Diagnosis of Early Menopause
The diagnosis of early menopause is based on symptoms, age, and hormone levels. Since early menopause can mimic other health issues, accurate diagnosis is important to avoid mismanagement or emotional distress. Many women go months or even years without understanding the true cause of their symptoms.
Doctors begin with a full medical history and physical examination. They ask about menstrual patterns, family history of menopause, use of medication, previous surgeries, and symptoms like hot flushes, mood swings, or fatigue. A detailed account of menstrual irregularity is especially important. If periods have stopped or become erratic for several months before age 45, early menopause is suspected.
The next step is hormone testing. Blood tests are taken on specific days of the menstrual cycle—or at random if periods have stopped—to measure levels of:
Follicle-stimulating hormone (FSH): Elevated levels suggest ovarian failure.
Oestrogen: Low levels support a menopause diagnosis.
Luteinising hormone (LH): Often increased during menopause.
Anti-Müllerian hormone (AMH): Assesses ovarian reserve, useful for fertility evaluation.
Doctors may also check thyroid function and prolactin levels to rule out other hormonal causes of irregular periods.
In cases of suspected early menopause, additional tests may include:
Pelvic ultrasound: To check the size and activity of ovaries.
Bone density scan (DEXA): As oestrogen protects bones, women in menopause are at increased risk of osteoporosis.
Genetic testing: If early menopause occurs before age 35 or there’s a strong family history, testing for chromosomal abnormalities may be advised.
Diagnosis of Early Menopause
In South Africa, public healthcare access to hormone testing and bone scans is often limited. Many women in rural areas are diagnosed based on symptoms alone, which can lead to underdiagnosis or incorrect treatment. Access to gynaecologists is better in urban hospitals, but many women cannot afford private care.
Mental health evaluation may also be part of the diagnostic process. Women dealing with early menopause often experience anxiety, sadness, or grief related to fertility loss, ageing, and social isolation.
An accurate diagnosis of early menopause ensures appropriate treatment and counselling. It also helps identify health risks that may arise from long-term oestrogen deficiency, such as heart disease or bone thinning. Early diagnosis empowers women to protect their health and understand the changes their bodies are going through.
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