Perimenopause Tests: Why They Matter

Today, we're diving into the world of perimenopause testing. If you're in your 40s or early 50s and starting to experience some of the common symptoms of perimenopause (think hot flashes, irregular periods, mood swings, and more), your healthcare provider may recommend specific tests to help confirm the diagnosis and rule out other potential causes. But what exactly do these tests involve, and why are they important? Let's break it down.

Blood Tests for Hormone Levels

One of the most common types of perimenopause tests is a blood test to measure your hormone levels.

Your provider may check your levels of:

• Follicle-stimulating hormone (FSH): FSH is a hormone produced by your pituitary gland that stimulates your ovaries to produce estrogen and mature eggs. As you enter perimenopause, your FSH levels may start to rise as your ovaries become less responsive. Consistently high FSH levels (above 30 IU/L) can be a sign that you're in perimenopause.
• Estradiol (E2): Estradiol is the main form of estrogen produced by your ovaries. During perimenopause, estradiol levels can fluctuate and eventually decline. Low estradiol levels (below 30 pg/mL) can be a sign of perimenopause or menopause.
• Thyroid-stimulating hormone (TSH): While not directly related to perimenopause, thyroid disorders can cause symptoms that mimic perimenopause, such as irregular periods, fatigue, and mood changes. Checking TSH levels can help rule out a thyroid issue.
• Anti-Müllerian hormone (AMH): AMH is a hormone produced by your ovarian follicles that can provide an estimate of your remaining egg supply (ovarian reserve). Low AMH levels can be a sign of declining ovarian function and the transition to menopause.

It's important to note that hormone levels can fluctuate significantly during perimenopause, so a single test may not always provide a clear answer. Your provider may recommend repeating tests over time to look for patterns or changes.

Pelvic Ultrasound

In some cases, your provider may recommend a pelvic ultrasound to assess your reproductive organs and check for any abnormalities that could be contributing to your symptoms.

An ultrasound can help:

• Evaluate the thickness of your uterine lining (endometrium): A thickened endometrium can be a sign of hormonal imbalance or a potential precursor to endometrial cancer.
• Check for ovarian cysts or tumors: While most ovarian cysts are harmless and resolve on their own, some can cause pain, bleeding, or other symptoms.
• Assess the size and shape of your uterus: Conditions like fibroids or adenomyosis can cause an enlarged or abnormally shaped uterus and contribute to heavy or irregular bleeding.

Endometrial Biopsy

If you're experiencing persistent or heavy irregular bleeding during perimenopause, your provider may recommend an endometrial biopsy to check for any abnormal cells in your uterine lining. This procedure involves inserting a thin catheter through your cervix and into your uterus to remove a small sample of tissue for analysis. While an endometrial biopsy can be uncomfortable, it is typically a quick and well-tolerated procedure.

Mammogram and Bone Density Scan

While not explicitly related to perimenopause, your provider may also recommend a mammogram and/or bone density scan as part of your overall health screening during this time. A mammogram is an X-ray of your breasts that can help detect early signs of breast cancer, while a bone density scan can assess your risk of osteoporosis (bone loss) as you transition to menopause.

Why Testing Matters

So why go through all these tests?

There are a few critical reasons:

• Confirming the diagnosis: While the symptoms of perimenopause can be pretty telling, testing can provide objective confirmation that you're in this transitional phase. This can be especially helpful if you're experiencing symptoms at an earlier-than-expected age or have other health conditions that could be contributing to your symptoms.
• Ruling out other causes: Many of the symptoms of perimenopause (like irregular bleeding or mood changes) can also be caused by other health conditions, such as thyroid disorders, uterine fibroids, or even certain cancers. Testing can help rule out these other potential causes and ensure that you're getting the appropriate treatment.
• Guiding treatment decisions: Understanding your hormone levels and reproductive health status can help guide decisions about symptom management and potential treatments, such as hormone therapy or non-hormonal options.
• Establishing a baseline: Testing during perimenopause can provide a snapshot of your health, used to monitor changes over time and inform future health decisions.

Advocating for Your Health

Ladies, I know that going through medical tests can be intimidating and sometimes uncomfortable. But I want to encourage you to be proactive about your health during this transformative time. Don't hesitate to talk to your healthcare provider about your symptoms, concerns, and questions. Advocate for tests and screenings that can provide valuable insights into your health.

Remember, knowledge is power. The more you understand about your body and your unique perimenopause journey, the better equipped you'll be to make informed decisions about your health and well-being.

And if you ever feel dismissed or unheard by a healthcare provider, don't be afraid to seek a second opinion or find a provider who specializes in women's health and menopause. You deserve compassionate, comprehensive care that honors your experiences and prioritizes your needs.

You've got this, ladies. Keep taking charge of your health, keep advocating for yourself, and keep believing in your body's wisdom and resilience. Better days are ahead.

Content Copyright © 2026, MBK Cultivate Skin & Nutrition Wellness   

PERMISSION TO REPRINT: You may use any items from this article in your print, blog, magazine, or electronic newsletter. However, you must include the following paragraph, which should contain a link to www.mebykatie.com.   

"Information courtesy of www.mebykatie.com; Katie Marshall is a certified Medical Esthetician, Acne Specialist, Functional Nutrition Counsellor, Holistic Chef, and Integrative Nutrition Health Coach. Specializing in skin health, gut health, hormone health, and the whole body. The basic premise is that functional nutrition addresses the root cause of the problem and resolves the underlying issue. This differs from conventional medicine, which often prescribes multiple medications to address symptoms, with little regard for resolving their underlying causes. Functional nutrition is more personalized, customized, and holistic in approach. My job is to work with your medical team and advocate for you if necessary."   

Health/Medical Disclaimer:   

The content of MBK Cultivate Skin & Nutrition Wellness, either through these social media pages, websites, or any other materials distributed by MBK Cultivate Skin & Nutrition Wellness, is intended to provide helpful and informative material. Please note that my personal and professional opinions expressed on these social media pages and websites are entirely my own. This site provides information on skin, diet, fitness, health, and nutrition, and is intended in good faith for educational purposes only. Care has been taken to confirm the accuracy of the information and describe generally accepted practices. However, the authors, editors, and publishers are not responsible for errors, omissions, or any consequences from the application of the information in these publications and make no warranty, expressed or implied, concerning the currency, completeness, or accuracy of the publication's contents. It would be best not to rely on this information as a substitute, nor does it replace professional medical advice, diagnosis, or treatment.   

I, Katie Marshall, am not a doctor or medical provider and do not provide medical advice. Readers are advised to research and make decisions in partnership with their healthcare provider.   

If you are pregnant, nursing, have a medical condition(s), or take any medication(s), please consult your family physician.   

Always consult your family physician or other qualified healthcare providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you read on my social media pages or websites.   

If you have a medical emergency, call your family physician, go to the nearest emergency department, or call 911 immediately. Reliance on any information provided by MBK Cultivate Skin & Nutrition Wellness or Katie Marshall, or on content presented for publication on these social media pages or websites, is solely at your own risk. Administrators and Moderators are not liable for your actions.   

Health Canada & FDA Disclaimer:   

Neither Health Canada nor the Food and Drug Administration has evaluated the advice and statements on this page.