A Blood Test for Menopause?>
Ask the Experts

A Blood Test for Menopause

by Wellness Letter  

Q: I heard about a new test called MenoCheck that can supposedly determine how close I am to menopause. As a middle-aged woman, is this something I should consider doing?

A: It depends how “middle-aged” you are. If you are in your early 40s or younger and you have vague symptoms suggestive of menopause (hot flashes, irregular periods, night sweats, or vaginal dryness), you could consider asking your doctor for this test to help determine whether the symptoms are actually due to menopause or something else.

But if you are in your mid-to-late 40s or older, this test isn’t going to give you any additional information, since such symptoms in that age group are typically indicative of menopause, according to Tami Rowen, MD, an obstetrician/gynecologist at UC San Francisco Medical Center and member of our editorial board—and you don’t need a test to tell you that. (By definition, menopause occurs 12 months after the last menstrual period.)

This blood test, PicoAMH Elisa, marketed as MenoCheck, detects very low levels of anti-Müllerian hormone (AMH), which is produced by cells in ovary follicles. Named after the 19th century German physiologist Johannes Peter Müller, this hormone is essentially a marker for estimating the supply of eggs left in ovaries. AMH testing has been around for at least 15 years, but this new ultrasensitive test reveals even lower levels of AMH, which steadily decline with age.

Ansh Labs received FDA clearance in October 2018 to market MenoCheck as an aid in determining menopausal status, based on a large study of 690 women ages 42 to 62. According to the FDA’s news release, the test “performed reasonably well at determining levels of AMH in the blood and identifying women who had their last menstrual period, as well as those who were more than five years away from their last menstrual period.” The news release further noted that determining menopausal status can help a woman (and her doctor) better understand her health risks—and take preventive steps if necessary—since this transition time is associated with accelerating bone loss and increased risk for cardiovascular disease.

However, there are caveats, according to Dr. Rowen. For one, there’s no defined AMH level indicating perimenopause or menopause—the test just gives an idea if the egg count is low or high. A low level simply means you’re low on eggs and nearing menopause, while a high level can reassure a woman that she has a high number of eggs left (though it doesn’t predict their quality). On the other hand, “even with a very low AMH level, you can still have one healthy egg and become pregnant,” says Rowen. That’s why the FDA advises that women should not use this test to assess their fertility and should not stop using contraceptives until they have reached menopause for certain.

It’s also not clear if MenoCheck is any more helpful or better than other AMH tests, which already pick up low levels of the hormone but are not traditionally used in gynecology practices to test for menopause. And even if the test is helpful in some ways, no matter what it shows, if a woman, especially a younger woman, is having menopause-like symptoms, she should see her doctor for a full workup to make sure the symptoms are not due to something else (such as a thyroid condition).

Note: A variety of home tests are also marketed for supposedly detecting menopause by measuring various hormones—but women should not use them without consulting their doctor, since results can be confusing, anxiety-provoking, and not useful. Also, the new MenoCheck blood test should not be confused with a home urine menopause test of the same name that checked for a different hormone (follicle-stimulating hormone, or FSH) and has been discontinued.

This article first appeared in the UC Berkeley Wellness Letter.

Also see Menopause—in Your 30s?