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Our mothers and grandmothers waited and watched for menopause. But our generation is used to having more knowledge of our bodies and control over our health. It’s little wonder, then, that we’re embracing at-home menopause tests in an effort to better understand which stage of menopause we’re in.
Since menopause is defined by having gone 12 months without a period, you’d think that we’d at least know when we were there. But in my own case, I was confused. Yes, I went from my 49th birthday to my 50th one with no bleeding, so my ob-gyn ordered a blood test and agreed I was “probably” menopausal. Except that after my milestone birthday, each time I got a COVID shot, I’d spot a little for a few months. So was I or wasn’t I?
Yes, I know my ob-gyn should be able to answer that. But few ob-gyns are well-trained in menopause, a fact now abundantly clear to me. I replaced the one who figured I was “probably” menopausal with a new one who just looked at me like I was lying liar about my spotting — and who took zero notes about it. She didn’t even offer a blood test. So you can see why, when I learned that there was a new Clearblue Menopause Stage Indicator test that just required me to pee on a stick, I felt like it was totally worth $20. Maybe the test would be definitive in a way my doctors were not. In the end I got one for free at an event for the brand. Given my doctor’s weak “diagnosis,” I figured there was zero harm in seeing what Clearblue had to tell me.
First thing: This is not an immediate-gratification menopause kit. The test is designed to test levels of follicle-stimulating hormone (FSH) five times over the course of 10 days. The soonest you start is the morning after you acquire the test, because it’s best to pee on one of the sticks when you first wake up, per the brand directions.
It’s also critical to use the Clearblue ME app (available on iOS and Android). The app is where you get your answer about your menopause stage — it’s not going to magically appear on one of the sticks. In other words, though you use the five sticks in the kit like you use pregnancy tests, you’re not going to get a binary pregnant/not pregnant kind of answer on one. It’s not a simple menopausal/not menopausal situation — there are actually four possible stages the test can sort you into.
Other important directions from Clearblue: It’s best to test when you’re not having your period. You shouldn’t use the test if you’re breastfeeding or if you’ve had a hysterectomy. Oh, and if you’re currently using any hormonal birth control, including an IUD with hormones like the Mirena that I used for years, you’re not going to get an accurate read and shouldn’t buy this test. But you might not know that until you buy the test and are setting up the app. Which leads me to…
You might be eager to get started with the sticks, but you need to set up the app first. Like seemingly everything in our lives, this app requires a username and password. It also needs your birthdate, height, and weight, and whether you’re on hormonal birth control or hormone replacement therapy (if yes to either, the test is not for you).
Then you answer a question about your periods: Have you seen a difference of 7 days or more between the length of one cycle and the next at least twice in the last year? Or have you not had a period in 12 months? I checked off that last one because my spotting doesn’t really count as a period. But then I felt like an idiot, because I know not having a period means I am menopausal, so did I just diagnose myself with menopause? But anyway… here were my directions to start.
This is just my reality, as a “probably” menopausal woman: I wake up in a fog and stumble to the bathroom and pee before I’ve given a thought to anything in the world. So on the first day I was supposed to take the test, I forgot. No worries, the app reassured me, you can just start tomorrow instead. Which was fine, but I realized this whole project was going to take about two weeks from the day I acquired the box to the day I was going to get an answer — and I’d just set myself back yet another day.
The next morning I remembered to pee on one of the five sticks. They really do work just like a pregnancy test — you hold one in your urine stream, or pee into a cup and dip a test in. Then you lie the test flat and wait. With this kit, you have to read the result after 5 minutes and dismiss anything after 8 minutes. It’s a very specific window of three minutes when you’re supposed to decide if your test is positive or negative. I found it annoying, because if you’ve just gotten up and want to go back to bed, 5 minutes feels like an eternity. But you can’t go back to sleep and check the test in an hour, because by then it’s void. You have to wait, and hope you don’t freak out your partner or your kids if they catch you staring at what looks like a pregnancy test. (It’s really hard to do this test without your family knowing, as it turns out.)
