Read the full video transcript below
Today's topic
Hello, and welcome to my weekly video blog. And today on, A.Vogel Talks Menopause, I'm going to be discussing the various tests that you might want to get done or you may need to get done during the menopause.
Now, I'm often asked about these, "Do I need to go and see the doctor, are there any tests that I should be getting?" Now, I have mentioned a number of tests in passing of the last couple of years, but I thought, today, I would just go through them all in a little bit more detail and have everything under one roof, so to speak.
Is there a test for menopause?
Now, one of the main questions I get asked is, "Can I have a test to see whether I'm in the menopause or not?" Now, in theory, you can. You can go and ask your doctor for a blood test. The problem with blood tests is that they depend on your hormone level on the day that you're getting the test done.
So if you're still getting periods, even if they're not regular, even if you're only getting them maybe once every couple of months, even if they're very light, even if some of them are missing or they're very, very short, that still indicates that you're having some kind of hormonal cycle which means that your hormones will be higher at some days than others.
So if you go and get a test done when your hormone levels are reasonably high, the test is going to come back negative and you could be sitting there going, "But everything else fits, I'm getting the hot flushes, I'm getting the fatigue, my periods are tailing off. How come I'm not in the menopause?" So that is the main reason why.
What can you do?
Now, you have a couple of options here. You can wait maybe six months to see if your periods are tailing off a little bit more and maybe go and ask for a repeat test. You can also get a saliva test which sometimes is supposed to be a bit more accurate. But they're not normally offered here in the UK purely because they're a lot more expensive. But you could certainly try if you're really desperate to know whether you're going through the menopause or not.
In our understanding, if you are within the average age group, that's 45 to 55, if your periods are changing, if you're getting other menopausal symptoms, then it's more than likely that you are on your way. But there are other circumstances where you can get menopause-like symptoms that could be caused by other things, and I'm going to go through those now.
Thyroid problems
So the first, sort of, complication, if you like, in the menopause is the possibility of having thyroid problems. We know this is very common. We have a huge number of women who are coming to us and they fit the low-thyroid picture and it just seems to be that when your oestrogen starts to fall, it can have a knock-on effect on thyroid function.
The problem is that a lot of women are just borderline and it can be difficult to distinguish between thyroid and menopause. Now, the main low-thyroid symptoms will be fatigue, it will be either sudden weight gain or you find that you're really piling on the pounds and no matter what you do, you can't shift the weight. It can be hair loss. You can get anxiety, that's a really big one in the thyroid problems.
What can you do?
What to do here is just to make sure that you get diagnosed properly, is to ask for both a T3 and T4 test. These are much broader and take in a lot more into account than a basic T4 test, which very often comes back negative, even though you may well be borderline.
Low Vitamin D
Second problem is low Vitamin D. And here in the UK, we're probably facing a low Vitamin D epidemic. We're not getting a lot of sunshine, we're not getting out into the sunshine, and when we go into the sunshine, we're putting suntan cream on and that's basically blocking the production of Vitamin D.
So with Vitamin D, you're possibly going to get the fatigue, you're going to get muscle, joint or bone aches. So it could be a combination of the three of these or, possibly, even all of them. You're going to get low mood and anxiety. You're probably going to get a little bit of fatigue and you may well get heavy periods. Really serious Vitamin D deficiency can trigger heavy periods as well. So it's a good one if you're in that situation just to ask for your Vitamin D.
What can you do?
Now, the one thing we do not want you to do is just go out and buy a Vitamin D supplement and take it, just in case. The reason being is there's been a lot of news and interest on Vitamin D over the last few years and you can now get really high supplements.
So some women are taking very high doses on a daily basis without even knowing if they're really low in Vitamin D. And what can happen then is that you can end up getting side effects from taking too high a dose of Vitamin D. So if you think you're low, the best thing to do is ask to be tested first and then you can take a supplement, if you really need one.
High blood pressure
Now, the next one is high blood pressure. And we know that falling oestrogen can trigger high blood pressure. Sometimes, high blood pressure has no symptoms at all. So this is one that I would say, maybe, ask to get tested every six months to a year.
