Menopause is often diagnosed when a middle-aged woman displays classic symptoms of the condition and cessation of menses. If there is any question about the diagnosis, a blood test can be taken to measure the level of follicle stimulating hormone, or FSH. During menopause, this hormone is elevated because the brain attempts to stimulate the ovaries, but they do not respond. Measurement of FSH levels should not be used to determine the appropriate dose of estrogen to use in treatment, however.
In addition to the symptoms of menopause, other changes occurring in menopausal women can be dangerous.
At menopause, the risk of heart attack and stroke increase because there is no longer enough estrogen to prevent atherosclerosis, or plaque buildup in the arteries.
Estrogen also acts to increase HDL, or "good" cholesterol, and to decrease LDL, or "bad" cholesterol. Lowered estrogen levels can lower HDL and raise LDL, thus increasing the risk of heart disease. Remember that heart disease is still the overall leading cause of death among women.
Calcium loss from bone is a normal part of the aging process. From menopause on, untreated women lose one percent to two percent of their bone mass each year. Estrogen acts to help keep calcium in bone so it remains strong. Even with weight-bearing exercises and adequate calcium/vitamin D intake, a woman’s bones may become less dense if estrogen is not present.
Seventy-five percent or more of the bone loss that occurs in women during the first 15 years after menopause is attributable to estrogen deficiency rather than aging itself. Combined estrogen replacement and calcium use can result in an 80 percent decrease in compression fractures of the spine during menopause.
Insufficient estrogen levels have also been associated with altered memory, an increased risk of Alzheimer's disease, macular degeneration in the eye (which may cause blindness), and colon cancer. Skin becomes drier and thinner, and hair loss may occur as well.