Hormone testing-what do I ask for???

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Dear Ellen,

I am experiencing sleeplessness, hot flashes and overall irritability. Probably menopause, right???  I have an appointment with my gynecologist next month to get some help.  Can you advise me on what tests to ask for?

                                                                                                    Please get back to me soon!

                                                                                                                                Denise

Hi Denise,

Fortunately for us, when it comes to testing for hormone levels – no pencil is needed, and you really can’t fail.

Be sure that your gyn is a Menopause Specialist.  Often the doctor that delivered your babies is not up on the latest menopause research and treatment options.  You can ask the receptionist if there is a menopause specialist in the office that you are going to.  If not, I have some helpful tips on how to find one, here.  Your specialist is your partner in your menopause business….find the smartest partner!!!

There is a broad range of what is considered “normal” when it comes to hormone levels. What is “normal” for some may not be normal for you.  To help you communicate, “how your feel” – quickly and clearly, I have created a Menopause Symptoms Chart.  Fill this out for at least 2 weeks before you go to see your specialist. Your blood work together with your filled out symptoms chart will enable your specialist to create an individualized program to help you achieve hormone happiness.

Here are some suggested tests to speak with your specialist about:

Hormone Panel:  (If you’re still menstruating, have your hormone panel (blood test) done during the first three days of your period.)

DHEAS: DHEA sulfate is a hormone that easily converts into other hormones, including estrogen and testosterone. This adrenal hormone triggers puberty and is of the highest concentration of the hormones in the body. DHEAS is the sulfated form of DHEA in the blood. While DHEA levels fluctuate throughout the day, DHEAS blood levels are steadier and more reliable.

Estradiol is the main type of estrogen produced in the body, secreted by the ovaries. Low levels can cause memory lapses resulting in sticky notes aplenty, anxiety, depression, uncontrollable bursts of anger, sleeplessness, night drenches and much more.

Free and Total Testosterone Free testosterone is unbound and metabolically active, and total testosterone includes both free and bound testosterone. In women, the ovaries’ production of testosterone is necessary for muscle tone, mood, strong bones, cardiovascular function, and sexual health. Women with low testosterone levels can experience depression, fatigue, low libido, weight gain, bone and muscle loss, and cognitive dysfunction.

FSH (follicle-stimulating hormone) is a pituitary hormone that stimulates the growth of the ovum (the egg and surrounding cells that produce ovarian hormones). This test can help indicate whether you’ve entered menopause. However, the suggested normal ranges need to be examined along with your Menopause Symptoms Chart, so that your doctor can properly evaluate the test results. There is no one-size-fits-all correct test result. What is normal for your best friend, sister or mother may not be normal for you.

Anti-Mullerian Hormone (AMH) Test A blood test that estimates the number of the eggs in the ovaries.

Progesterone is a hormone that stimulates the uterus and prepares it for pregnancy. It also regulates the menstrual cycle, and low levels of progesterone can cause irritability. Results will vary depending on when the test is done.

Thyroid workups usually include checking your TSH (thyroid-stimulating hormone). If there is an irregularity with your TSH, you may need to get your Total T3 and Free T4 checked as well. (Free means it won’t be affected by your estrogen status, not free of charge!) Remember that the symptoms for perimenopause and menopause and a thyroid disorder can be very similar.

Other Important Tests For Women In Perimenopause And Menopause:

Bone density is a measure of calcium and other materials in your bones. Also called a DEXA scan, the bone density test can determine whether you have or are susceptible to osteoporosis. When you enter perimenopause and menopause, the decline in estrogen can trigger a rapid loss of bone mass, so it’s important to check. The test measures the strength of the hip and spine. It takes only minutes and exposes you to very little radiation.

CA-125 (cancer antigen 125) is a protein best known as a blood marker for ovarian cancer. It may be elevated with other malignant cancers, including those originating in the endometrium, fallopian tubes, lungs, breasts and gastrointestinal tract. Be sure to talk with your doctor about the pros and cons of this test, as the normal value range varies among laboratories, and the CA-125 test can result in false positives.

Cholesterol is a waxy substance produced by the body. It makes hormones, skin cells, and digestive fluids. Cholesterol levels change in perimenopause and menopause. Too much cholesterol can build up artery plaque, narrowing blood vessels and potentially causing a heart attack. A cholesterol panel usually includes checking your HDL (high-density lipoprotein or the good cholesterol), LDL (low-density lipoprotein or bad cholesterol) and Triglycerides (molecules of fatty acids), and gives you your total cholesterol/HDL ratio. You’ll need to fast for this test, so don’t eat or drink for 12 hours beforehand.

Vitamin D3 (Cholecalciferol) is the vitamin that helps maintain normal blood levels of calcium and phosphorus, keeping your bones nice and strong.

BTW, I always ask for a copy of my lab results and keep them in a notebook or folder.

Do not be shy about asking for the tests you need. You’re worth it!  Your test results, together with an evaluation of how you feel and a discussion of your medical history will enable your specialist to successfully help you find hormone happiness and regain your quality of life back.

Good Luck!

Hugs,

Ellen

After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause MondaysTM, was born.

  • Lynne Haws

    I saw you today on Katie Couric. I am upset! I am 72 years young, and it seems like once you pass 60, nobody wants to talk to or about you. I am still alive and healthy, but my sex life sucks! My husband is ten years younger than me and I would like to keep him satisfied, but sex is not a pleasurable experience, Ican’t even get an orgasm anymore. Nobody on TV or anywhere else has anything to help me. In 2009 I had a complete hysterectomy, and had a mesh sling put on my bladder. It solved my bladder problem, but left me with almost no sex drive. When I asked my doctor about it he had no answers at all. Do you have any suggestions for me?

    • Ellen Dolgen

      So glad that you reached out, Lynne. Yes, there are many things you can try. You will need to find a good menopause specialist who is up on the latest studies and options. I have some tips here in Dear Ellen. Talk to your menopause specialist about testosterone therapy. If you want to chat further – email me at ellendolgen@ellendolgen.com.

  • staro

    Hi,
    I have tried many times to get doctors from primary, obgyn and an endocrinologist to do some of these tests but none would. I have a myriad of symptoms including chronic fatigue, insomnia, mood swings, brittle nails and hair, painful periods, low libido, extreme fatigue, brain fog, headaches etc… I am in my 40’s but have had these symptoms a long time. Been suffering for a long time.
    The doctors say none of the sex hormone tests are accurate (progesterone, estrogen, testosterone)
    I’ve never heard of the FSH, estradiol, CA-125 and don’t think I’ve ever had that either. Not sure if I’ve had DHEAS.
    So what do you do when your doctor brushes your request for these tests or tells you to stop reading the internet ?(hate that)
    Thanks.