In a patient with anxiety and depression, what is the most appropriate next step to evaluate for menopause as a cause of symptoms?

In evaluating a patient with anxiety and depression for potential menopause as a contributing factor to their symptoms, measuring the follicle-stimulating hormone (FSH) level is the most appropriate next step. FSH is produced by the pituitary gland and is an important indicator of reproductive hormone levels. During menopause, FSH levels typically rise due to decreased estrogen production. Elevated FSH levels can indicate that a woman is in perimenopause or has reached menopause.

Determining the menopausal status is crucial in managing the patient’s symptoms, as hormonal changes related to menopause can significantly affect mood and general well-being. By checking FSH levels, healthcare providers can gain insight into whether hormonal fluctuations are a possible cause of the patient's anxiety and depression.

While measuring luteinizing hormone (LH) levels can also be relevant, FSH is more commonly used as a primary marker for assessing menopause status. Conducting a psychiatric evaluation could provide insight into the patient's mental health, but it does not directly address the hormonal component. Prescribing an antidepressant might be necessary later, depending on the overall assessment, but it does not assess the menopause status at this stage. Therefore, determining FSH levels is the most relevant and immediate step in this evaluation process.