Diagnosis of Hot Flashes

Hot flashes and sweating attacks are the commonest symptoms of menopause. They may happen any time of the day, even several times in an hour. Hot flashes can be diagnosed clinically based on medical history and physical examination. There is no test to diagnose that hot flash is occurring because of menopause. Tests may be done if the doctor suspects that your symptoms are caused because of some other problem and not menopause.

Medical history and physical examination: Your doctor will take a detailed history, examine you and if needed recommend some tests. Some questions that the doctor may ask are:

• when did you have your last period?
• how often do you experience hot flashes, and sweating?
• are the symptoms really bothersome and uncomfortable?
• what seems to improve your symptoms?
• what probably makes your symptoms worse?

During physical examination the doctor will do a complete general check-up with specific attention to rule out other problems (such as hyperthyroidism) which can cause similar symptoms.

Your doctor may ask you to make a note of your symptoms. It is useful to note down all your symptoms, the frequency with which you experience them and how severe they are. Inform your doctor about all your medications and vitamin supplements. Rarely further evaluation may be recommended.

Blood tests

Tests are usually not needed to diagnose menopause and may be performed if the diagnosis is unclear. Your doctor may recommend tests to rule out other conditions which can cause hot flashes. Some other condition which cause hot flashes include:

• fever
• benign cutaneous flushing
• rosacea
• carcinoid tumour
• pheochromocytoma
• medullary carcinoma of the thyroid (MCT)
• hyperthyroidism.

Blood tests may be done to rule out infection. Your doctor may recommend testing of levels of hormones to check to diagnose medical conditions such as hyperthyroidism, pheochromocytoma, medullary carcinoma of the thyroid.

FSH level testing: In rare cases the doctor may check the level of follicle-stimulating hormone (FSH) and oestrogen (estradiol) with a blood test to diagnose menopause. However, tests to check level of follicle-stimulating hormone (FSH) and oestrogen (estradiol) to diagnose menopause are not recommended. During menopause blood FSH levels increase and estradiol levels decrease. But these tests are not reliable as your hormone levels may fluctuate from one day to the next. Hence many do not consider hormone levels to be a reliable indicator for diagnosing menopause. For some women blood test to determine the level of thyroid-stimulating hormone may be done as hypothyroidism (low thyroid level) can cause symptoms like menopause.