Testing Perimenopause Hormone Levels
Perimenopause is the time in a woman’s life when she is transitioning to menopause. The average age of menopause is 51, but for most women, perimenopause begins during the decade prior.4 You will know that you have reached menopause when you have had no menstrual period for at least 12 months in a row.2 At this time, egg production (ovulation) has ceased, and it is the natural end to your child-bearing years.
But this process doesn’t happen suddenly, and it’s different for every woman. If you are concerned that you might be in perimenopause and would like to know for sure, there are blood tests that your doctor can arrange that will inform you regarding your hormone levels.
How to Test for Perimenopause Hormone Levels
You may guess you are nearing menopause when you begin to experience some new symptoms and unexpected changes in your body. While some women begin to notice these changes in their 40s, others may not notice them until their early 50s. Similarly, while the average length of perimenopause is four years, for some women, it could be much shorter. Because the process is unique for everyone, it can be difficult to know for sure that you are perimenopausal.
Sometimes it is possible to determine whether you are perimenopausal with blood tests administered by a doctor that detect and measure certain hormones. Which tests your doctor advises and how reliable they are will depend on your age and whether you are using hormonal contraception or hormone replacement therapy (HRT).
What Tests Confirm Perimenopause (Test Types)
Your doctor may suggest you undergo tests to detect the level of certain hormones in your blood.1 These hormones include the following:
Estrogen is an important hormone for women because it helps ensure a properly functioning reproductive system. During perimenopause, your estrogen levels can become erratic. While it can feel like a bit of a wild ride, your estrogen levels overall will continue to decline.
Both ovulation and menstruation continue during perimenopause, although they can be unpredictable due to changing hormone levels. Therefore, although it is still possible to become pregnant in perimenopause, it might be a bit more challenging to do so.
Your ovaries are prompted to create estrogen by FSH, or follicular stimulating hormones. FSH is produced by the pituitary gland situated at the base of the brain stem. It stimulates follicles to form on the ovaries. You can think of follicles as little incubators.5 Each month one follicle releases a single mature egg which moves down the fallopian tubes and becomes available for fertilization.
As a woman ages, follicles decrease, and therefore, estrogen levels decline. In response to this slow-down in egg production, the brain prompts the pituitary gland to manufacture more FSH in order to jump-start follicular growth and egg production. For this reason, women in perimenopause often have elevated levels of FSH. Although test results can be a little tricky to analyze, as a general rule, if the level of FSH in your blood exceeds 30 IU/L, you are nearing menopause.3
LH (luteinizing hormone), which plays a role in controlling the menstrual cycle and triggering ovulation, will also be elevated during perimenopause and menopause. That’s right-estrogen declines, but FSH and LH climb! Take a look at the perimenopausal hormone chart below for a snapshot of the phases of menopause.
Perimenopausal Hormone Chart
When Should You Test for Perimenopause
Tests confirming that you are heading toward menopause are not necessarily needed or recommended for women over the age of 45. If you have been keeping track of your symptoms (which is recommended) and have shared those with your doctor, a good determination can usually be made on this basis alone.
If you are younger than 45 and experiencing menopausal symptoms, hormonal blood tests can give you a pretty accurate picture of where you are in the transition process. If you are under 40 and experiencing menopausal symptoms, hormonal blood tests can also help doctors determine whether you have premature ovarian insufficiency (POI) or premature menopause, both of which might require special care.
What lies beyond Perimenopause?
There are actually three stages on the menopausal journey:
We’ve already discussed perimenopause and menopause, but what is post-menopause?
- After you reach menopause, you then become post-menopausal. During this phase, irregular hormones will stabilize, and the unpleasant symptoms of perimenopause will usually decrease.
During post-menopause, it is important that you take good care of yourself and see your doctor regularly.
Perimenopause can be a bit disconcerting for even the bravest of us. As we enter this transitional phase, we begin to have strange and uncomfortable symptoms, and oftentimes, we have no idea what is happening to our bodies. Just remember that perimenopause is a natural phase- the end of one chapter of your life and the beginning of another.
Work with your doctor, who can recommend the best course of action for you. Depending on your age, this might include testing your estrogen, FSH, and LH levels to confirm that you are nearing menopause.
Although perimenopause can be an emotional time for some women, there is help. Equelle is powerful and helps support general well-being during menopause †. Taking Equelle twice daily in as little as 4 weeks can reduce hot flashes, vaginal irritation, and mood swings. It also leads to more sleep and reduced muscle aches. You deserve to feel good, and Equelle can help you have an easier and happier transition into the new phase of your life!
1 Burns GP, Dr Kate, and Gp. “Blood Tests for Menopause & What Results Mean.” Health & Her, October 12, 2022. https://healthandher.com/expert-advice/period-changes/hormone-blood-test-menopause/.
2 Jewell, Tim. “Diagnosis and Tests for Menopause.” Healthline. Healthline Media, March 8, 2019. https://www.healthline.com/health/menopause/tests-diagnosis.
3 “Menopause.” Menopause | Penn Center for Women's Behavioral Wellness | Perelman School of Medicine at the University of Pennsylvania. Accessed October 25, 2022. https://www.med.upenn.edu/womenswellness/menopause.html.
4 Silver, Natalie. “Postmenopausal Health: What to Expect.” Healthline. Healthline Media, May 29, 2020. https://www.healthline.com/health/menopause/postmenopausal-health#osteoporosis.
5 “What Are Follicles and Why Are They Important for My Fertility?” London Women's Clinic. Accessed October 25, 2022. https://www.londonwomensclinic.com/what-are-follicles-and-why-are-they-important-for-my-fertility/#