What are the blood tests that are appropriate for perimenopause and Primary Ovarian insufficiency (POI)?

AMH (Anytime in your cycle – Fee £98)

Research has shown that low AMH is a good predictor for the onset of menopause. This is particularly true for older women. It is relatively inexpensive and easy to do. You can have the test anytime in your cycle. This can be ordered on the same day and the result will come out the next day.  Give us a call on 0207 096 0283. We are more than happy to help.

Once AMH is tested, further investigations may include:

A menopause profile test that would test:

FSH, LH, Oestradiol (17-beta), TSH, FT4

(Day 2, 3 or 4 in your cycle – Fee £125)

Progesterone (Day 21 – Fee £76)

ovulation-test

What is Menopause?

Menopause occurs when a woman’s ovaries stop producing an egg every four weeks. Monthly period ceases and she is therefore unlikely to get pregnant

In the UK, 51 is the average age for a woman to reach the menopause, although some women experience the menopause in their 30s or 40s.

Menstruation (monthly periods) can sometimes stop suddenly when you reach the menopause. However, you are more likely to find that your periods will become less frequent, with longer intervals between each one, before they stop altogether.

You will get a diagnosis of ’menopause’ if you have had no period at all for 12 consecutive months.

What causes the Menopause?

The menopause is caused by a change in the balance of the body’s sex hormones. In the lead-up to the menopause, known as the perimenopause, oestrogen levels decrease – therefore causing the ovaries to stop producing an egg each month (ovulation).

You will also find that levels of FSH (which is required to stimulate the ovaries) increase, and that levels of AMH (which is a marker for ovarian reserve) decrease.

What is Perimenopause?

Perimenopause, or menopause transition, begins several years before menopause. It’s the time when the ovaries gradually begin to make less oestrogen. It usually starts in a woman’s 40s, but can start in her 30s or even earlier.  Perimenopause lasts up until menopause, the point at which the ovaries stop releasing eggs. F

What are the likely Perimenopause symptoms?

Women in perimenopause have some of the following symptoms:

Hot flushes, breast tenderness, worse premenstrual syndrome, low sex drive, fatique, irregular periods, vaginal dryness, urine leakage when coughing or sneezing, an urgent need to urinate more frequently and mood swings.

For a fuller discussion of perimenopause and how we treat it, please click “How do we treat perimenopause”.

Can Menopause be delayed?

It is generally assumed by western medical specialists that AMH and FSH levels cannot be changed and that they will deteriorate as one ages.

However, at TCM HealthCare Fertility Clinic, we have extensive experience in reducing FSH levels (sometimes by as much as a third) and increasing AMH levels (sometimes by up to 200% per cent).

We believe our clinical experience is particularly relevant to the condition of perimenopause or POI (see section on POI) where the ovarian function is faltering but menopuase has not yet occurred. For more details about our treatment for enhancing AMH, please go to treatment for increasing AMH page. For more details about reducing FSH, please go to treatment for reducing FSH page. For details about perimenopause treatment, please go to treatment for perimenopause.

What is Early Menopause (Premature Menopause)?

If you experience menopause before the age of 40, it’s known as a premature menopause.

Is Early Menopause the same as Premature Ovarian Failure?

If Early Menopause happens spontaneously, it is called Premature Ovarian Failure.

What is Primary Ovarian Insufficiency (POI)?

Primary Ovarian Insufficiency (POI) is a condition in which the ovaries stop functioning normally in women who are under the age of 40. The condition used to be called “premature ovarian failure” and “premature menopause,” but these terms are misleading, because women with POI do not always stop menstruating (having periods), and their ovaries do not always completely shut down. The diagnosis of POI therefore does not always mean that pregnancy is impossible. What’s more, the condition does not imply that a woman is aging prematurely. It simply means that her ovaries are faltering.

In women with POI, the ovaries:

– Stop releasing eggs, or release them only intermittently, and

– Stop producing the hormones estrogen, progesterone, and testosterone, or produce them only intermittently

What are the likely Primary Ovarian Insufficiency Symptoms?

Most women with primary ovarian insufficiency (POI) undergo a normal puberty and have regular periods before developing ovarian insufficiency.

The most common symptom that prompts them to seek medical care is missed or infrequent periods.

Some women first notice that their periods are infrequent or absent when they stop taking birth control pills, but that does not mean that the pills have caused POI. While taking the pill may mask the condition, it cannot cause it.

Other POI symptoms include hot flushes or vaginal dryness, because women eventually produce little or no oestrogen. As the condition progresses, some women may also develop vaginal inflammation and thinning of the vaginal walls, which can make intercourse painful.

Can I still conceive?

A woman is experiencing menopause i.e has not had periods for at least 12 months, has little chance of getting pregnant, naturally or with IVF, while a woman with POI has a greatly reduced chance of getting pregnant, but pregnancy is still relatively feasible.

Most IVF clinics will not treat women with a confirmed diagnosis of POI, as they have a much-reduced chance of conceiving and will respond poorly or not at all to the drugs used in assisted conception. Clinics can still treat patients who choose the donor egg route.

Between 5 percent and 10 percent of women with POI do become pregnant, even though they have not had fertility treatment. Scientists don’t know why this is the case.

Can POI be treated?

It is generally assumed by western medical specialists that AMH and FSH levels cannot be changed.

However, at TCM HealthCare Fertility Clinic, we have extensive experience in reducing FSH levels (sometimes by as much as a third) and increasing AMH levels (often by up to 200% per cent).

We believe our clinical experience is particularly relevant to the condition of POI or perimenopause where the ovarian function is faltering but menopuase has not yet occurred. For more details about our treatment for enhancing AMH, please go to treatment for increasing AMH page. For more details about reducing FSH, please go to treatment for reducing FSH page. For details about primary ovarian insufficiency and perimenopause treatment, please go to treatment for perimenopause

How Is POI diagnosed?

A number of blood tests are usually ordered to determine if you may have POI. These may include:

AMH (Anytime in your cycle – Fee £98)

A menopause profile test that would test:

FSH, LH, Oestradiol (17-beta), TSH, FT4

(Day 2,3 or 4 of your cycle – Fee £125)

Progesterone (Day 21 – Fee £76)

Are these tests appropriate for Perimenopause?

These tests are also appropriate when you are going through perimenopause.

To keep the cost down, one option is to start with AMH test. It is also a test that you can do anytime in your cycle. The result will come out the next day. We can then discuss next steps.

 

shun_au_obe2
Professor Shun Au OBE
Director
TCM Healthcare Fertility Clinic
We offer a Fast and efficient service. Most tests can be organised either on the same day or in one day if pre-test conditions are met. Most test results will be available between 1 and 3 days. All tests are carried out by reputable laboratories in this field. The test results will be accepted by any doctor or clinic in the world. Test reports will be forwarded to you promptly. We will follow up with a call to explain the result and explore the bigger picture with you. We work with a range of clinics and will help you navigate the landscape of fertility services.