Perimenopause Tests - Ellen Dolgen

Perimenopause Tests

Do you think you might be beginning your menopausal journey? Then you might be in perimenopause.

Perimenopause defines the years before the body makes the transition leading up to menopause. The journey can begin in your 30s, but most women begin perimenopause between 40 to 44. The first symptom is often changes in menstrual flow and the length of your cycle.

Nearly two million women reach menopause every year (that’s equivalent to 6,000 women each day).  Sadly, Johns Hopkins did a small survey of U.S. obstetrics and gynecology residents found that fewer than one in five received formal training in menopause medicine!  YIKES!!!  This is important info as most women believe that every gynecologist is trained in menopause. However, there are specifically trained specialists in menopause.  Be sure to find one to be your business partner in this menopause business.

Remember the results of the hormone tests below are only half of the conversation you want to have with your menopause specialist.  The other half is an open and honest conversation about how you feel at these levels.  You can download my free Menopause Symptoms Chart to help you communicate quickly and accurately exactly how you feel to your specialist.

Here are some blood tests to speak to your menopause specialist about:

Please note: If you are on certain hormone therapies (such as birth control pills), your hormone tests will not be valid. A doctor may ask you to stop taking birth control pills for a while before conducting these tests.  If you’re still menstruating, have your hormone testing done during the first three days of your period.

Follicle-Stimulating Hormone (FSH) Test

Follicle-stimulating hormone (FSH) levels are sometimes measured to confirm menopause. This test is also used to determine a woman’s likelihood of conceiving a child. The test is generally repeated over several months to account for fluctuations in hormone levels that may be occurring.  After several tests, if a woman’s FSH blood level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year, it is generally accepted that she has reached menopause.

Anti-Mullerian Hormone

Some doctors prefer to test the (AMH) levels instead of FSH. The AMH levels are decreased in perimenopause. Fertility doctors have been using this test for years as they find that the levels are not affected by taking birth control pills. AMH levels help show how many potential egg cells a woman has left. This is known as the ovarian reserve. If a woman’s ovarian reserve is high, she may have a better chance of getting pregnant.


DHEA-sulfate is a hormone that easily converts into other hormones, including estrogen and testosterone.


This is the main type of estrogen produced in the body, secreted by the ovaries. Low levels can cause memory lapses, anxiety, depression, uncontrollable bursts of anger, sleeplessness, night sweats, and more.

Free and Total Testosterone

Free testosterone is unbound and metabolically active, and total testosterone includes both free and bound testosterone. (No, this has nothing to do with 50 Shades of Grey.) In women, the ovaries’ production of testosterone maintains a healthy libido, strong bones, muscle mass, and mental stability.


Low levels of progesterone can cause irritability, breast swelling and tenderness, mood swings, “fuzzy thinking,” sleeplessness, water retention, PMS, and free membership to the sisterhood of the shrinking pants (weight gain).

As long as you are getting bloodwork done, speak to your doctor about the following tests:

TSH (thyroid-stimulating hormone)

Menopause symptoms can be similar to those of other conditions, such as thyroid disease. For some women, it may make sense to undergo medical tests to rule out such conditions as well. If there is an irregularity with your TSH, you may need to get your Total T3 and Free T4 checked as well.

Once you’ve determined that you actually are in the midst of perimenopause or menopause, here are other important tests to consider:

Bone Density Test

Also called a bone scan or DEXA scan, this test can determine whether you have osteopenia (low bone density) or osteoporosis (very low bone density). When you enter perimenopause and menopause, the decline in estrogen can trigger a rapid loss of bone mass. The scan takes only minutes and exposes you to very little radiation.


Cancer antigen 125 is a protein best known as a blood marker for ovarian cancer. It may be elevated with other malignant cancers, including those originating in the endometrium, fallopian tubes, lungs, breasts, and gastrointestinal tract. Note that this test can result in false positives. Another ovarian cancer prevention screening test is a transvaginal ultrasound. This is a non-invasive test.

Cholesterol Panel

Cholesterol levels change in perimenopause and menopause. Too much cholesterol can build up artery plaque, narrowing blood vessels and potentially causing a heart attack. A cholesterol panel usually includes checking your HDL (high-density lipoprotein or good cholesterol), LDL (low-density lipoprotein or bad cholesterol), and triglycerides (molecules of fatty acids). You’ll need to fast for 12 hours before this test.

Vitamin D3

This vitamin helps maintain normal blood levels of calcium and phosphorus, keeping your bones nice and strong. There is still controversy on how much and how effective Vit D3 supplementation is.  In 2015, it was reported that Vitamin D supplementation can significantly increase muscle strength and reduce the loss of body muscle mass in post-menopausal women. I’ll take that!

This is a lot of information, and you can feel like you’re back in school on an all-night, caffeine-fueled, cram session during finals week. Breathe, and take a few days to educate yourself about the tests your specialist may recommend. Education is empowerment. It’s true that your specialist needs to be your partner in evaluating your health and treatment options, but a partnership takes equal participation.

Be proactive about your health – not reactive!

Make an appointment with your menopause specialist and take good care of YOU!

Remember:  Suffering in silence is OUT!  Reaching out is IN.

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* does not recommend, endorse or make any representation about any tests, studies, practices, procedures, treatments, services, opinions, healthcare providers, physicians, or medical institutions that may be mentioned or referenced.



2 thoughts on “Perimenopause Tests”

  1. I have not had a period for over five years now. I want to start HRT bio-identical hormones. I know i need an estradiol 0.05mg to fight off diseases later on in life and progesterone to keep a healthy uterus, but I am confused of the amount or a brand i should use to keep healthy testosterone levels. Testosterone is not made for a women, but rather, a man. Do you recommend a patch cream gel for the estradiol and do you believe its better to get a Mirena IUD vs. using a cream?

    1. Hi Darlene, I recommend that you find a Menopause Specialist to create an individualized plan that fits your personal health needs. Download my free Menopause Mondays Symptoms Chart and start charting your symptoms. Bring this chart in with you to your doctor’s appointment. It will help you communicate very quickly and clearly how you are feeling. If you don’t have a Menopause Specialist, here are some tips on how to find a Menopause Specialist. Once you have a specialist, they can talk thru the different options and recommend which one is best for you. Good Luck!

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