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Re: Menopause diagnosis

From: Thomas (anonymous@obgyn.net)
Fri, 31 Jul 1998 14:39:02 -0500 (CDT)


At Fri, 31 Jul 1998, Victoria wrote: >
>I'm 46, regular periods (27 days apart, 4 days duration), no obvious
>menopausal symptoms except maybe night sweats. I was surprised when my
>doctor said the results from my recent physical indicate I am in
>menopause: Estradiol was 31 (PG/ML) and FSH was 20.4 (MIU/ML), HDL was
>79, cholesterol 193, Chol/HDL 2.44. When blood was drawn I had finished
>my period about one week prior. Due to my size and family history,
>(5'1", 105 pounds, white, grandmother with severe osteo and mother with
>heart disease), the doctor has recommended prempro, even though I had a
>breast biopsy 6 years ago - it turned out to be an abcess.
>
>My questions:
>What are the relevant values for menopause for estradiol and FSH, the
>range that says I'm menopausal?
>
>Since my periods have always been regular and haven't stopped, can I
>still get pregnant? I assume the answer is yes, but the doctor had her
>PA tell me since I'm in menopause I can't. This is contrary to what I
>have read.
>
>Thanks for any information you can provide.

YOU ARE NOT IN YOUR MENOPAUSE. By defintion you are not in your menopause as you are still having regular periods. By definition your periods should have ceased for a year before menopause can be diagnosed. However, you may be in your 'Climacteric' (the period leading up to your menopause). There are times in your climacteric when HRT is advised and this is probably what your doctor is talking about.

The cholesterol and HDL are of no proven value indiagnosing menopause (especially at the age of 46). However, they may be of value in determing your future cardiac risk which HRT may prevent. This is the area of a primary health care physician so you should speak to him/her about this. The low estrogen levels and high FSH levels are suggestive of climacteric and impending menopause but can be caused at a certain very small time in a normal premenopausal woman's cycle. If you are still menstruating regularly, then it is worth repeating the test at another time in your cycle.

If you are still menstruating you should assume that you can still get pregnant and use contraception.

--
Dr Thomas Ind MB BS MD MRCOG
St George Hospital
Kogarah
Sydney
NSW 2217
AUSTRALIA





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