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How to Accurately Test for Perimenopause – and a Giveaway!

Posted Oct 01 2012 12:00am

Today’s post is sponsored by Ageology, a Chicago Doctor’s Network which specializes in natural, Bioidentical Hormone Replacement Therapy and Alternative Medicine. 

In addition to sponsoring this post, Ageology is also hosting a healthy hormone giveaway.  Be sure to check out the details at the bottom of this post!

As many women in perimenopause will tell you, obtaining an accurate diagnosis is not always as easy as you might think. In fact, outside of the actual symptoms of perimenopause , this is perhaps the biggest complaint I hear from women at this blog.

Unfortunately, it is not uncommon for a woman to be in her mid to late 40s, who is also displaying classic perimenopause symptoms such as weight gain, mood swings, hot flashes, night sweats and erratic menstrual cycles, to be told she is not in perimenopause.  But, why?

A lot of it has to do with the fact that most physicians will run only one blood test to check a woman’s FSH (follicle stimulating hormone) levels.  Depending on the severity of her symptoms, the blood test often returns a “normal” result and therefore, her physician determines she is not in perimenopause in spite of her very obvious symptoms.

According to Dr. Paul Savage, MD¹, a member of the Ageology physician group , and an expert in the field of bioidentical hormones, this problem is due in part to the training that physicians receive, and that a blood test alone is not always sufficient in detecting the hormone imbalance which occurs during perimenopause.

In general, says Dr. Savage, physicians have been trained that perimenopause is actually pre-MENOPAUSE.  Therefore, when they test FSH levels they are looking for changes in estrogen, which signals the onset of actual menopause.

Perimenopause, however, is more often a change in the progesterone levels and not estrogen. It is the decline in progesterone which is often related to changes in the menstrual period (making them heavier and longer, for example) since it is progesterone which controls a woman’s menstrual cycle.

A loss of progesterone is also related to night sweats.  A drop in progesterone diminishes estrogen receptors, which in turn, makes them less able to respond to estrogen signals.  It is believed that low estrogen levels trigger hot flashes and night sweats. Other symptoms of perimenopause related to a loss of progesterone can include weight gain, irritability, depression and fatigue.

Progesterone levels by blood tests alone are often not reliable. If a blood test does not indicate any changes in progesterone, I also suggest doing a salivary test as well.

I have had some physicians tell me that saliva testing for hormone levels is ineffective.  While I’m not a physician, it does seem to me that any single test, whether it is blood or saliva, is not going to give you enough information about a patient’s symptoms.  It only seems logical that the more information you are able to gather, the more accurate your diagnosis is going to be.

In addition to blood tests and saliva tests, Dr. Cheryl Perlis, MD², also a member of Ageology physicians believes that physicians should also listen to how a patient actually feels in order to help them arrive at an accurate diagnosis.

When a patient comes to my office I have several questions I specifically ask them in regards to perimenopause, and I treat them according to their symptoms.

I tend to rely more on my patients and what they tell me to gauge how they are doing rather than a simple lab test.

If they have symptoms of fatigue, for example, I would check their thyroid and Vitamin B12 levels. Based on their initial symptoms, I might also start them on estrogen, progesterone and testosterone.  I would then follow up within a month by reviewing their lab work.

At that time, I would also discuss additional vitamin supplements which might help them, and adjust their hormones according to how they might be feeling, and any other symptoms they may still be displaying. Primarily,  I tend to rely on my patients and what they tell me to gauge how they are doing.

I believe patients will tell me much more than a simple lab test.  By asking them for specific signs and symptoms, I am able to again a lot of valuable information. Even subtle symptoms like depression and anxiety which a patient may not even realize is related to perimenopause is important to an accurate diagnosis.

Again, speaking as a layperson, it seems to me, any time a physician is actually willing to listen to a patient describe her symptoms, even if those symptoms contradict a lab test, obtaining an accurate diagnosis is much more likely.

If you feel you are in perimenopause but your physician has told you based on your blood work that you are not, by all means, seek a second opinion. It’s important that you trust your instincts when it comes to your health.  No one knows your body better than you, and no one will advocate for you better than you will for yourself!

If you are interested in learning more about saliva testing and bioidentical hormones, check out the healthy hormone giveaway sponsored by Ageology!

Enter the Healthy Hormone Giveaway Sponsored by Ageology!

In the Health Hormone Giveaway sponsored by Ageology, there will be there will be five grand prize winners who will each win a comprehensive hormone evaluation test with a report of the tested hormone lab levels provided by ZRT Laboratory.

There will also be runner up winners who will win a variety of other prizes as well. You can find a complete description of the giveaway along with more details on the prizes and how to enter at Ageology’s website located here.

Don’t delay ladies!  The giveaway will continue to run through the end of this week.  There are several ways to win so be sure and enter!


¹ Dr. Savage is board-certified by the American Academy of Anti-Aging Medicine (A4M) as well as a Fellow of Anti-Aging and Regenerative Medicine. He has been practicing anti-aging medicine as his solo specialty since 2002. His goal of regaining and maintaining optimum health for his patients as the best method of preventing disease is well-established.

² Dr. Perlis is board certified in obstetrics and gynecology in 1990, and has been mentored by Dr. Erika Schwartz, a leading expert in the field of bioidentical hormone therapy. She believes that the more medical knowledge patients have, the more active role they can take in choosing and creating a healthy and fulfilling life.  Dr. Perlis’ goal is to impact and empower both men and women in health and wellness at every stage of their lives.

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