Test for Perimenopause

FSH and Estrogen Tests


When your monthly cycles become irregular you may want to know if you are starting the menopause transition. Time to get a test for perimenopause – right?

Yes, there are tests for perimenopause but are they really working and worth the effort? After you read this article you will be able to make a decision about:

  • Perimenopause testing in general
  • The kind of test to take
  • What the results mean

You will also understand that there is no clear yes or no answer as a result of the tests. Contrary to pregnancy, you can indeed be just a little bit perimenopausal.

There are two kinds of tests for perimenopause:

  • The FSH test
  • Estradiol test
The FSH Test

01-lEIMaDGL._SL160_The FSH test is the most common perimenopause test.

Follicle stimulating hormone or FSH is released by the pituitary gland to stimulate the ripening of a follicle for ovulation. When the ovaries begin to fail, the pituitary releases more FSH to kick the ovaries into action. This elevated hormone level is used as an indicator of perimenopause.

Normal FSH level vary widely during the menstrual cycle, throughout the day and also from individual to individual.

During perimenopause, when ovulation becomes irregular, the FSH levels vary even more. So single FSH tests, early in perimenopause are not very valuable and a series of at least two FSH tests should be considered.

FSH tests are done either through a blood or a urine test. If these tests are done in a lab, it will give you the level of FSH at the time of the test. This test is also available as a home test kit.

Levels above 25 mIU/mL indicate that you are in menopause. FSH levels for women who are post menopausal are between 25.8 – 134.8 mIU/ml. During perimenopause these levels can vary widely.

Test results can be influenced by several factors such as:

  • What time of day you are taking the test (best is early in the morning when the hormone levels are higher),
  • If you had a lot of water before the test
  • If you are, or where recently, on birth control pills
  • Other factors such as stress, recent illness etc.
Estrogen Test for Perimenopause

Positive test results do NOT mean that you can’t get pregnant.

Estradiol, the most common estrogen, can be measured through either blood or saliva tests.

This testing is done when specific symptoms are present and more information is necessary about the function of the ovaries. The serum estradiol concentration is tested in conjunction with an FSH test.

Estradiol tests are more commonly used in younger women (under 40 years of age) who have indications of premature ovarian failure or early menopause. Low estradiol levels indicate that the ovaries have stopped working properly and confirm the results of the FSH tests.

Low estradiol levels (below 30pg/ml) are a sign of menopause in women who have stopped having a period. In younger women estradiol levels fluctuate widely throughout the menstrual cycle.

Bioidentical Hormone Testing

Estrogen tests (plus tests for other hormones), are also performed to determine how much additional estrogen is needed to bring your estrogen back to a predetermined premenopause level.

Why Do You Want to Test for Perimenopause?

Many women want to know as early as possible if they are in perimenopause to be able to start hormone therapy. This issue has caused a lot of confusion ever since the new recommendations for hormone therapy came out. These recommendations say that you should start hormone therapy as close as possible around menopause.

Many women interpret this as starting hormone therapy as soon as possible after the first symptoms appear. But your doctor will tell you that this is not so.

Aside from FSH tests and estradiol tests, there may be other more important tests at this time of your life. Consider a bone density test to check for osteoporosis or osteopenia to see if you need to add calcium or start osteoporosis treatment.

Thyroid disease has many similar symptoms as menopause, so a thyroid test may also be advised.

Menopause is the point when your periods stop altogether and if you still have periods, even just occasionally, you may be years away from menopause.

But the first step is to confirm that your symptoms are related to perimenopause and are not caused by something else. Only a health exam can tell you that.

Some Final Thoughts

There are many things you can do beside hormones to get through perimenopause.

If you are otherwise healthy, you can start with natural treatments and some lifestyle changes to help you with your symptoms. Help your body to find its own balance as much as possible.


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