What tests should be done before starting hrt?

The evaluation consisted of a clinical and medical examination and a medical history. Mammography is a necessary test for the exclusion of malignant neoplasms and also for the evaluation of. Routine blood tests are not recommended when you are taking hormone therapy. This is because blood tests to check estradiol levels can be prone to errors.

This means that the estrogen dose must be adjusted according to the symptoms of menopause. These blood samples may include hormonal tests and, usually, a test to detect other causes of similar symptoms, for example, to detect thyroid problems, anemia, vitamin B12 or folic acid deficiency, or type 2 diabetes. According to the North American Menopause Society, determining doses of menopausal hormone therapy based on blood or salivary hormone tests doesn't make sense for middle-aged people, as these levels vary from day to day and even from hour to hour. Thyroid stimulating hormone (TSH) levels should be monitored regularly (for example, 6 to 12 weeks after starting oral hormone hormone therapy) to ensure that the levels remain within the acceptable range, as the dose of the levothyroxine (LT) medication may need to be increased. We know that some doctor's offices will continue to request hormone tests as part of a menopausal care evaluation, and some patients will like that.

However, it's important to note that a “normal” range hormone blood test doesn't mean that a hormone therapy trial isn't useful if a more serious cause has not been found to explain the symptoms. For women under 45, where there is no strong suspicion that the symptoms are related to another diagnosis, some doctors, especially specialists with experience in treating menopause, will be happy to prescribe hormone therapy without blood tests. They advise that blood tests for follicle stimulating hormone (FSH) be considered in women aged 40 to 45 who have symptoms of menopause, including a change in the menstrual cycle, and that blood tests are important in women under 40 years of age who are suspected of having menopause. In the United Kingdom, NICE guidelines for the diagnosis and treatment of menopause state that, in women aged 45 and over, there is no need for blood tests to detect hormones such as follicle stimulating hormone (FSH), estradiol and progesterone in healthy women who have menopausal symptoms or whose periods have changed. Arrange to see the woman after three months if HRT has been started or modified and, thereafter, at least once a year, unless there are clinical indications for a previous review (such as treatment ineffectiveness or adverse effects).

In women younger than 45, hormonal blood tests can sometimes be useful if periods have changed or to rule out other possible causes of similar symptoms.

For women aged 45 and over, NICE guidelines state that, when symptoms coincide with those of menopause or perimenopause, there is no need for blood tests before starting hormone replacement therapy

(TRH). Blood tests, such as those for follicle-stimulating hormone (FSH), are not routinely needed to diagnose perimenopause or menopause in otherwise healthy women (not using hormonal contraceptives) older than 45 years, with typical menopausal symptoms.

Many women ask us to do a blood test to check their estrogen levels to monitor their hormone replacement therapy (HRT).