Convenient, discreet and offering results in minutes, rapid health and wellness tests are popping up on pharmacy shelves across Australia. There are pinprick blood tests for vitamin D and iron levels, urine tests for perimenopause and menopause, and multi-health kits covering urinary tract infections and a cocktail of metrics such as glucose, ketones and pH.<\/p>\n
Most range from $5 to $30, which is cheaper than a private GP consultation fee. You don\u2019t need to speak to a doctor or medical professional to buy one (or a whole basketful). So can a pee-on-a-stick test confirm if I\u2019m perimenopausal? Will low ferritin (iron stores) solve the mystery of my eternal tiredness? And, if they do work, does a positive result simply mean more clinical tests down the track?<\/p>\n
Patti Shih, senior lecturer in public health at the University of Wollongong and co-author of an Australian study<\/a> on direct-to-consumer tests, says there are hundreds of self-testing kits on the market. Some offer \u201cresults in minutes\u201d, while others require you to post samples of hair, saliva or blood to a laboratory for analysis.<\/p>\n There are upsides to home testing kits, says Shih, especially where they can \u201chelp someone who has social or geographic barriers to access healthcare\u201d.<\/p>\n \u201cSome people don\u2019t feel they can access their doctors quickly. It\u2019s also more expensive to go to the doctors,\u201d she says. But \u2013 and it\u2019s a big caveat \u2013 most \u201chome testing kits are nowhere near as accurate as a laboratory test\u201d. The chances of false positives or false negatives \u201care a lot higher\u201d, which may lead to further testing, false reassurance or confusion.<\/p>\n Emma Joyce road tests a selecton of at-home test kits. Photograph: Blake Sharp-Wiggins\/The Guardian<\/p>\n \u201cYou should only do a test if you absolutely need it,\u201d Shih says. There\u2019s a risk of \u201cthe wrong test or the unnecessary test to the wrong consumer\u201d, she says. Context and a full understanding of your medical history is important for interpreting results, which is why she would be wary of most health and wellness tests on the market.<\/p>\n Wellness has also become about \u201coptimising\u201d oneself, she says, which is leading to an \u201cover-commercialised\u201d self-testing ecosystem.<\/p>\n Some rapid tests, including pregnancy, sexual health tests and Covid tests, are very reliable says Prof Martha Hickey, director of the Women\u2019s Gynaecology Research Centre at the Royal Women\u2019s hospital in Melbourne. Shih agrees.<\/p>\n However, Shih believes others can be like \u201cstabbing in the dark\u201d.<\/p>\n Perimenopause tests<\/p>\n Hickey says there\u2019s no evidence a urine FSH test, or any urine test, can predict when you\u2019re going to go into perimenopause. There are a number of reasons for that, she says. \u201cOne is that it\u2019s a hormone that fluctuates quite considerably through your cycle.\u201d<\/p>\n double quotation markTo me, a test that doesn\u2019t work \u2013 for something that you might be frightened of \u2013 is a bad combinationProf Martha Hickey<\/p>\n The biggest predictor of perimenopause is age, she says, but the professor understands why there has been a gold rush in menopause products<\/a>.<\/p>\n \u201cThere\u2019s been a massive explosion of \u2026 direct-to-consumer products around women\u2019s healthcare generally, but specifically around menopause and fertility,\u201d she says. \u201cIt\u2019s very hard for women to navigate this when there\u2019s a gap in high-quality information for them to turn to.\u201d<\/p>\n FSH rapid tests, sold in Australia by several manufacturers, including We Test Bio<\/a> \u2013 whose test we chose to picture for its eye-catching packaging \u2013 measure follicle-stimulating hormone through urine tests. Hickey says FSH in your blood can be detected in urine, but it \u201cis not a reliable way of knowing if you\u2019re in perimenopause\u201d.<\/p>\n A spokesperson for We Test Bio says the test \u201cis not to diagnose perimenopause, but to provide an accessible indicator that hormone levels may be changing\u201d. The word \u201cperimenopause\u201d doesn\u2019t appear on its bright pink box, but it is used in its instructions inside the packet, on shelf labels in chemists and on We Test Bio\u2019s website.<\/p>\n FSH rapid tests measure follicle-stimulating hormone through urine tests, but experts warn they are not a reliable way of determining perimenopause. Photograph: Blake Sharp-Wiggins\/The Guardian<\/p>\n A spokesperson for TerryWhite Chemmart, the pharmacy we bought the FSH test from, says their use of \u201cperimenopause\u201d to describe the test is \u201cintended to help customers identify the context in which the product may be useful, particularly given that \u2018FSH\u2019 is not a widely understood term\u201d.<\/p>\n \u201cFor women experiencing symptoms such as irregular cycles, hot flushes or sleep disruption, the test can provide an additional piece of information that may prompt a conversation with a healthcare professional,\u201d says We Test Bio\u2019s spokesperson. All its at-home tests \u201cempower people with accessible health insights in the privacy of their own homes\u201d, they say.<\/p>\n \u201cI don\u2019t think these self tests are empowering,\u201d says Hickey. \u201cTo me, a test that doesn\u2019t work \u2013 for something that you might be frightened of \u2013 is a bad combination.\u201d<\/p>\n TerryWhite Chemmart\u2019s spokesperson says the products are \u201cpositioned as a starting point, not an endpoint\u201d.<\/p>\n double quotation markThere is a huge fitness and wellness industry driving these testsPatti Shih<\/p>\n \u201cWe recognise that perimenopause is complex and cannot be diagnosed through a single test,\u201d they say, adding that TerryWhite Chemmart\u2019s trained pharmacists can provide guidance and, where appropriate, refer patients to a GP or other specialist care.<\/p>\n The Australian Menopause Society<\/a> has a free score sheet of symptoms for perimenopause and menopause, which can be used in consultation with a doctor. \u201cChecking FSH or AMH levels or serum oestradiol and progesterone are unnecessary tests in diagnosing menopause for most women,\u201d says the Australian Menopause Society website.<\/p>\n Iron and vitamin D pinprick blood tests<\/p>\n