB)
In general, normal FSH levels for women or people AFAB include:
· Before puberty: 0 to 4.0 mIU/mL.
· During puberty: 0.3 to 10.0 mIU/mL.
· Menstruating people: 4.7 to 21.5 mIU/mL.
· After menopause: 25.8 to 134.8 mIU/mL.
Funny, perimenopause and menopause itself are not mentioned and they probably both fall into the “Menstruating people” and “After menopause” category. I say this based on the FSH level difference in the categories. That’s a huge range. They couldn’t pin it down a bit more?
Then I googled “do we need to monitor our FSH levels” I didn’t get much more then my previous google search, so I added “in menopausal women” so this was the next search “do we need to monitor FSH levels in menopausal women”.
That search provided some results and reasoning. From breastcancer.org: https://www.breastcancer.org/treatment-side-effects/menopause/types/testing
“Follicle-stimulating hormone (FSH). FSH is a protein made by the brain that stimulates ovulation. If your ovaries are beyond menopause, they no longer respond to FSH, and your brain reacts by sending out even more of these hormones. If your periods have stopped for some time, a persistently high level of FSH (over 40 milli-international units per milliliter, or mIU/mL) indicates that menopause may be permanent. Tracking your results over time is important because these levels can swing widely from day to day. For example, in a normal perimenopausal woman, it’s not unusual for her FSH level to be low one day and then quite high the next.”
Hmmmmm.
This is the important part:
“These blood tests are not the final answer to whether or not you are in menopause, however. Even if you have postmenopausal levels of FSH and estradiol, these levels can change over time. The longer you go without a menstrual period, and the longer that repeat testing suggests you are menopausal, the more likely it is that you are in this stage of life for good. You may encounter other menopause tests that you can do at home, on your own, using urine or saliva. However, these tests aren’t considered reliable. If you’re interested in testing, be sure to discuss it with your doctor.”
From NAMS (North American Menopause Society)
“How can you tell if you're nearing menopause or are already past it? Is there a simple hormone test?
During perimenopause, hormone tests are generally not helpful because hormone levels change throughout the menstrual cycle. Sometimes testing is done to check specific hormone levels, especially to evaluate fertility problems or when periods stop at an early age. This can help women make decisions about beginning or adjusting treatment. For some women, it may make sense to test for other causes of symptoms that can mimic perimenopause, such as thyroid disease.”
“What about follicle-stimulating hormone testing?
Sometimes, elevated follicle-stimulating hormone (FSH) levels are measured to confirm menopause. When a woman’s FSH blood level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year, it is generally accepted that she has reached menopause.
However, a single FSH level can be misleading in perimenopause because estrogen production does not fall at a steady rate from day to day. Instead, both estrogen and FSH levels can vary greatly during perimenopause. One elevated FSH level is not enough to confirm menopause. More important, a low FSH level in a woman who is having hot flashes and changing periods does not eliminate the likelihood that she is still in perimenopause. Also, if a woman is using certain hormone therapies (such as birth control pills), a FSH test is not valid. Over-the-counter urine tests for menopause that measure FSH levels are often advertised but are expensive and not informative, for the same reasons discussed above.”
Once you have hit “menopause” – 12 months with no period, that’s it. You are in menopause and there is no need to do daily, weekly or monthly FSH tests unless your doctor recommends it for some reason.
Ladies, do not waste your money on over the counter FSH tests for menopause. Save it for your next vacation.