Tests
1st tests to order
pregnancy test
Test
Indicated in sexually active women with amenorrhea. A negative urine human chorionic gonadotropin (hCG) test reliably excludes pregnancy.
Quantitative blood tests for hCG should be reserved for special clinical circumstances, such as following a possible ectopic pregnancy.
Result
negative
Tests to consider
follicle-stimulating hormone (FSH)
Test
Recommended for diagnosis in women under 40 years of age, and may be helpful in women ages 40 to 45 years.[1][28] An elevated FSH level may be predictive of impending menopause after several months of amenorrhea.
Not recommended in women over 45 years of age; testing for FSH early in perimenopause is usually not helpful because of variability in levels from day to day and during the menstrual cycle.[29]
Result
elevated >30 IU/L
serum estradiol
Test
Testing is not usually indicated.
Estradiol is the predominant estrogen before menopause. Serum estradiol levels vary throughout the menstrual cycle but average about 100 picograms/mL (367 picomol/L).
After menopause, estrone, which is derived from estradiol metabolism in the liver and peripheral conversion of androstenedione in adipose tissue, becomes the dominant estrogen.
Result
<30 picograms/mL (<110 picomol/L)
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