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Premature Menopause: Investigations

Blood tests to measure hormone levels are rarely useful in diagnosing the menopause when it occurs at the “usual” age, but in women in whom Premature ovarian insufficiency (POI) is suspected, then measurement of Follicle Stimulating Hormone (FSH) is useful and, if raised, should be repeated around six weeks later. When the ovaries have failed, estrogen level will be low and consequently, FSH level will rise since its level is controlled by a feedback mechanism involving estrogen.

Interest has recently been shown in measuring Anti Mullerian Hormone (AMH) level. AMH is produced by the egg cells and so a reduced number of egg cells will lead to a low AMH level and it has been suggested that it may be possible to predict the age of the menopause from AMH level. This test is not yet widely available though it may be used in certain situations under specialist advice.

Thyroid function and prolactin level should be checked since abnormalities in thyroid function and high prolactin can temporarily disturb ovarian function.
Autoimmune studies can be carried out from blood tests and, in women with POI below the age of 30 years, chromosomes should be checked.

More specialised investigations may be suggested depending on the history and clinical findings.

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