One of the problems with getting an accurate diagnosis of menopause is that the typical signs, including hot flushes, night sweats, heavy irregular bleeding and mood disorders, can sometimes be caused by other health conditions.
And it’s important to rule these out.
‘Of course, if a woman is aged over 45 and has tell-tale symptoms that her oestrogen levels are declining, such as these characteristic symptoms, it’s probably perimenopause or menopause, but it’s not always so straightforward,’ says Dr Karen Morton, a consultant gynaecologist who runs a menopause clinic in Guildford, Surrey, and online.
Many women going through the perimenopause and menopause experience low mood (stock photo used)
Tests typically aren’t needed to diagnose menopause, but your doctor may recommend checking levels of follicle-stimulating hormone (FSH) and oestrogen (specifically estradiol, the most common type of oestrogen); FSH levels increase and estradiol levels decrease as menopause occurs.
While you can get FSH home tests (these check levels in your urine; doctors check levels in your blood), it’s unwise to self-diagnose, says Sid Dajani, a pharmacist at Bishopstoke in Hampshire.
He says there is a risk in assuming the menopause is to blame for every ill that affects women in mid-life.
‘For example, heavy bleeding during periods may be a sign of uterine fibroids,’ he says.
Irregular bleeding, which women so often think is a normal part of the menopause, may be a sign of cancers, explains Dr Morton.
‘We always look out for red flags that suggest there may be a malignancy.’
In some cases periods stopping could actually be pregnancy. ‘You should always ask the question: ‘Could I be pregnant?’ ‘ says Sid Dajani.
‘Menopause’ symptoms can have many other causes.
HIGH BLOOD PRESSURE: Recent research published in the European Heart Journal found that many middle-aged women may be living with undiagnosed hypertension because symptoms — including chest pain, exhaustion, headaches and heart palpitations — are blamed on the menopause instead.
This is because the way coronary arteries age ‘is different among women and men, and this starts around menopause’, says Angela Maas, lead author of the study and a professor in women’s cardiac health at Radboud University Medical Center in Nijmegen, Netherlands.
IRREGULAR HEARTBEAT: A racing heart (occurring alongside hot flushes and other symptoms) can be a sign of the menopause — there are oestrogen receptors in the heart, explains gynaecologist Dr Heather Currie, former chair of the British Menopause Society.
But it’s important not to miss heart rhythm problems due to electrical faults in the heart which are more common as we age.
Dr Morton adds: ‘People think it is just the menopause when actually it could be the heart developing a funny rhythm which is nothing to do with hormones.’
THYROID PROBLEMS: These are also relatively common and can cause menopause-like symptoms such as hot ftlushes and rapid heart beat. Thyroid problems can be detected with a simple blood test.
DEMENTIA: A recent study in Scientific Reports found that menopause affects a woman’s brain structure and the way that brain cells connect.
‘Some women may wrongly fear they’re suffering from early stage dementia,’ says Dr Morton.
But unlike the ‘brain fog’ associated with menopause, Alzheimer’s is a progressive disease and gets worse over time.
Brain fog affects around two-thirds of women going through the perimenopause and menopause, possibly because there are also oestrogen receptors in the brain.
ARTHRITIS: Pain is another health concern that worsens with menopause, but persistent discomfort which doesn’t fluctuate may be caused by other conditions such as arthritis.
‘Don’t assume it’s the menopause. You should see your doctor if you have concerns,’ says Sid Dajani.
DEPRESSION: Perhaps one of the more common areas of confusion is about whether it’s the menopause or depression.
Many women going through the perimenopause and menopause experience low mood.
‘The causes of mood swings in menopausal women are complex but oestrogen has a role in many brain functions, so falling levels during the perimenopause may affect psychological wellbeing in some women,’ says Dr Morton.
Yet unfortunately some are misdiagnosed with depression and given antidepressants when they really need hormone therapy, says Dr Currie.
‘Fortunately, there is a growing awareness among doctors that low mood and anxiety can be hormonally based.’
Source: | This article originally belongs to Dailymail.co.uk