The typical way to determine whether menopause has occurred is to record when a woman has not had a menstrual period for 12 consecutive months and no other biological or physiological cause for this phenomenon can be identified.

To determine whether the absence of menstrual periods is caused by menopause or another illness, a physician will perform a physical examination and compile a medical history of the patient. Some women may be referred to an endocrinologist, a physician who specializes in the diagnosis and treatment of disorders related to glands and hormones. Physicians may perform a number of tests that may help reveal whether menopause has occurred.

For example, a blood test that reveals the level of follicle stimulating hormone (FSH) is frequently used to determine if menopause has occurred. FSH is made in the pituitary gland in the brain and circulates in the blood to stimulate the ovaries to make estrogen and progesterone during a woman’s reproductive years. Once the ovaries stop making estrogen and progesterone, the pituitary gland compensates by making more FSH. FSH levels greater than 25 to 40 mIU/ml (milli-international units per millimeter) are a sign of menopause.

The Food and Drug Administration (FDA) has approved a home urine test kit that measures FSH in a woman’s urine. This may help women determine if they are in menopause or the period leading up to menopause known as  perimenopause.

A physician may also test for levels of estradiol. This is a type of estrogen, and its levels fall in the body once the ovaries fail. A test for luteinizing hormone (LH) – the hormone that triggers ovulation  – also may indicate menopause has occurred if higher levels are detected.  

Once a woman has entered menopause, it becomes even more important to monitor aspects of her health that may be affected by the hormonal changes associated with menopause. Tests that can help a physician monitor a woman’s postmenopausal health include:

• Pap smear. A scraping of the surface of the cervix to obtain cells that can be analyzed for signs of cancer or other disorders of the cervix, uterus or other pelvic organs. 
  
  
• Mammography. An annual x-ray of the breast that can reveal signs of breast cancer.
  
  
• Bone density screening. This can be used to help detect signs of osteoporosis, thinning of the bones that can be accelerated by low levels of estrogen. Women with osteoporosis are at greater risk for fractures of the wrist, hip and spine.
  
  
• Blood tests. Tests may be conducted to monitor a woman’s cholesterol levels due to the higher risk of heart disease. Blood sugar also may be checked with blood tests.