Is this woman going through menopause?

Relevance to family physicians Informed consumers are a good thing, but one of the side eff ects of being informed is their increased desire for testing. Patients have, I would say, an incredible faith in diagnostic testing, especially tests that involve high technology. Test results are often viewed by the public as black and white. Those of us who have dabbled in the science of diagnosis have found them very gray territory. An increasing number of patients are asking to be tested for a variety of conditions; requests for testing to confi rm menopause are common. Th is is understandable, given that the transition can be complex and troubling for women. One Scottish survey (6096 women aged 45 to 54) found that 84% of women had experienced at least one classic symptom of menopause, and 45% found these symptoms a problem.1 As well, an increasing number of women are taking oral contraceptives in their 40s and 50s and are wondering if their true hormonal state is menopausal. Overview of study and outcomes Th e authors searched MEDLINE from 1966 to 2001 using logical inclusion criteria regarding perimenopausal diagnostics. Th e search yielded 1246 articles, of which 16 met the inclusion criteria. Sensitivity, specifi city, and likelihood ratios with confi dence intervals were calculated for diagnostic tests.