Should You Take a Blood Test for Menopause?

If this is the first time you’re hearing the term “perimenopause” — welcome! We’ve been expecting you. Everyone who gets a period goes through menopause, and perimenopause refers to the time period leading up to the day when you’re officially out of the egg-dropping game — aka no more periods.

During this time, your hormone levels start to decline and many women and people assigned female at birth (AFAB) experience a wide range of menopausal symptoms, including hot flashes, fatigue and night sweats. But some people don’t experience any changes at all. To further complicate things, the amount of time spent in perimenopause land is different for everyone. The average number is four years but perimenopause can go on for as long as 14 years. And studies show that people of color are typically in perimenopause longer compared to white people.

So, how do you know for sure if you’re in perimenopause/menopause? We asked Sabrina Sahni, M.D., MSCP, a menopause and breast medicine physician and member of HealthyWomen’s Women’s Health Advisory Council, for her thoughts on taking a blood test for menopause and if the new at-home menopause test kits can provide any answers.

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​1. Is there a blood test that can confirm that you’re in perimenopause/menopause?

There is no single blood test that can detect perimenopause. Your hormone levels fluctuate throughout perimenopause, which can make interpretation of any hormone level during this time period tricky. A diagnosis of perimenopause is usually clinical and based on a woman’s age and symptoms such as hot flashes, night sweats, vaginal dryness, sleep issues and irregular [menstrual] cycles.

​2. It seems that most healthcare providers don’t recommend getting a blood test to check hormone levels for perimenopause. Why is that?

Obtaining a blood test of a specific hormone level really only gives us a snapshot in time. There’s so much fluctuation of hormones that it really can make it difficult to truly interpret. A proper evaluation of a woman’s clinical symptoms is usually the best way to determine if a woman is in perimenopause.

Read: Menopause Is Complex. Is Your Healthcare Provider up for the Job? >>

​3. What about using one of the new at-home menopause tests that measures follicle stimulating hormones (FSH) to see what stage of menopause you may be in?

Urinary FSH may not be a reliable indicator since it may not be able to reflect fluctuations throughout a woman’s cycle or even day to day. A sole FSH — which may be elevated in menopause — must be looked at in the context of other hormones. For example, a high FSH along with a low estradiol level usually indicates that someone is in menopause. Again, tracking clinical symptoms — with or without hormonal testing — may give a woman a clearer picture of where she may stand — and should always be discussed with a healthcare provider.

​4. What is your advice for people who think they are in perimenopause but don’t know for sure?

If you think you’re in perimenopause, start by tracking your symptoms, including your cycles, sleep patterns, mood changes, etc. Find a The Menopause Society Certified Practitioner (MSCP) — someone who has had extensive education and training about menopause — to help guide you during this period and address the potential treatment options. Menopause can be really challenging, but you don’t have to navigate it alone.

​Resources

The Menopause Society Certified Practitioner – Find a Practitioner