Menopause diagnosis and treatment

Menopause is a normal and natural stage in every woman’s life, but that doesn’t mean it’s always easy! Menopause can affect your relationships, work life, physical and mental health, and it’s important to get the right treatment, support, and guidance during this time. 

Read on to find out how menopause is diagnosed, when tests can be useful to diagnose menopause, and what treatments can help ease symptoms. 

The National Institute for Health and Care Excellence (NICE) recommends diagnosing menopause when the following criteria are met: 

Diagnosis of menopause without a blood test is recommended for: 

• Healthy women over 45 with irregular periods and vasomotor symptoms (such as hot flashes).
• Women who have not had a period for 12 months and are not using hormonal contraception (birth control containing hormones).
• Women with symptoms of menopause who do not have a uterus (womb). 

A blood test to diagnose menopause is recommended for: 

• Women aged 40 to 45 with menopause symptoms, including irregular periods.
• Women under 40 in whom menopause is suspected. 

Common menopause symptoms such as hot flashes, fatigue, low mood, and difficulty sleeping can have a serious impact on your life, work, and relationships. 

If your menopause symptoms are affecting your relationships, quality of life, or ability to carry out day-to-day tasks, make an appointment to see your GP.

There are many treatments to help with the symptoms of menopause. These include: 

• Hormonal treatments
• Non-hormonal treatments
• Natural treatments

Hormonal Treatments

Hormone replacement therapy (HRT) is the most common menopause treatment and involves replacing the hormones that naturally decrease during this time. HRT normally resolves most menopause symptoms when taken correctly and can lower your risk of developing conditions like osteoporosis and heart disease. 

There are two types of HRT: 

• Oestrogen-only HRT. This is normally used if you have had an operation to remove your womb (hysterectomy). It is available as a tablet, skin patch, gel, spray, and an implant just under the skin. 
• Combined HRT. This contains both oestrogen and progesterone and is recommended if you still have your uterus (womb). It comes as a tablet, skin patch, and an intrauterine system (IUS) which is a type of coil. 

Vaginal oestrogen is available as a cream, pessary, or a ring that you place inside your vagina. It can help with vaginal dryness as a symptom of menopause. Vaginal oestrogen is not classed as HRT as it’s effect is limited to the vagina, so it will not help with other menopause symptoms. It is often used in combination with HRT. 

Testosterone is sometimes prescribed during menopause to help with a low sex drive if other HRTs haven’t worked. It is available as a gel that you apply to your skin and is normally used in combination with HRT.  

 Non-hormonal treatments

If you cannot or choose not to take HRT there are other treatments available that do not contain hormones. 

Clonidine is a blood pressure medication that has been shown to help with hot flashes and night sweats.

Gabapentin is a medication normally prescribed for epilepsy, seizure disorders, or nerve pain. It has also been shown to be effective in reducing hot flashes and night sweats. 

Both Clonidine and Gabapentin can cause side effects and may not be suitable for everyone. Talk to your GP about whether these treatments could be right for you. 

Antidepressants may be prescribed if your symptoms include depression, low mood, or anxiety; but to be effective during menopause, they are normally prescribed alongside HRT.

Cognitive behavioural therapy (CBT) can also help with low mood and anxiety. CBT is a talking therapy that aims to change the way you think about problems and break negative patterns of behaviour. CBT is usually given alongside HRT to be effective in patients during menopause.

Natural remedies

There are many natural remedies that may report to help symptoms of menopause. These include: 

• Herbal supplements like black cohosh and red clover.
• Lifestyle changes like diet and exercise.
• Home remedies such as baking soda and essential oils. 
• Holistic therapies like Ayurveda.

You can find out more about natural treatments for menopause by reading our article, Menopause Natural Treatments. 

The evidence for natural remedies is limited, and they may have side effects or interact with other medication that you’re taking, so always talk to your doctor before trying any alternative treatments.

Your GP can normally diagnose menopause by asking questions about your age, symptoms, and menstrual cycle (periods). Your doctor may order a blood test if you:

• Are between 40 and 45 years of age and have menopause symptoms including absent or irregular periods.
• Are under 40 years of age and have symptoms of menopause, or your doctor thinks you may be going through menopause. Note that menopause before the age of 40 is called premature menopause.

The blood test measures your levels of follicle-stimulating hormone (FSH), a hormone that increases during menopause.  You should be offered 2 tests which are done 4 to 6 weeks apart to allow for natural fluctuations in your FSH levels. 

If you are experiencing symptoms and would like to know if you may be going through menopause, there are many test kits available that you can do yourself at home. These tests involve taking a finger-prick sample of blood and sending it to the lab to be tested. You normally receive the results in a few days. 

Alternatively at Medicspot, we offer a rapid home urine test. This test can be delivered straight to your door, is quick, easy, and painless, with results in just 3 minutes. If this is positive, your doctor may recommend a blood test to confirm the diagnosis.

Some women may experience menopause early. Menopause between the ages of 40 and 45 is known as early menopause, and is not normally anything to worry about. If you experience it below the age of 40, this is known as premature menopause, and your doctor will need to discuss this with you. The medical term for early or premature menopause is premature ovarian insufficiency. 

Premature ovarian insufficiency may be triggered by surgery such as a hysterectomy (removal of the womb) or oophorectomy (removal of one or both ovaries), or medical treatments like chemotherapy. In the majority of cases, the cause is never known and it is nothing to worry about. 

Premature ovarian insufficiency cause menopause symptoms, including: 

• Irregular or absent periods
• Hot flashes and night sweats
• Vaginal dryness
• Mood changes and low mood
• Difficulty sleeping
• Fatigue

If you are under 40 and experiencing symptoms of menopause, your doctor will usually order blood tests to help with this diagnosis. Depending on the results, you may be referred to a specialist doctor for further tests. 

Treatment for early menopause is most commonly HRT. This should be continued until at least the typical age of menopause (45 to 55) to reduce your risk of conditions such as osteoporosis and heart disease. HRT is not suitable for everyone. If you can’t or don’t want to take HRT, your GP will discuss other treatment options with you.

Menopause is a time of significant change in a woman’s life and it’s normal to feel isolated and overwhelmed at times. Menopause is a normal part of life, not an illness, but many women still need help and support through the transition. If you are struggling with menopause symptoms, or they are affecting your relationships, quality of life, or ability to carry out day-to-day activities, make an online GP appointment. The majority of women can enjoy a great improvement in their menopause symptoms with treatment.

National Institute for Health and Care Excellence (NICE): Menopause diagnosis and management December 5th, 2019 (Accessed July 22nd, 2022) 

NHS: Treatment. Menopause May 17th, 2022 (Accessed July 22nd, 2022)

NHS: Symptoms, Menopause May 17th, 2022 (Accessed July 11nd, 2022)

NHS: Types. Hormone replacement therapy (HRT) September 9th, 2019  (Accessed July 22nd, 2022)

PubMed: The levonorgestrel-releasing intrauterine system for endometrial protection during estrogen replacement therapy: a clinical review March 7th, 2015 (Accessed July 22nd, 2022)

National Institute for Health and Care Excellence: Premature menopause (premature ovarian insufficiency) November 12th, 2015  (Accessed July 23rd, 2022)