Women wondering how close to menopause they are may now have some more clues. On October 24, 2018, the U.S. Food and Drug Administration (FDA) approved the marketing of PicoAMH Elisa, a diagnostic tool that can show a woman’s menopause stage.
“Diagnostic results about a woman’s menopausal status may prompt discussions about preventative care for women experiencing menopausal symptoms,” said Courtney Lias, PhD, director of the division of chemistry and toxicology devices in the FDA’s Center for Devices and Radiological Health in Silver Spring, Maryland, in a released statement. “This test, when used in conjunction with other clinical assessments and laboratory findings, can help inform discussions about preventative care, such as ways to help prevent loss in bone mineral density [osteoporosis] or to address cardiovascular disease, both of which are known to increase after menopause.”
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JoAnn V. Pinkerton, MD, executive director of The North American Menopause Society (NAMS) in Charlottesville, Virginia, adds that while it has been possible to order anti-Müllerian hormone (AMH) testing before this, “Having an FDA-approved AMH assay gives patients and healthcare providers results that are more trustworthy, as it should provide consistent and dependable results.”
What Is Menopause and What Does It Mean for Health?
Defined as the last menstrual period, menopause marks the point in time when a women stops experiencing menstrual cycles, according to the Mayo Clinic.
A menopause diagnosis is confirmed in hindsight: According to NAMS, a woman has reached menopause after she has gone a full 12 consecutive months without a menstrual period. After a woman reaches menopause, she is no longer fertile, and no longer has protective levels of estrogen in her body, which increases her risk for disease.
Menopause Status Test Is Not Necessary for All Premenopausal Women
“While not needed for women undergoing a natural menopause at age 51, this test will be very helpful for women at risk of early ovarian failure, such as following chemotherapy for cancer, or genetic or endocrine reasons. Women desiring pregnancy who are missing periods can be more reassured if their AMH is normal, as studies suggest that AMH is highly predictive of timing of menopause,” explains Dr. Pinkerton.
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How Measuring AMH Levels Helps Predict Menopause Onset
The PicoAMH Elisa test works by measuring blood levels of anti-Müllerian hormone (AMH), a protein hormone released during pregnancy of a male fetus. The levels are a good indication if a women is reaching her last menstrual cycle. Still, the test is not to be used as a single diagnostic tool — it should be used in conjunction with other tests.
Test Results Can Help a Women Understand Potential Future Fertility
“For women who want to know how likely they are to become pregnant, this test is intended for use in conjunction with other clinical and laboratory findings, such as antral follicle count. It would be used for example before starting fertility therapy or if someone wanted to delay fertility, to understand the potential risks of delay if they have low ovarian reserve or possibly before deciding whether to freeze eggs for future fertility,” says Pinkerton.
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The Test Helps Women With Early and Premature Menopause Symptoms
The analysis could be especially useful for women who experience symptoms, such as hot flashes, night sweats, or insomnia, that may be related to going through perimenopause, particularly if it is earlier than expected from a normal natural menopause (average age is around 52).
Premature menopause is menopause that starts before age 40; early menopause is menopause that occurs between ages 40 and 45, according to the U.S. Department of Health & Human Services' Office of Women's Health.
The use of current tests of menopausal status, such as FSH (follicular stimulating hormone) and estradiol (estrogen) level, are not predictive of how soon a woman may reach menopause; the levels may vary throughout the cycle and don’t work if women are on oral contraceptives or other type of hormonal birth control, or hormone therapy.
Causes of Early or Premature Menopause
- Genetics
- History of cigarette smoking
- Chemotherapy or pelvic radiation
- Surgical removal of ovaries or uterus
- Autoimmune diseases, AIDS or HIV, chronic fatigue syndrome
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“AMH can either provide reassurance that symptoms may be premenstrual syndrome (PMS) or worsened by stress, or that indeed a woman may be going through an earlier menopause,” notes Pinkerton.
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Take Preventive Steps to Protect Health if It’s Early or Premature Menopause
If the diagnostic steps show that you are in early or premature menopause, you and your physician should be talking about preventive care. “Early and premature menopause is associated with a higher risk of osteoporosis and fracture, heart disease, cognitive changes, vaginal changes, loss of libido, and mood changes,” says Pinkerton.
Symptoms That Could Mean You Are Experiencing Perimenopause
- Headaches and joint aches
- Hot flashes, night sweats, or sleep disruption
- Vaginal dryness or painful sex; depression or loss of sex drive
- Weight gain due to slower metabolism
- Worsening of premenstrual symptoms (PMS)
Related: Menopause Symptoms That May Surprise You
An Ounce of Prevention Is Worth a Pound of Cure
If you are in early menopause, Pinkerton recommends:
For Bone Loss Take 1200 mg of calcium daily (diet combined with supplement if needed), and 1000 to 2000 IU of vitamin D. Do strength training or weight bearing exercise.
For Preventing Heart Disease Combining cardio exercises and strength training burns calories and strengthens muscles. Eat foods that are rich in fiber — lots of vegetables, including dark leafy vegetables, and fruits. Avoid fried and fat-laden foods; eat more lean protein and vegetables. Drink six to eight glasses of water daily.
For Losing Weight Postmenopausal women burn less fat than they did in their premenopausal years. Cells not only store more fat, but also are less willing to part with it. Weight management during menopause and postmenopause is important because weight gain increases the risk of many diseases, including cardiovascular disease, type 2 diabetes, high blood pressure, osteoarthritis, and some types of cancer, including breast cancer and colon cancer.
- Keeping a food diary is always helpful, whether by paper or on your phone.
- Eat more frequently to avoid hunger or blood sugar drops.
- Exercise 30 minutes on most days of the week. If you want to lose weight, increase either the frequency, the duration, or the intensity of your workouts. Getting into a training program helps.
- Get seven hours of sleep at night.