Top Labs To Run On Your Patients Going Through Menopause

Menopause is a natural occurrence that indicates the end of menses, that signals the end of their reproductive years. These patients will typically start experiencing this hormonal shift in their early 50s. Around 1.3 million women start this next chapter of their lives every year.For many women, menopause can be a stressful time. It is estimated that 75% of women will have vasomotor symptoms, 60% will have urogenital symptoms, and 45% will have psychogenic symptoms. Therefore, it is essential that these women have options to help them minimize those symptoms so they can have a smoother transition through this phase. From an integrative perspective, functional medicine labs can offer insights into specific imbalances that occur. These labs can help facilitate a personalized a holistic plan for patients to alleviate their discomfort and fully support them through this transition.

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What Is Menopause?

Menopause occurs when menstruating patients cease their menses for a 12-month duration. This hormonal shift is not associated with pathology and is a normal physiological process. During this transition, ovarian follicles are significantly reduced and don't respond to the effects of FSH, preventing an LH surge and ovulation. This change creates a decline in estrogen and an end to menstruation. Menopause can also be medically induced by procedures such as hysterectomies or medications such as chemotherapy.

When Does Menopause Start? 

There are three stages that occur during menopause: perimenopause, menopause, and post-menopause. Perimenopause is considered the transition and can begin up to ten years prior to menopause as the ovaries gradually start to decrease their hormone production of estrogen. This stage typically starts in the 40's. Menopause is the stage where the patient's ovaries aren't releasing eggs and stop producing estrogens, which stops the menstrual cycle. This stage typically occurs at 51 and 52. It's important to note that about 5% of women may have menopause in their 40s. Post-menopause is the part of the patient's life after not having a menstrual cycle for 12 months.

Possible Menopause Symptoms

During the transition into menopause, symptoms and intensity of symptoms can vary for each patient as hormone levels will vary. Menopausal symptoms include:  

Vasomotor Symptoms:

• Hot flashes
• Night sweats
• Heart palpitations
• Tension headaches
• Migraines

Urogenital Symptoms:

• Vaginal atrophy and dryness
• Dyspareunia (painful intercourse)
• Urinary urgency and frequency
• Painful urination
• Incontinence

Psychogenic Symptoms:

• Irritability
• Mood changes
• Sleep issues
• Inability to concentrate
• Anxiety
• Depression
• Loss of confidence

Other Symptoms:

May include,

• Irregular periods
• Increased intensity of PMS
• Muscle aches
• Weight gain
• Hair thinning

What Are The Benefits of Regular Lab Testing For Patients Going Through Menopause?

Regular labs for patients going through menopause can help practitioners understand the key factors contributing to their symptoms. The results of these tests can aid in creating individualized strategies to manage menopause for these patients so they can have a more comfortable transition. These tests may also be beneficial to help effectively monitor any treatment protocols that may be implemented for these patients, such as hormone replacement therapy (HRT), and retesting should occur in 3-6 month increments during this time. This approach can help your patients get ahead of their symptoms so this natural process doesn't negatively impact their daily lives. 

Although HRT has been shown to be used often in relieving menopausal symptoms and decreasing the risk of conditions such as osteoporosis, there are some risks associated with HRT that should be mentioned. HRT has also been indicated in increasing the risk of breast cancer and strokes. New research is showing that the benefits of HRT for menopausal symptoms may not outweigh the risks and should be carefully considered before utilzing this approach. 

Top Labs To Run Bi-Annually On Patients Going Through Menopause

The diagnosis of menopause is made through a clinical intake of the patient's age and symptoms, ruling out other conditions, and discussing their menstrual cycle within the past year. Here are some top labs to consider running regularly for your patients going through menopause:

Comprehensive Hormone Panel

A comprehensive female hormone panel is indicated for patients going through menopause, as this is a phase of hormonal change. This functional lab test assesses all the necessary hormone markers associated with menopause, including FSH, LH, estrogen, and progesterone levels. Elevated FSH and LH levels with low levels of estrogen and progesterone can indicate menopause. Testing for these hormones regularly can provide accurate monitoring of treatment protocols that intend to balance hormones to help reduce menopausal symptoms.

Micronutrient Assessment

Nutritional needs vary for each patient during this transition phase. Nutrients such as vitamin D3 and calcium are needed for bone health and the risk of osteoporosis increases for women going through the menopausal transition. Therefore, measuring these nutrient levels can be beneficial for these patients to ensure that they have sufficient levels to support them through this time. The micronutrient panel can analyze different vitamins, minerals, amino acids, and antioxidants to screen for any deficiencies.

Cardiometabolic Analysis

Research indicates that lipid levels can be affected for women in menopause. These changes can increase their risk for cardiovascular issues as total cholesterol, LDL, triglycerides, and lipoprotein(a) can increase during this stage. The lipid panel measures all these markers and others to assess the patient's risk of cardiovascular disease. This test can help address these risks and allow you to keep track of and support healthy lipid levels for your patients.

Complete Thyroid Test

Thyroid disruption has been shown to increase in menopausal women. The risk of thyroid conditions such as thyroid cancer also increases for these patients. A complete thyroid panel assesses for all the relevant thyroid hormones, including reverse T3 and antibody levels that may be imbalanced for this group. A thyroid panel should be considered to be included in your lab orders for patients going through this transition to detect any thyroid risk and associated symptoms. 

GI-MAP

Evidence suggests that the gut microbiota can be significantly altered for women going through menopause. Imbalances in the microbiome can increase intestinal permeability, lead to digestive issues, and result in other negative implications such as weight gain, diabetes, and cardiovascular disease in these patients. A thorough examination of the gut microbiota using labs such as the GI-MAP can give you insight into the diversity and health of the microbiome. This test can guide personalized gut health protocols to improve microbiome health and gut function while reducing the risk of other health conditions associated with a disrupted microbiome.

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Summary

Women go through many different hormonal changes throughout their lives. The hormonal transition of menopause is just another part of your patient's health journey. In order to fully support these patients through this phase of female health, a comprehensive approach to care needs to be utilized. Many women will experience some, if not a combination, of vasomotor, urogenital, and psychogenic symptoms that include hot flashes, night sweats, decreases in libido, difficulty sleeping, and many others that can impact their daily life during menopause. Regular lab testing can individualize treatment options for these patients to address any underlying factors that are contributing to those symptoms and help your patients enjoy this part of their lives more fully.