Menopause%20-and-%20hormone%20therapy Diagnosis
Physical Examination
- Complete thorough physical exam
- Papanicolaou smear
- Breast exam
Laboratory Tests
- Baseline mammogram if indicated
- Bone density if risk factors for osteoporosis are present
- Use World Health Organization (WHO) Fracture Risk Assessment Tool (FRAX™) for estimating probability of a hip fracture and a major osteoporotic fracture in 10 years (other major bones include clinical spine, forearm, shoulder, or hip fracture)
- Lipid profile [low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and total cholesterol]
- Liver function tests (LFTs)
- Urinalysis
- Thyroid stimulating hormone (TSH)
- If atypical clinical features are present: Follicle stimulating hormone (FSH)/luteinizing hormone (LH)/Estradiol to confirm menopause
- FSH test may be used to diagnose menopause in women aged <40 years old in whom premature menopause is suspected or aged 40-45 years with symptoms of menopause
- In healthy women >45 years old presenting with menopausal symptoms, the following may be diagnosed in the absence of lab tests:
- Perimenopause from irregular periods and vasomotor symptoms
- Menopause in those without a period for at least 12 months and are not using hormonal contraception
- Menopause from symptoms in women with no uterus
Evaluation
Rating Scales
- Each symptom is graded according to its severity (eg Menopause Rating Scale, Greene Climacteric Scale) and how it affects the patient’s well-being (Menopause-Specific Quality of Life)
- Reliable and valid tools for assessment of menopausal symptoms