Dr Ee Mun Lim
1PathWest Laboratory Medicine & Sir Charles Gairdner Hospital, Perth, Australia
Biography:
Dr Lim is a Chemical Pathologist in the Department of Clinical Biochemistry, Pharmacology & Toxicology at PathWest QEII. She is currently the Clinical Lead Pathologist who provides clinical governance to the laboratories at PathWest QEII. She is also Acting Director of Regional Support and Services and supervises 22 branch laboratories. She has an appointment at Sir Charles Gairdner Hospital as Consultant Endocrinologist.
Abstract:
Sex hormones such as oestradiol and FSH can fluctuate significantly during perimenopause and measurement of these hormones may not be useful. Furthermore, sex hormones cannot predict when menopause will occur. Menopause is a clinical diagnosis when a woman has her last period at least 12 months ago. There is significant variation in the lower limit of detection of oestradiol between different immunoassay platforms. Not all formulations of menopausal hormone therapy (MHT) will cross react in the oestradiol assay and it is not recommended to monitor MHT with oestradiol and FSH. Oral and transdermal preparations with oestradiol and oestradiol valerate will cross react in most oestradiol immunoassays.
Current testosterone immunoassays correlate well with the highly sensitive and specific liquid chromatography mass spectrophotometry (LCMS) for investigations of women with androgen excess or when women are prescribed testosterone therapy. Bleeding post menopause should always be investigated and some rare endocrine disorders with hyperandrogenaemia should be excluded. Investigations with sex hormones and testosterone will be illustrated with cases.