Investigations

FSH only helpful if diagnosis is in doubt, such as below age 40 and levels in menopausal range (>30IU/L).

Luteinizing hormone, oestradiol, and progesterone are of no value in the diagnosis of ovarian failure.

Thyroid function tests (free T4 and thyroid-stimulating hormone) as abnormalities of thyroid function can be confused with menopausal symptoms.

Testosterone levels are of uncertain value.

BMD if significant risk factors for osteoporosis (Table 21.2).

Table 21.2
Bone mineral density (BMD)

Description

Definition

Normal

A person has a BMD value between −1 SD and +1 SD of the young adult mean (T score −1 to +1)

Osteopenia

A person has a BMD reduced between −1 and −2.5 SD from the young adult mean (T score −1 to −2.5)

Osteoporosis

A person has a BMD reduced by equal to or more than −2.5 SD from the young adult mean (T score −2.5 or lower)

Description

Definition

Normal

A person has a BMD value between −1 SD and +1 SD of the young adult mean (T score −1 to +1)

Osteopenia

A person has a BMD reduced between −1 and −2.5 SD from the young adult mean (T score −1 to −2.5)

Osteoporosis

A person has a BMD reduced by equal to or more than −2.5 SD from the young adult mean (T score −2.5 or lower)

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