Does my AMH level of .278 indicate perimenopause?


Q: I am 44 years old and just received my AMH blood test results, which were .278 ng/mL. The notes from the lab just say: Low, Indicating Perimenopause. I was wondering what the low, normal, high ranges are for this test. What levels indicate perimenopause is occurring, what levels indicate full menopause is occurring? Thank you!

Symptoms:  Low Testosterone (.2), fatigue, insomnia, night sweats, urine urgency, low sex drive

A:   Thank you for choosing ATD.

AMH or anti-Mullerian hormone is a substance produced by granulosa cells in ovarian follicles. It is first made in primary follicles that advance from the primordial follicle stage. At these stages follicles are microscopic and can not be seen by ultrasound. AMH production is highest in preantral and small antral stages (less than 4mm diameter) of development. Production decreases and then stops as follicles grow. There is almost no AMH made in follicles over 8mm. Therefore, the levels are fairly constant and the AMH test can be done on any day of a woman's cycle.

The chart below has AMH interpretation guidelines from the fertility literature and from accumulated clinical experience. Do not get carried away with the cutoff values shown here. For example, the difference between a 0.9 and a 1.1 ng/ml test result puts a woman in a "different box" in this table - but there is very little real difference in fertility potential. In reality, it is a continuum - and not something that categorizes well.

Interpretation AMH Blood Level
High (often PCOS) -Over 4.0 ng/ml
Normal -1.5 - 4.0 ng/ml
Low Normal Range -1.0 - 1.5 ng/ml
Low -0.5 - 1.0 ng/ml
Very Low -Less than 0.5 ng/ml

AMH has been used a predictive marker of menopause. In a study of 35-39 year-old pre-menopausal women, the median time to menopause was 9.94 years when the AMH level was below 0.20 ng/mL and 13.01 years when the AMH level was > 1.5 ng/mL. Smoking also significantly reduced the time to menopause.

Hope this helps you.

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