Testing time: predicting the menopause

Researchers are developing a test that could take the guesswork out of balancing family and career by predicting the age at which a woman can expect to reach menopause,

Most women over the age of 35 do not need reminding that their biological clocks are ticking; tick-tocking their way to infertility, according to many newspaper reports - and the odd well-meaning parent. What is less clear, but is something that would be infinitely more useful than this information, is an indication of how fast. Now, thanks to a new test that is in the early stages of development, a woman as young as 20 may be able to find out when she can expect her menopause, the time when she ceases to be fertile. All that is required is a blood test, from which the levels of anti-Müllerian hormone (AMH), are measured. Since AMH controls the development of follicles in the ovaries (from which the eggs are developed), the higher the level, the more time she has.

It is the test's predictive ability that makes something of a landmark, and which could make it a valuable tool for women trying to balance career and family. "On average," says Dr Carol Smylie, the medical director at the Dubai London Clinic in Festival City, who treats many menopausal women, "women go through the menopause at 51, although fertility drops off considerably around 10 years before that. For women who are looking at careers, particularly those that involve a lot of training, but who want to somehow fit in children, being able to plan could be extremely useful."

Currently, the test has only been tried on a small scale by a group of Iranian scientists, who took blood samples from 266 women, aged 20 to 49. Using a combination of their AMH levels over two three-yearly intervals, as well as information on their socio-economic backgrounds and reproductive histories, the researchers estimated when the women's menopauses were likely to take place. Of the participating women, 63 reached menopause during the course of the study and showed it to be accurate to, on average, four months.

So would you have the test? "Absolutely, I would have it," says Katrina Anderson, 35, a marketing director living in Abu Dhabi whose first child is on the way. "Anything that can help you understand your body better helps you to make a more informed decision. If we have a better understanding of the parameters we're working with, it will make people feel a little more comfortable. Women are working against a ticking clock. By the time your career takes off you're 30, and you're told that fertility cuts in half at 34."

She feels that 20 is not too young to know when your menopause will take place. "You know when you're supposed to hit puberty. You have these life milestones and this could simply be another one." "I would seriously consider having it done," says Sandra Blake, 33, a business development manager from Abu Dhabi, who is single. "I would like to think that having children is a choice and to be able to plan for them the way I do all other aspects of my life. I realise it's not that simple, that falling pregnant may be an issue, but knowing when the menopause is going to come would allow me to make the most of my fertility."

Fatima (who didn't want her surname to be used), a 30-year-old corporate lawyer in Abu Dhabi with one son, is less convinced. "I think it would be of more interest to career women in the West. In the Middle East it is part of our culture to have children early. I wouldn't have the test for cultural and religious reasons because I don't want to predict something like that." However, Maryam Husani, 22, an Emirati student from Abu Dhabi, can see the benefit, even at her age. "A lot of people I know would take the test as it is a time when you plan for study and career."

For all its benefits, some doctors are concerned that, should the test become widely available, women might come to rely too heavily on its findings. "As with all tests we do in medicine," says Smylie, "no test is 100 per cent accurate. For a certain percentage of women who try to plan their family around it and then find out it's wrong - they were relying on this test, and they've already gone through the menopause - that could be fairly catastrophic."

For that reason, she believes it may not be suitable for all women. "We wouldn't suggest that everyone has it done. It could just be available to anyone who thinks it might be of use." In particular, she says, it may be of interest to women who suffer from early menopause (about one per cent of women experience it under 40 and five to 10 per cent under 45). Often the condition runs in families, but the test could be a useful way of giving an exact time-frame to at-risk women. Equally, for those who experience it with no prior history, finding out that they have considerably less time that they thought could help them to plan accordingly.

"The youngest I have ever come across it is 35," says Smylie. "I see very few women, though, who have had an early menopause before they have had the chance to have children."