The days of pass/fail, all-nighters and cramming for tests may be over, but there are certain tests — the medical kind — that we haven’t outgrown. In fact, for women in perimenopause and menopause, these tests could mean the difference between life and death.

Please note: This is not intended to be medical advice. Consult your menopause specialist about the best course of action to take, as every woman has unique needs.

The symptoms of menopause are similar to those of other conditions, such as thyroid disease. For some women, it may make sense to undergo medical tests to rule out such conditions.

Follicle-Stimulating hormone (FSH) Testing

Follicle-stimulating hormone (FSH) levels are sometimes measured to confirm menopause. After several tests, if a woman’s FSH blood level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year, it is generally accepted that she has reached menopause. Also, if a woman is using certain hormone therapies (such as birth control pills), an FSH test is not valid. Some doctors prefer to test the anti-mullerian hormone (AMH) levels instead. The AMH levels are decreased in perimenopause. Fertility doctors have been using this test for years as they find that the levels are not affected by taking birth control pills.

Hormone Panel

If you’re still menstruating, have your hormone panel (blood test) done during the first three days of your period. It can test for the following hormones:

• DHEAS – DHEA sulfate is a hormone that easily converts into other hormones, including estrogen and testosterone.
• Estradiol – This is the main type of estrogen produced in the body, secreted by the ovaries. Low levels can cause memory lapses, anxiety, depression, uncontrollable bursts of anger, sleeplessness, night drenches, and more.
• Free and Total Testosterone – (Yes, some things in life are free). Free testosterone is unbound and metabolically active, and total testosterone includes both free and bound testosterone. In women, the ovaries production of testosterone maintains a healthy libido, strong bones, muscle mass, and mental stability.
• Progesterone – Low levels of progesterone can cause irritability, breast swelling and tenderness, mood swings, “fuzzy thinking,” sleeplessness, water retention, PMS, and weight gain.
• 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.

Once you’ve determined that you actually are in the midst of perimenopause or menopause, here are other important tests to consider:

Bone density test

Also called a bone scan or DEXA scan, this test can determine whether you have osteopenia or osteoporosis. When you enter perimenopause and menopause, the decline in estrogen can trigger a rapid loss of bone mass. The scan 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. Note that this test can result in false positives.

Cholesterol panel

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 good cholesterol), LDL (low-density lipoprotein or bad cholesterol), and triglycerides (molecules of fatty acids). You’ll need to fast for 12 hours before this test.

Vitamin D3

This vitamin helps maintain normal blood levels of calcium and phosphorus, keeping your bones nice and strong.

Other important exams

Of course, don’t forget your monthly breast self-examination and your annual mammogram. At the very least, you should schedule an annual checkup with your general physician and an annual pelvic exam with your gynecologist. Depending on your medical history and age, it might be time for you to have a colonoscopy screening. Be sure to discuss this with your medical provider.

Your legs aren’t the only thing you should open wide! Regular dental checkups are important, too, as untreated gum infections can lead to more serious health issues. Apparently, people with periodontal (gum) disease are almost twice as likely to have heart disease.

So crack open those books (appointment books, that is) and start cramming (those test dates into your calendar). Here’s hoping that you’ll pass with flying colors.