How i test hormones for perimenopausal women + why labs matter
I have a confession to make. I asked ChatGPT the top things women are asking the internet about hormone and lab testing in perimenopause. So we’re gonna talk about it (in my fucking words)
Can you ACTUALLY test FOR Perimenopause? No. Not really. Now like any good clinician it depends. Things we COULD see happening, but don’t need to be happening for you to be in perimenopause include: slightly rising FSH levels, estradiol levels over 75 on cd 3-5 testing, blood sugar markers (see prior post), low testosterone, low progesterone. Now these tests are NOT DIAGNOSTIC of perimenopause. However, they can give a good clinician clues as to if your symptoms are perimenopause related or not!
When to Test Your Hormones? We test at two points during your cycle if you are cycling relatively regularly (not skipping cycles). Cycle Day (CD) 3-5: estradiol, FSH + LH. 5-7 Days Post Ovulation (DPO): estradiol, full testosterone panel, progesterone, DHEA-s. The next few segments of this series are going to focus on how to determine when 5-7 days post ovulation is for you and what if you don’t have a uterus. Don’t worry. I got you! You CAN still test.
Does Hormone Testing Still Matter In Perimenopause + For HRT? Yes. Is it the holy bible, end all be all live and die by it— NO. But any practitioner to say it doesn’t add value to how you approach your patient isn’t doing their due diligence IMO. It also matters because when you come in and say “I feel so fucking good” I want to test you to see where THOSE levels are!!! Labs are a tool but not the entire story!
Why Symptoms + Cycle History > “normal” Labs. If I had a dollar for every time a woman told me “but my PCP told me my labs are normal”. 1. They didn’t run all the right labs. 2. the hormone labs had ZERO instruction on when and how to test accurately. BUT— the first and most troublesome symptoms of perimenopause arise BEFORE labs get wonky and cycle changes happen. That’s why your sh*t insurance based practitioner who have 7 minutes with you isn’t talking to you about perimenopause because they don’t know this information. Period. (pun intended)
“Your Labs Are Normal” Doesn’t Mean Shit. For reasons noted above, you can have perfectly looking labs and even hormones and need support (like I said they are only a PART of the puzzle— the patient in front of you is always the most important and the story they are telling you). The reason so many traditional docs knock hormone testing is because levels do fluctuate quite a bit through the day. I get it. And also they’re still very closed minded IMO. If you have a doc telling you “labs are normal” and you’re sick of walking out of their office feeling like you know more about perimenopause + HRT than they do—- first of all you probably do— second of all its time for a change.
If your brain is like FUCK YES I’ve been looking for you. Sign up for a Hormone Strategy Session Here.
If you want to know more you can always book a consultation call so you have the clarity + understanding you need (and yes again, with me— not a sales person or a bot :)
Disclaimer: The information on this blog is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. It should not replace personalized medical advice. Always consult your healthcare provider before making changes to your medications, supplements, diet, or treatment plan.
