Perimenopause & Menopause Blood Test Panel

Eight tests: FSH (follicle-stimulating hormone), estradiol and progesterone (ovarian hormones that change through the cycle and the menopause transition), free and total testosterone, TSH (thyroid function), a standard lipid panel (total cholesterol, LDL, HDL, non-HDL cholesterol and triglycerides), hemoglobin A1c (average blood sugar over about three months) and 25-hydroxy vitamin D.

Women in their late 30s, 40s or 50s with changes in their periods, hot flashes, night sweats, sleep problems, mood changes or fatigue who want a baseline of their hormones and midlife health markers; women whose periods have stopped before 45 and who want to discuss it with a clinician; and women who want to check thyroid function, cholesterol, blood sugar and vitamin D at the same time as their hormones. It is educational testing, not a substitute for a clinician's evaluation.

Further reading: Hormone Therapy Monitoring Labs for Menopause: A Guide; Estrone and Hormone Health After Menopause in 2026.

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Any time you have symptoms or cycle changes you want to understand, or as a midlife check. If you still have periods, write down the first day of your last period before your visit: hormone levels change across the cycle, and your clinician needs your cycle day to interpret them. ACOG notes that progesterone is checked about one week before an expected period to see whether ovulation happened. Because hormones fluctuate during perimenopause, a clinician may suggest repeating hormone tests rather than relying on a single result. No fasting is needed; a morning appointment is a good default.

The results are read together and in the context of your age, symptoms and cycle history. A high FSH with low estradiol is consistent with the menopause transition, but because levels swing during perimenopause, a normal FSH does not rule it out and a single high value does not confirm it. A low progesterone in a cycling woman can mean that ovulation did not happen that cycle, which is common in perimenopause, or simply that the draw fell outside the luteal phase. A high or low TSH points to a thyroid problem that can explain symptoms on its own. High LDL, low HDL or high triglycerides, an A1c in the prediabetes or diabetes range, or low vitamin D are results to address regardless of menopause status. Quest notes that its standard estradiol assay is not designed for very low levels such as those after menopause; if a precise low estradiol matters, your clinician may order the ultrasensitive test. JustLabs results are informational: review them with a clinician, who decides whether follow-up testing or treatment is appropriate.