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Menopause - Evidence
Evidence on diagnosis of menopause
- A systematic review of 16 cross-sectional or longitudinal studies on women 40 years of age or older aimed to study the accuracy of self-assessed symptoms, signs, and laboratory tests in diagnosing the perimenopause. All studies defined perimenopause as 3–11 months of amenorrhoea or irregular periods, included a premenopausal control group, and reported a clinical examination finding. The review found that [Bastian et al, 2003]:
- No single symptom or laboratory test could either rule in or rule out the perimenopause.
- The prior probability of perimenopause is directly related to a woman's age.
- After considering age, the following yielded the greatest positive likelihood ratios (LRs+):
- Self assessment of going through the transition (LR+ range 1.53 to 2.13).
- Hot flushes (LR+ range 2.15 to 4.06).
- Night sweats (LR+ 1.90, 95% CI 1.63 to 2.21).
- Vaginal dryness (LR+ range 1.48 to 3.79).
- High follicle-stimulating hormone levels (LR+ 3.06, 95% CI 2.06 to 4.54), and low inhibin B levels (LR+ 2.05, 95% CI 0.96 to 4.39). provided weak evidence to rule in the perimenopause. However, neither normal follicle-stimulating hormone level (LR 0.45, 95% CI 0.36 to 0.56) or normal inhibin B level (LR 0.70, 95% CI 0.51 to 0.96) could rule out the perimenopause.
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