During perimenopause, hormone tests are often not helpful because hormone levels change throughout a menstrual cycle. Sometimes testing is done to check specific hormone levels, especially with fertility problems or when periods stop at an early age. This can help women make decisions about beginning or adjusting medications. For some women, it may make sense to test for other causes of symptoms that can seem like perimenopause, such as thyroid disease.
Sometimes, elevated follicle-stimulating hormone (FSH) levels are measured to confirm menopause, especially in women who have had a hysterectomy and have no menstrual period to follow to let them know what is happening. When 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.
However, a single FSH level can be misleading in perimenopause since estrogen production does not fall at a steady rate from day to day. Instead, both estrogen and FSH levels can vary greatly during perimenopause. One elevated FSH level is not enough to confirm menopause. More importantly, a low FSH level in a woman who is having hot flashes and changing periods does not eliminate the likelihood of perimenopause. Also, if a woman is using certain hormone therapies (such as birth control pills), an FSH test is not valid.
Some clinicians recommend testing a woman’s saliva for estrogen or other hormone levels. Saliva hormone levels are not recommended in this setting and should not be used to evaluate or treat menopausal symptoms.
For more information on symptoms and solutions visit menopause.org.
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