The Hormonal Shift of Perimenopause
Perimenopause is the precursor period before menopause, the time when ovulation has halted for 12 months. During perimenopause you’ll feel the effects of hormone shifts as your body adjusts to post-ovulation.
During perimenopause estrogen levels can be all over the place. It can surge one month and steeply decline the next. This is why irregular periods are common during perimenopause. Changes in progesterone are a little more consistent. The ovaries will steadily produce less progesterone.
It’s important to know that perimenopause is a phase that begins 8-10 years before menopause. However, the symptoms may not become apparent for 4-6 years since it can be a slow process. Given that the typical age range for menopause is 45-55 years old (average age for menopause is 51), it's possible for perimenopause to begin in the late 30s. By the late 40s many women are perimenopausal and experiencing symptoms from hormone shifts.
Why an At-Home Perimenopause Blood Test is an Essential First Step
| Topic |
Details |
| When something feels off |
When something feels off, our first inclination is often to visit the doctor. The problem with perimenopause is that it’s often overlooked by many medical professionals. |
| Perimenopause is often overlooked |
Until a few years ago, the concept of perimenopause wasn’t well known even to many physicians. And because the symptoms can be attributed to other conditions there’s a chance it will get misdiagnosed or a “let’s wait and see” approach will be taken. When you have the results from a full hormone panel in hand, it changes things. |
| Fluctuating Hormones in Perimenopause Means One Test Might Not Be Enough |
In the years leading up to menopause, your hormones can be all over the place. One month they can be relatively normal and then the next it’s way off. That’s why a single test may not be enough to catch the magnitude of the disparities. At-home blood testing makes it easy and affordable to check hormone levels periodically to get the best gauge of whether perimenopause is a factor. |
| Better Understanding of What’s Going on in Your Body |
You can tell something is off, but you don’t know what. Blood testing gives you a deeper understanding of what’s happening inside your body. It’s data that you can’t get any other way. When it comes to perimenopause symptoms, all it takes is one hormone being off. |
| Your Concerns Are Less Likely to be Dismissed |
When you have data to back up what you’re saying, you’re much less likely to be dismissed by doctors. You can point to an actual biological issue that the doctor can explore further. |
| Data Opens the Discussion With Doctors |
Instead of being dismissed, having data from an at-home blood test is a way to open up the discussion about what could be off and if perimenopause is the cause. You can talk directly about different data points and how the doctor interprets the results. |
| You Can’t Get the Data From Trackers or Wearables |
If you’re already taking control of your health with apps and wearables, that’s great! They can provide a lot of information for optimizing your health, but they have their limitations. Only blood tests can tell you what’s going on with your hormone production. |
| When to Test Hormones For Perimenopause |
Countless women have been told they are too young to worry about perimenopause. On the opposite end of the spectrum there are many women that assume because of their age full-blown menopause is right around the corner. |
| Hormone timing matters |
Because hormones fluctuate so much in perimenopause, timing really matters when you’re testing. Given that women in perimenopause don’t always have normal monthly cycles, a single test can be misleading and is far from a complete picture. Retesting every 3–6 months gives a better picture of how things are progressing and if you are in perimenopause. |
| Age to Start Testing For Perimenopause |
There’s no set age for when perimenopause can start. Generally, around age 35 is when women may start noticing the effects of changing hormone production. However, early menopause can occur at age 40, which means someone as young as 30 could be entering perimenopause. |
| When to start testing |
The time to start testing is less about age and more about experiencing symptoms like an irregular period. However, many women can benefit from hormone testing and tracking starting in their early 40s based on what is known about the average age range for menopause. |
| Hormone |
Best Day / Time to Test |
| Estradiol |
Day 3 of the cycle |
| FSH |
Day 3 of the cycle |
| LH |
Day 3 of the cycle |
| Progesterone |
5–7 days after ovulation (around day 19–21 of a 28-day cycle) |
| DHEA-S |
In the morning, any day of cycle |
| Testosterone |
In the morning, any day of cycle |
Rather than using age, some women test hormones based on symptoms. This can be a good strategy if you’re wondering about perimenopause since there’s a significant age range,
At Choose Health you can find special discounts for purchasing multiple tests so accurately tracking your hormones is more affordable.
What Hormones to Test For Perimenopause
Now for the information that every woman wants to know. What hormones to test to determine if you’re in perimenopause. There are 6 key biomarkers that will give you the best idea of what is happening with your reproductive system.
| Hormone |
Reference Levels |
Why It Matters During Perimenopause |
| Estradiol (E2) |
Follicular Phase: ~22–218 pg/mL
Midcycle Peak: ~40–511 pg/mL
Postmenopause: <10 pg/mL
|
One of the hallmarks of perimenopause is wildly fluctuating estradiol.
|
| Progesterone |
Follicular Phase: <1 ng/mL
Mid-Luteal Phase: 5 to 20 ng/mL
Postmenopause: <0.5 ng/mL
|
Progesterone levels steadily decline in perimenopause.
|
| Follicle-Stimulating Hormone (FSH) |
Follicular Phase: 1.4–21.5 mIU/mL
Mid-Luteal Phase: 1.1–9.2 mIU/mL
Postmenopause: 19.3–100.6 mIU/mL
|
More FSH is produced as ovarian reserve drops.
|
| Luteinizing Hormone (LH) |
Follicular Phase: 1.6 to 15.0 IU/L
Mid-Luteal Phase: 1.0 to 11.4 IU/L
Postmenopause: 14.2 to 52.3 IU/L
|
As ovarian function winds down and estrogen declines more LH is produced.
|
| Testosterone (Free + Total) |
Total Testosterone
Follicular Phase: 10 to 40 ng/dL
Mid-Luteal Phase: 15 to 45 ng/dL
Postmenopause: 5 to 30 ng/dL
Free Testosterone
Follicular Phase: 1.5 to 6.4 pg/mL
Late-Luteal Phase: 0.3 to 2.0 pg/mL
Postmenopause: 0.1 to 1.5 pg/mL
|
Female testosterone testing is important because levels can drop as much as 50% during perimenopause.
|
| Dehydroepiandrosterone Sulfate (DHEA-S) |
Follicular Phase: 65 to 380 μg/dL
Mid-Luteal Phase: 55 to 320 μg/dL
Postmenopause: 15 to 200 μg/dL
|
DHEA-S in the adrenal glands responds to fluctuating ovarian hormones.
|
Ready to see where your hormone levels stand? The Choose Health Comprehensive Female Hormone Panel tests key markers from home — no appointment, no waiting room, results in days.
Shop the Comprehensive Female Hormone Test
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