Is It Worth Testing Your Hormone Levels in Perimenopause and Menopause?

Oct 02, 2025 |
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Is hormone testing worth it in menopause? Discover when blood tests help, what to measure, & how holistic and medical support can guide your next step

One of the most common questions I hear from women in their 40s and 50s is:

"Should I get my hormone levels tested? Wouldn’t it give me clarity on where I am in menopause and explain my symptoms?"

It’s an understandable question. Numbers feel reassuring. They make our symptoms feel more concrete. But the truth is, hormone testing in midlife isn’t always straightforward. Sometimes it’s useful. Sometimes it’s misleading. And sometimes, looking at other markers can give us more helpful answers than hormones themselves.

So let’s walk through this together: when testing helps, when it doesn’t, what it can (and can’t) tell you if you’re on HRT or contraception, the pitfalls to be aware of, and why other blood tests often matter just as much.

Why Testing Isn’t Always the First Step

Here’s the thing: once we hit our mid-40s, our hormone levels naturally start fluctuating in ways that make one-off blood tests hard to interpret. Oestradiol, for example, might be high one day and low the next. Follicle-stimulating hormone (FSH) can rise and fall depending on whether your ovaries happen to release an egg that month.

That’s why most medical guidelines say: for women over 45 with typical symptoms, menopause is a clinical diagnosis. In other words, the first look is at your symptoms, hot flushes, night sweats, irregular periods, mood changes, and sleep problems, because they tell the story more reliably than a single blood test result

But does that mean hormone testing is never useful in midlife? Not at all

When Testing Hormones Is Helpful Over 45

Even though we don’t always need hormone bloods to “prove” menopause, there are situations where testing adds real value:

When symptoms don’t fit the usual pattern. If you’re experiencing extreme fatigue, hair changes, or mood shifts that don’t match your menstrual history, a hormone panel can sometimes highlight imbalances that give us a better steer.

When you’re already on HRT and symptoms aren’t improving. Blood testing isn’t used to fine-tune every dose, but it can be a useful check to see whether your oestrogen is being absorbed well, or if levels are much lower (or higher) than expected.

When you’re on contraception. If you’re taking the combined pill, hormone levels can’t be used to check menopausal status (the pill suppresses them). But if you’re over 50 and on a progestogen-only method (like the mini-pill, implant or Mirena), an FSH test can sometimes help determine whether you’re menopausal and if contraception is still needed.

When there’s a family history or higher risk factors. For women with early menopause in the family, autoimmune conditions, or ongoing uncertainty, hormone testing can provide clarity.

So, while it’s not needed for everyone, testing can still be a helpful tool, especially when symptoms and history don’t give the full picture.

What Hormones Might Be Worth Testing

If testing is considered, the basic markers are usually:

  • FSH (Follicle-Stimulating Hormone): often raised as the ovaries slow down.
  • Oestradiol (E2): fluctuates but gives a rough idea of oestrogen status.
  • Progesterone: mainly useful if you’re still ovulating or cycle tracking.
  • LH (Luteinizing Hormone): sometimes included alongside FSH.

But in practice, I often go further. Depending on your symptoms and history, I may also look at:

  1. Prolactin: High prolactin can disrupt cycles, cause breast changes, or contribute to fatigue. It sometimes rises due to stress or medication but can also signal deeper issues that need checking.
  2. DHEA (Dehydroepiandrosterone): Made by the adrenal glands, DHEA is a precursor to both estrogen and testosterone. Low levels can be linked to low energy, reduced resilience, or lower libido.
  3. Testosterone: Women produce testosterone too, and although levels are lower than men, it plays a role in libido, energy, and muscle health. Measuring testosterone (with SHBG) can help explain persistent symptoms.
  4. SHBG (Sex Hormone Binding Globulin): This protein binds to sex hormones and affects how much is available for your body to use. Levels are strongly influenced by stress, thyroid health, insulin resistance, and liver function, so SHBG can act as a “window” into how your lifestyle and health are shaping hormone balance.

Interpreting Results: The Pitfalls

Even with a more complete panel, there are some key things to remember:

  • Day-to-day fluctuations: A “low” oestrogen result doesn’t mean you’re always low, it just means you were on that day.
  • Assay limitations: Not all labs use sensitive enough methods, especially for oestradiol and testosterone at low levels.
  • Number chasing: It’s easy to fixate on results, but the real test is whether your symptoms improve with the right support.