I expected my test to have two pink lines, like on the box. I’m 52 now and — again! — probably menopausal. But my test came back looking faint. The second line was so very light I thought I might be hallucinating. I know that a faint second line on a pregnancy test = pregnant, and a faint second line on a COVID test = COVID. With this, a faint second line on the Menopause test meant that I was to check off “positive” in the app. But my head was full of doubts. If we’re measuring FSH level, shouldn’t the faintness of the line mean something?
Standing at the bathroom sink at 6:30am, bleary-eyed, I couldn’t help but wonder: AM I seeing two lines?
I did the journalist cheat and emailed a picture of the test to a representative from Clearblue, to ask if what I saw counted as a positive. Yes, they said. You have two lines.
Like a teen who has to remember their gym uniform every other day, I was not perfect with remembering this testing process every other day. I missed a morning again, and the app rolled with it, just bumping my test day.
But there wasn’t nothing to do on my off days. The Clearblue ME app is also a place to log any menopausal symptoms. You can rate a whole spate of things as low, medium or high, or not rate them at all if you’re not experiencing them. This includes symptoms such as anxiety, cold sweats, headaches and heart palpitations. I had to kind of laugh at weight gain (are we talking about over the last day, month, year, or decade?). But I went ahead and put in that I had medium hot flashes. “Tiredness” seemed so vague, as did “low mood,” but at the very least, the list got me thinking of things to bring up at my next doctor’s appointment. That’s actually the whole point of the symptoms log: To get you talking more fully with your doctor about everything that you feel.
Meanwhile, every test I took had the same very faint second pink line. I dutifully reported them all as positive, so my end result looked like this:
No surprise, the app announced at the end that my “most likely” stage was postmenopause. It wasn’t any different than my doctor telling me I was “probably” menopausal. Clearblue makes it abundantly clear that only a healthcare professional can offer the confirmed, clinical diagnosis. My results:
If a user gets all negative tests, they are presumably premenopausal. I am not actually sure how the app determines if a person is in early perimenopause or late perimenopause — that was one of the questions I was left wondering. And it’s a big question, since plenty of my friends are still getting periods and wondering when they will finally end. Many other women are trying to calculate whether they can get pregnant during perimenopause. But this kit can’t predict your ovulations nor can it tell you if you’re near the period finish line. It can only guess at your stage, and each stage can last many years.
I was also curious about what doctors think of these at-home kits. So… I asked.
Heidi Flagg, MD, is a medical advisor to Flow Space and a menopause specialist. Dr Flagg told me, “I am not a fan of the tests. I’d rather people come talk to me and then we work through it together.” Doctors can measure FSH level via blood tests several months apart, Dr. Flagg said, to come up with a clinical diagnosis.
I made my case for my own situation, where two different ob-gyns did not offer me two blood tests, though one gave me one test. Dr. Flagg acknowledged that, in today’s insurance climate, it’s true that doctors are not reimbursed for spending a lot of time with patients and might not show interest in deeply investigating a healthy woman’s menopausal stage, probably especially if they’re done having kids. But, Dr. Flagg said, people like me who are trying to diagnose their menopausal stage with an at-home test might end up with either unnecessary fears or unwarranted confidence.
“I know that people want data, and they want predictability, and they want some control,” Dr. Flagg said. “But genetics are at play. It’s not as simple as just an FSH test. There’s just a lot that goes into the formula that gives us a real prediction of when you’ll run out of your ovarian reserve entirely.”
Which reminded me that many women will be taking a menopause test because they’re wondering if they can still get pregnant — one reason why it’s so critically important that women get accurate answers. Dr. Flagg offered some future reassurance along those lines, saying that there’s currently a lot of research money going towards accurately predicting when menopause will begin for a woman.
Until then, unfortunately, there’s no crystal ball. And Dr. Flagg cautioned against assuming that your menopause journey will be the same as your mom’s, grandmother’s, aunt’s, or sister’s — genetics play a part, but are maybe only about 60 percent of the whole pie, she said. Your best bet for answers should always be your doctor. Ideally, an at-home test like the Clearblue Menopause Stage Indicator might give you some ideas or a place to start — and prompt some questions that you can bring to your doctor for your next conversation.
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