However, with high blood pressure, you can get anxiety, you can get vision problems. If you find that maybe your eyesight is changing or you're getting a little bit of blurry vision, that could be something to do with your blood pressure. And you can also get headaches with high blood pressure as well.
Low blood pressure
Now, at the other end of the scale, we've got low blood pressure. Now, low blood pressure is going to give you fatigue, it's going to give you dizziness, especially if you bend down and you pick something up and stand up too quickly, or get out of bed too quickly, if you feel dizzy. It can give you headaches. It can give you cold hands and feet, and it can also give you palpitations.
What can you do?
So it's a really important one to get checked. The reason being is that in a lot of cases, if you've got minor low blood pressure, it's not seen as a problem, but it's always important just to double-check with this one.
Vitamin B12
The other one that you may need to get tested is low Vitamin B12. Now, this is one that you can get that seems to be very specific symptoms such as a sore tongue, you might get mouth ulcers, you tend to get pins and needles, or you might get sort of shooting nerve pains that can just suddenly appear out of nowhere. Again, you can get problems with your vision and also, sometimes it can affect your balance a little bit as well. So anything like that, just get that checked out too.
Iron
And the last one is low iron. Now, especially on the run-up to the menopause, if you've had a lot of frequent periods, if you've had a lot of really heavy periods, then you can very, very quickly end up with low iron. And you don't always get tested for this. And for a lot of women, that sort of phase of heavy or prolonged periods might only last a few months, but that will be enough to give you possibility of low iron.
Low iron, you're going to get fatigue, you can get things like dizziness, you can get really pale. People can say, "Huh, looking a bit pale, are you all right?" You can get cracks in the corners of your mouth and you can also get a sore tongue. You can get heavy periods. So it can actually trigger heavy periods and that can become a real vicious cycle. It can also trigger hair loss, and some women find that they get very brittle nails and they don't grow particularly well.
So as you can see, all these particular issues have a menopause picture as well. So these are ones I would say to you, if you know you're approaching the menopause, and you're getting a combination of symptoms, then it is a good idea just to double-check because these can all be sorted really easily.
Checklist
Now, what we have done is we've done a little piece of paper with all these things written down, it's almost like a little checklist. For those of you who've been watching for a while, you know we did this a little while ago. But for those of you who maybe recently joined, you click on the link, you can just tick the symptoms you have and this is a nice way to take to your doctor, if you feel that you can't really explain all the things that you feel are going on for you.
Breast check
Now, there's two other tests that you really need to possibly think of getting done as you're going through the menopause. One is to get your breasts checked. Now, after you get to a certain age, you're usually asked to go and get a mammogram. In this instance, there are a lot of pros, there are a lot of cons. So this is one test where you really have to make your own mind up if you decide to go and get it done or not. Having said that, if you don't go for the test, it's absolutely vital that you check your breasts on a regular basis, and especially, if you're on things like HRT, really, really important. So that's something you really need to keep ongoing, if you like.
Smear test
The other thing that we often get asked about is smear tests. And in most situations, I think it's right about 62 is when you last get your smear test. But I know there's lots of women who are maybe in their late 40s early 50s going through the menopause and they absolutely dread going to get a smear test.
One of the reasons being is that if you start to get vaginal dryness, it can be very, very painful. If you start to get a little bit of tilting going on within the pelvic organs, again, the vagina can slightly shift position, and a misaimed smear kit can be really, really painful.
So when you go and get a smear test done and you're going through the menopause, especially with the vaginal dryness, then speak to the nurse beforehand, and just explain the situation, and ask them just to be really gentle with you.
It is still important that you get this test done right up until the last moment. So don't delay, don't put them off just because you've had some discomfort. Just make sure that you explain the situation fully the next time you go.
So I hope this has been of interest. It's quite complex, little bit long-winded, but hopefully, I will see you next week on another edition of, A.Vogel Talks Menopause.
