UK Guidelines Quiz – Menopause: Diagnosis and Management

Dr Rob Hicks

Disclosures

October 18, 2019

NICE advises not using a follicle stimulating hormone (FSH) test to diagnose menopause in women over the age of 45 as FSH levels fluctuate considerably over short periods during the time leading up to the menopause making blood level measurement unhelpful. It also advises not testing FSH levels in women using combined oestrogen and progestogen contraception or high-dose progestogen as these affect FSH measurement. NICE highlights that if a woman is aged over 45 years and has not had a period for at least 12 months, or has vasomotor symptoms and irregular periods (or just symptoms if she doesn't have a uterus), this is adequate information to diagnose menopause and perimenopause respectively.

NICE says an FSH test should be considered to help diagnose menopause only in women aged 40 to 45 years with menopausal symptoms, including a change in their menstrual cycle, and in women aged under 40 years in whom menopause is suspected.

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