I had my cervix and uterus removed for a diagnosis of cervical cancer. Eight years later, I remain cancer-free. I have also had a portion of my thyroid removed. I am now 40 years old. I have had hot flashes all of my teen/adult life. How will I know when I start going through the change? How can I know if I have already gone through it?

C.A.

Because you have had a hysterectomy, you will not be able to look for cessation of periods to diagnose menopause. Symptoms such as hot flashes, night sweats, vaginal dryness, irritability, depression and forgetfulness may provide clues. Since you have been having hot flashes for years, you will need to pay attention to subtle differences, such as more frequent or intense hot flashes.

You can also have blood tests to measure the level of FSH (follicle-stimulating hormone), a hormone released by the pituitary gland that stimulates your ovaries to produce eggs. Levels of FSH rise in menopause, as your pituitary tries to force your failing ovaries to ovulate. Your thyroid function should also be checked annually to make sure it is functioning properly and, if you are on thyroid medication, to make sure that you are getting the right amount.

If you think you may be entering menopause, you can ask your internist, family practitioner or gynecologist to do these blood tests to assess your status. As you approach 51 -- the average age at which American women become menopausal -- you may want to make these tests part of your annual exam. If an FSH test reveals that you are in menopause, you can discuss hormone replacement therapy with your doctor.