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Manisha Sharma had the kind of symptoms that made her think she was well into perimenopause. After all, she was a 49-year-old woman who was suddenly sprouting hairs on her chin, having mood swings and constantly arguing with her husband about the thermostat settings (she wanted them cooler).
To reassure herself she was “not crazy,” Sharma purchased an at-home menopause test from her local drugstore. The kit included urine test strips to be used over 10 days and instructions for logging the information into an app that would generate a report about her menopausal status.
“It actually said I was premenopausal,” said Sharma, a physician in San Diego. Sharma said she found the answer frustrating because she believed she was probably further along the menopausal timeline. “I wanted to shout at the test, ‘You have no idea what you’re talking about!’ Because I know what I feel, and I feel different,” she said. “I look different. And my body’s changing.”
The age of home testing for menopause has arrived. A spate of new products promises to deliver important information about the journey to menopause, a transition many women experience in their 40s and 50s. You can stop in CVS or Walgreens and for about $20 pick up a ClearBlue Menopause Stage Indicator, or try one from Femometer.com, Oova or everlywell.com.
“If women live to a certain age, 100 percent of them will go through menopause. And yet, we still have very little understanding about what that transition looks like,” said Amy Divaraniya, founder and chief executive of Oova. “The technology that we’ve developed really enlightens a woman with data so she can finally have a two-way conversation with her doctor, really understand what her body’s telling her and advocate for her own health, which is the ultimate goal.”
Experts say the tests may give some women the reassurance that what they are experiencing is real. It can also help women distinguish between menopause and other conditions with similar symptoms. But ideally, these are discussions best had with a physician, and doctors say they don’t think women need an at-home test to start a conversation about menopause.
“I don’t see much value in these tests for the average woman,” said Susan E. Loeb Zeitlin, director of the Women’s Mid-Life Center at Weill Cornell Medicine in New York City. “It’s the symptoms that matter – not what this test shows. The most important thing a provider will do is discuss symptoms, including bleeding and other hallmarks of menopause.”
When you urinate on the test kit sticks, they measure your body’s hormone levels. The tests detect levels of follicle stimulating hormone, a hormone produced by the pituitary gland that promotes egg formation. Some tests include other measures including estrogen levels (which decline during the menopausal transition) or luteinizing hormone, which helps control the menstrual cycle.
“Our test uses serial FSH testing, cycle variability, data, and age to identify a woman’s likely menopause stage,” said Fiona Clancy, research and development director for ClearBlue. These variables were selected because they are part of a standardized set of measures related to assessing menopause.
After a woman uses the urine indicator five different times over 10 days, she gets a report that gives her the five FSH results, an estimated stage of menopause and a summary of any symptom data that she tracks, using the app that comes with the kit.
“We found that women really liked this report because it either gave them a little bit of validation of what they were feeling, and it helped prepare them for a conversation with their doctor,” Clancy said. “They didn’t go into the appointment feeling unprepared.”
One study estimates that in 1990, there were 467 million postmenopausal women in the world; by 2030, that number will grow to 1.2 billion. “So, there’s some ‘meno-profiteering’ going on out there,” said Lisa Larkin, president of the Menopause Society (formerly known as the North American Menopause Society).
“I see it as companies now recognizing the size of the market opportunity and the money that can be made right now,” she said.
The main problem she sees with at-home testing is that the premise is flawed. “Menopause hormone levels change minute to minute, day-to-day,” she said. “And so, you get data points, but it’s like doing your blood sugar when you’re fasting and then again after you’ve had McDonald’s and french fries. Even on the same day, you can get very different results.”
“When a patient comes to see me, I don’t need tests to tell her that she’s perimenopausal,” Larkin added.
Loeb-Zeitlin agrees. “We’re not treating the numbers,” she said. “We’re treating the patient and her symptoms.”
That’s exactly what happened to Sharma, who finally went to her doctor to discuss her symptoms. “You’re in perimenopause,” Sharma said the doctor told her, “and you are doing great.”
“Her words were more validating to me than peeing on a stick,” Sharma said. “I’ll be very honest, I cried. Because I don’t feel like I’ve had a space to just be a working woman who was feeling all these things. Just having someone tell me that ‘you’re very normal’ was very validating.”
Mary Jane Minkin, clinical professor in the department of obstetrics, gynecology and reproductive sciences at Yale University Medical School, said at-home menopause tests can be validating for some women. “They’re made for people who are skipping periods,” said Minkin, who was an adviser to ClearBlue on the development of its test. “It’s not going to tell you when your periods are going to stop, but it is telling you that a lot of what you’re experiencing is hormonal.”
“Is this a crucial test? No. But the feelings of perimenopause can be very, very frustrating for women. Extremely frustrating,” Minkin said. “I think that if they have numbers from these tests with them, they will feel less likely to be dismissed by doctors. No test can guarantee that you’re perimenopausal, but if you’ve got some symptoms going on, we can probably get you some help with them.”
Loeb-Zeitlin concedes that some women might find a test reassuring if they’re not getting satisfactory answers from their doctor, who may not be specifically trained in menopause. “Looking for a doctor who specializes in menopause might be the way to go,” said Loeb-Zeitlin.
