Perimenopause test: what blood tests can and can't show

If your periods have changed and you are wondering whether a blood test can tell you that you are in perimenopause, the short answer is no. No single test diagnoses it, and for most women over 45 guidance says you do not need one.

This page covers what the Office on Women’s Health and NICHD say, when a clinician does order blood work, and what you would be paying for if you test on your own.

FSH only

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What the guidance says

The Office on Women’s Health (US Department of Health and Human Services) answers the question directly. It says your provider can usually determine whether you are in perimenopause from your age, your symptoms and changes in your periods, and that blood hormone tests are not usually needed. It adds that if your periods stop or become irregular before age 45, your provider may order blood tests, and that testing is most useful before age 40.

The NIH’s NICHD says women typically notice the signs of menopause without a formal diagnosis from their healthcare provider, and that blood tests are not required.

The Menopause Society’s perimenopause page does not address blood tests. It describes the period changes of perimenopause as caused by the ovaries’ erratic production of hormones.

Why one result can mislead

Hormone levels move during the transition. MedlinePlus notes that FSH levels change throughout the month in women who have periods. It also says high FSH is a normal sign of perimenopause and menopause, which is why testing usually isn’t needed at 45 or older.

A hospital lab guide from the UK (Gloucestershire NHS) puts it plainly: LH and FSH are not routinely recommended for diagnosing menopause, and in women over 45 with typical symptoms the diagnosis is clinical. A test is only warranted if symptoms are atypical. The same guide says FSH is of no value in women taking combined oestrogen and progestogen contraception or high dose progestogen.

When a clinician does order blood tests

Tests are not useless. They are aimed at specific situations:

• Under 45 with changed periods. The Office on Women’s Health says your provider may order blood tests here, and that testing is most useful before 40. MedlinePlus lists early menopause (before 45) and premature menopause (40 or younger) as medical reasons to test FSH along with other hormone tests.
• Under 40 where premature ovarian insufficiency is suspected. A 2024 international guideline on premature ovarian insufficiency (POI) says a clinician can diagnose it from irregular or missed periods for at least 4 months plus one raised FSH result (above 25 IU/L), and that a repeat FSH or an AMH test may be needed where the diagnosis is uncertain. That is a clinician’s diagnosis, not something a single home result settles.
• Symptoms that don’t fit. MedlinePlus lists menopause-like symptoms with no clear cause as a medical reason to check FSH along with other hormone tests.

Even in these cases, MedlinePlus says your provider considers your age, symptoms, medical history and other hormone test results along with the FSH result.

If you test on your own

If you decide to test on your own, an FSH test gives you a number to take to a clinician. It won’t tell you whether you are in perimenopause. The cheapest FSH option is the FSH-only test, in the price box at the end of this page. FSH and LH together is a second option, and MedlinePlus notes the two are often tested together. An estradiol test is sold separately.

• FSH and LHFSH and LH on one order $59 See this test at HealthLabs

Sold by HealthLabs. Prices checked October 2026. Not available in ND, RI, NY, NJ, MD and HI. We earn a commission on sales.

The seller’s page says the FSH-only test does not include LH, estradiol or testosterone, that it is a blood draw, and that results appear in an online account within one to three business days. It also says fasting isn’t required, but it gives no cycle-day instruction. If you still have periods, MedlinePlus says you may need to be tested at a specific time in your cycle, so follow the order or your clinician. The cycle timing tool explains how timing is usually handled.

Bring the result to a clinician. None of the sources above treats an FSH result as a diagnosis of perimenopause.

What a test can’t tell you, and when to see someone

A blood test can’t tell you whether your symptoms come from perimenopause, and it can’t predict how your transition will go. See a clinician if your symptoms bother you, if your periods change before 45, or if you think you could be pregnant. The FDA’s consumer page on menopause tests notes that while hormone levels are changing, the ovaries can still release eggs and pregnancy is possible. A clinician can advise you on that and on contraception.

For related questions, see the menopause blood test page, the guide to FSH levels in menopause, and the at-home menopause test page.