The U.S. Food and Drug Administration (FDA) recently approved the first blood test for helping to determine when a woman has entered menopause. The test measures the amount of anti-Müllerian hormone (AMH) in the blood.
AMH is a hormone produced by a woman’s ovaries that has a role in egg maturation and release (ovulation). AMH levels fall as menopause approaches and is one of several indicators healthcare practitioners have to determine whether a woman is approaching or is likely to have reached menopause. The FDA cautions that the AMH test should be used with other lab tests and assessments.
Menopause marks the end of a woman’s menstrual cycles and fertility. A woman is generally considered to be in menopause if she has not had a menstrual period in twelve months. Women usually begin the gradual transition to menopause (perimenopause) between ages 45 and 55. During this transition, levels of the hormone estrogen can fluctuate, and women may experience symptoms such as:
- Irregular or skipped periods
- Vaginal dryness
- Hot flashes
- Night sweats
- Trouble sleeping
- Mood changes
- Weight gain and slowed metabolism
Although menopause is a natural part of aging, it is associated with an increased risk of adverse health conditions. Decreased estrogen can put women at risk for bone loss (osteopenia) and osteoporosis, which can lead to bone fractures. Low estrogen may also contribute to unhealthy lipid levels and increased risk of heart disease.
Because of varying symptoms and ages when women enter menopause, the condition can be difficult to recognize. Women’s health experts say it is important to determine if a woman is in menopause to be sure that another condition, such as endometriosis or low thyroid hormone levels, isn’t responsible for the symptoms a woman may be experiencing. Knowing that menopause is arriving or has arrived also allows healthcare practitioners to discuss treatment options, including medications to prevent osteoporosis and to reduce cholesterol levels to help prevent risk of heart attacks and heart disease.
“Diagnostic results about a woman’s menopausal status may prompt discussions about [preventive] care for women experiencing menopausal symptoms,” said Courtney Lias, Ph.D. director of the Division of Chemistry and Toxicology Devices in the FDA’s Center for Devices and Radiological Health. “This test, when used in conjunction with other clinical assessments and laboratory findings, can help inform discussions about [preventive] care, such as ways to help prevent loss in bone mineral density or to address cardiovascular disease, both of which are known to increase after menopause.” adds Dr. Lias.
Until now, healthcare practitioners have determined if a woman was approaching menopause by discussing symptoms and in some cases doing blood tests including tests to check a woman’s levels of follicle-stimulating hormone (FSH), estrogen, and thyroid-stimulating hormone (TSH). FSH levels increase and estrogen levels decrease as women transition to menopause. Low levels of TSH, a sign of thyroid dysfunction, can cause symptoms like those associated with menopause.
Before approving the AMH test, the FDA reviewed data on 690 women ages 42 to 62, which showed that the test performed “reasonably well at determining levels of AMH in the blood and identifying women who had their last menstrual period (have reached menopause) and women who were more than five years away from their last menstrual period.”
The FDA says it’s important for healthcare practitioners to use the test results only as one piece of data when assessing a woman so that other potential causes of symptoms are not missed. It is also important that women who have not reached menopause and are not trying to get pregnant continue to use birth control. The test has not been approved for assessing fertility or for evaluating women planning or undergoing fertility treatments.
COMPLETE BLOOD COUNT (CBC) AND COMPREHENSIVE METABOLIC PANEL (CMP-14) BLOOD TEST PANEL
A CBC and CMP-14 provide information about your health.
Complete Blood Count (CBC) gives important information about the numbers and kinds of cells in the blood, especially red blood cells, white blood cells, and platelets. A CBC helps your health professional check any symptoms, such as fatigue, weakness, or bruising, that you may have. A CBC also helps your health professional diagnose conditions, such as infection, anemia, and several other disorders.
Test includes: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelets, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)
Comprehensive Metabolic Panel (CMP-14) with eGFR is a group of 14 laboratory tests ordered to give information about the current status of your liver, kidneys, and electrolyte and acid/base balance. The test gives the current status of your blood sugar and blood proteins also.
Glucose-Blood sugar level, the most direct test to discover diabetes, may be used not only to identify diabetes, but also to evaluate how one controls the disease.
Bun or Urea Nitrogen BUN is another by-product of protein metabolism eliminated through the kidneys and an indicator of kidney function.
Creatinine, Serum An indicator of kidney function.
Bun/Creatinine Ratio Calculated by dividing the BUN by the Creatinine.
Glomerular Filtration (eGFR): Provides an assessment of the kidney’s filtering capacity.
Protein, Total Together with albumin, it is a measure of the state of nutrition in the body.
Albumin Serum one of the major proteins in the blood and a reflection of the general state of nutrition.
Globulin, Total A major group of proteins in the blood comprising the infection fighting antibodies.
Albumin/Globulin Ratio Calculated by dividing the albumin by the globulin.
Bilirubin, Total A chemical involved with liver functions. High concentrations may result in jaundice.
Alkaline Phosphatase A body protein important in diagnosing proper bone and liver functions.
Aspartate Aminotransferase (AST or SGOT)an enzyme found in skeletal and heart muscle, liver and other organs. Abnormalities may represent liver disease.
Alanine Aminotransferase (ALT or SGPT) an enzyme found primarily in the liver. Abnormalities may represent liver disease.
Fluids & Electrolytes
Sodium One of the major salts in the body fluid, sodium is important in the body’s water balance and the electrical activity of nerves and muscles.
Potassium Helps to control the nerves and muscles.
Chloride Similar to sodium, it helps to maintain the body’s electrolyte balance.
Carbon Dioxide, Total Used to help detect, evaluate, and monitor electrolyte imbalances.
Calcium- A mineral essential for development and maintenance of healthy bones and teeth. It is important also for the normal function of muscles, nerves and blood clotting).
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