Lab Testing in Perimenopause
Lab tests aren’t the gold standard for diagnosing perimenopause, but they can give us helpful context.
FSH:
One of the first hormones we often see shift is FSH (follicle-stimulating hormone) — levels over 10–12 IU/L on day 3 of the cycle might point to a declining ovarian reserve. That said, hormone levels in perimenopause can fluctuate a lot, so a single test doesn’t always tell the full story.
Thyroid Function:
Thyroid disorders can look a lot like perimenopause. A TSH test is essential to rule out hypo- or hyperthyroidism — both can cause things like fatigue, mood changes, and cycle irregularities.
Pregnancy Test:
Even though fertility is on the decline, pregnancy is still possible in perimenopause. If there’s a sudden change in your cycle or you’ve skipped a period, it’s worth testing.
Complete Blood Count (CBC):
Heavy periods? Let’s check for anemia. A CBC gives us insight into hemoglobin, hematocrit, and ferritin levels — all important when bleeding becomes heavier or more frequent.
Lipid Profile:
As hormones shift, so does cardiovascular risk. A full lipid panel (total cholesterol, LDL, HDL, triglycerides) helps us keep an eye on long-term heart health.
Blood Glucose & HbA1c:
Perimenopause can affect insulin sensitivity — so it's worth checking for early signs of diabetes, especially if you have a family history or other risk factors.
Vitamin D:
With changing hormones and shifting bone density, vitamin D is a must-check. It's key for bone health heading into menopause.
Liver Function Tests (AST, ALT, GGT):
These help us assess how your liver is processing everything — from hormones to medications and supplements.
Prolactin:
If your cycles are irregular and we’ve ruled out pregnancy and thyroid issues, checking prolactin can be useful — especially if there are symptoms like breast discharge or headaches.
Mood & Mental Health Screening:
We can't skip this one. Women in perimenopause are at higher risk for depression and anxiety, so mood check-ins or questionnaires can be just as important as blood work.
Not every person in perimenopause needs all of these tests — it really depends on your individual symptoms, medical history, and health goals.
Other things we consider when creating a care plan:
Family history of heart disease, cancer, diabetes, or osteoporosis
Past diagnoses like PCOS, endometriosis, or adenomyosis
Your pregnancy and fertility history — including things like gestational diabetes or preeclampsia
Whether routine screenings like Pap tests and mammograms are up to date
At the end of the day, lab tests are just one part of the picture. We also need a thorough health history, symptom tracking, and physical assessment to put the pieces together and guide personalized care.
We Are Flow
A multidisciplinary functional health care clinic focused on whole family health using natural and complementary therapies. We work on finding the root cause of health issues and help people thrive.