"A saliva panel will balance your hormones."
Is there a perimenopause test?
"A blood test will tell you if it's menopause."
Not one that settles it for most people. Ontario Health's guide to its menopause quality standard says your clinician should go through the possible symptoms with you, so you can decide together whether you're in perimenopause or menopause. For most people, symptoms are enough. Blood tests or imaging aren't needed.
Source: Ontario Health, Menopause quality standard, patient guide (Quality Statement 2).
The same guide notes that some people reach menopause before 40. If that might be you, say so at your assessment.
Why your list does more than a number
Symptoms come and go. A list doesn't forget. "I lose words mid-sentence" tells the NP more than a score out of ten, and so does "I wake up soaked" or "my periods have gone unpredictable". Your assessment starts from it. We work down it together, the line that bothers you most first.
It isn't a test either, and it can't tell you on its own whether you're in perimenopause. Many of these symptoms have other causes, from iron levels to stress, which is why an assessment matters.
Two minutes. Prints on one page. Nothing you tick leaves your device.
Do I need a saliva hormone test?
No. We don't use them to set doses.
The Endocrine Society says claims that saliva tests can customise hormone doses lack supporting scientific data. If we order bloodwork, we'll tell you what it's for and what it can and can't show.
Source: Endocrine Society position on compounded bioidentical hormone therapy (2019).
Saliva panels are often sold alongside custom-compounded "BHRT", the idea being a recipe mixed to match your numbers. That's a different thing from body-identical hormone therapy in Health Canada approved products.
Hot flashes, night sweats, broken sleep? See what menopause care here involves, hormone therapy included.
When we do order bloodwork
Bloodwork is ordered when it will change a decision. When we order it:
- You get a requisition, and go to a community collection centre near you with your health card.
- That testing is usually covered by OHIP.
- We tell you what each test is for, and what it can and can't show.
- If you start treatment, follow-ups repeat bloodwork when it's due.
Sources
- Ontario Health, Menopause quality standard, patient guide (Quality Statement 2): ontariohealth.ca/content/dam/ontariohealth/documents/filter-list/qs/qs-menopause-patient-guide-en.pdf
- Endocrine Society, Compounded bioidentical hormone therapy position (2019): endocrine.org/advocacy/priorities-and-positions/bioidentical-hormones