This is why, in my practice, I always interpret results alongside symptoms. Numbers on their own rarely give us the full story.

Testosterone, DHEA and the Adrenal Connection

We often think of menopause purely in terms of oestrogen and progesterone, but testosterone and DHEA matter too. Both naturally decline with age. Low levels can contribute to low libido, muscle weakness, or a general sense of “flatness.”

But here’s the important bit: these hormones are also influenced by adrenal health. Chronic stress, poor sleep, and blood sugar imbalances can all deplete DHEA and affect SHBG, which in turn alters how available testosterone is.

So, if your results show low DHEA or low free testosterone, it may not just be about “replacing” them, it’s also about supporting your stress resilience, sleep, and nutrition. That’s where a holistic approach is essential.

When Other Blood Tests Tell Us More

Here’s where I often find the most actionable information: in blood tests that aren’t strictly “hormonal” at all.

Why? Because symptoms like fatigue, low mood, brain fog, and hair loss can be just as strongly linked to nutritional or thyroid imbalances as to menopause.

The most useful additional bloods often include:

  • Thyroid function (TSH, free T4, free T3, total T4): an underactive thyroid is common in midlife women.
  • Full blood count and ferritin (iron storage): to rule out anaemia or low iron.
  • Vitamin B12 and folate: low levels can mimic neurological or mood symptoms.
  • Vitamin D: low vitamin D is widespread in the UK and can worsen muscle, bone, and mood problems.
  • HbA1c and cholesterol: to check longer-term risks as metabolism shifts in midlife.

Often, these markers tell us far more about ongoing fatigue or resilience than oestrogen or progesterone levels alone.

A Practical Way to Decide

So, how do you know if testing is worth it for you? Try asking yourself these questions:

  1. Will the result change my next step? If not, it may not be needed.
  2. Am I over 45 with classic symptoms? If yes, bloods may add little to the picture — unless symptoms don’t fit the usual pattern.
  3. Am I on HRT or contraception? This changes whether results are meaningful.
  4. Do I have symptoms that could be explained by something else? If yes, broader bloods (iron, thyroid, B12, vitamin D) might be more useful.

Talking With Your GP or Specialist

If you decide to go ahead, bring a clear plan to your GP or menopause specialist. Helpful questions include:

How will this test result change my treatment?

Which hormones are worth testing given my age and medication?

Could other blood tests explain my symptoms better?

And always bring a symptom diary if you can, tracking changes in sleep, mood, cycles, and hot flushes over a few weeks makes the discussion much more productive.

The Bottom Line

So, is it worth testing hormone levels during perimenopause and menopause?

For many women over 45 with clear symptoms, hormone tests won’t add much to the picture.

But in certain situations, unusual symptoms, being on HRT or contraception, or wanting a fuller picture, they can provide valuable insights.

Including prolactin, DHEA, testosterone and SHBG alongside the more common tests can help explain stubborn symptoms and highlight the impact of stress, adrenal health, or metabolic shifts.

Even then, results must always be interpreted in context, not in isolation.

The real power lies in using testing strategically, as one tool among many to help you and your clinician make the best decisions for your health.

Remember: your lived experience matters just as much as the numbers.

Taking the Next Step

If you’d like more clarity, I offer comprehensive blood testing as part of my Boost programme. These packages combine in-depth blood work with tailored nutritional and lifestyle support, so you don’t just get the numbers, you also understand what they mean for your energy, mood, and long-term health.

I also work closely with Peninsula Private Medical, which means that while I focus on the holistic side, nutrition, stress, lifestyle, and functional testing, you can also access expert medical support for options like HRT and clinical prescribing. Together, this offers you a joined-up approach: practical strategies to feel better now, underpinned by medical expertise where it’s needed.

If this resonates, I’d love to help you feel clearer, more supported, and more confident about your next steps. You can book a free call here.

About Claire

Claire Thomas is a Nutritional Therapist, NLP Practitioner, and Phlebotomist with a background in Children’s Nursing. She specialises in supporting ambitious women who feel exhausted, burnt out, or stuck in survival mode. Through personalised nutrition, mindset coaching, and functional testing, Claire helps her clients increase their energy levels, find clarity, and do more of what they love. Based near Cullompton, Devon, she works both in-person and online through her clinic, Nourish to Soar

Categories: : boost your energy, blood testing, hormone testing