Which test is the most sensitive initial test for menopause?

Which test is the most sensitive initial test for menopause?

• A. LH assay
• B. Estradiol level
• C. FSH assay
• D. Estrogen receptor test

Answer: (C)

Menopause is driven by loss of ovarian follicles, which lowers estrogen and inhibin B production. With less estrogen feedback, the pituitary increases FSH release. This rise in FSH happens earlier and more reliably than changes in LH or estradiol during the transition, so measuring FSH is the most sensitive way to detect the shift toward menopause. Estradiol can be variable and may still appear normal in early transition, and LH is less consistently elevated. A markedly elevated FSH level (often around or above 30 mIU/mL) in a patient with cessation of menses supports menopause, making the FSH assay the best initial test.

Menopause is driven by loss of ovarian follicles, which lowers estrogen and inhibin B production. With less estrogen feedback, the pituitary increases FSH release. This rise in FSH happens earlier and more reliably than changes in LH or estradiol during the transition, so measuring FSH is the most sensitive way to detect the shift toward menopause. Estradiol can be variable and may still appear normal in early transition, and LH is less consistently elevated. A markedly elevated FSH level (often around or above 30 mIU/mL) in a patient with cessation of menses supports menopause, making the FSH assay the best initial test.