When to Call a Doctor

Call your doctor if you have:

• Menstrual periods that are unusually heavy, irregular, or prolonged (1½ to 2 times longer than normal).
• Bleeding between menstrual periods, when periods have been regular.
• Renewed bleeding after having no periods for 6 months or more.
• Unexplained bleeding while you are taking hormones.
• Symptoms, such as insomnia, hot flashes, or mood swings, that aren't responding to home treatment and are interfering with your sleep or daily life.
• Vaginal pain or dryness that doesn't improve with home treatment, or you have signs of a urinary tract infection.

Who to see

The following health professionals can help you manage menopause symptoms and evaluate menstrual period changes:

• Family medicine doctor
• Gynecologist
• Internist
• Nurse practitioner
• Physician assistant

Exams and Tests

Your age, your history of menstrual periods, your symptoms, and the results of your pelvic exam will tell your doctor whether you are near or at menopause. If possible, bring a calendar or journal of your periods and symptoms.

If you have severe symptoms, if your doctor suspects another medical condition, or if you have a medical condition that makes a diagnosis difficult, your doctor may do one or more of the following blood tests:

• A pregnancy test is done if there is a chance that you are pregnant. (This can also be a urine test.)
• A follicle-stimulating hormone (FSH) test can be used to confirm whether you have reached menopause. FSH levels increase during perimenopause and are high after menopause.
• An estrogen test is sometimes done to see how low estrogen has dropped after menopause.
• A thyroid-stimulating hormone test is used to see whether irregular menstrual periods or perimenopause-like symptoms are being caused by a thyroid problem.

If you have had no menstrual periods for 1 year, this is a good time to have a full physical exam, with particular focus on your heart health and risk factors for osteoporosis.