Menopause Hormone Testing: What It Can (and Can't) Tell You
You've been waking up at 3am, your mood is all over the place, and your cycles are unpredictable. It feels like perimenopause, but couldn’t it just be stress?! It's natural to want a test that just tells you what's going on in your body, but hormone testing is rarely that simple.
With the range of emotions that the menopause transition can bring about, it sure would be comforting for women to be able to have the validation of hard scientific data collection to confirm a suspicion of age-related decline in hormone production. Unfortunately, hormone testing isn’t the simple solution that many self-proclaimed hormone coaches on social media may have you believing that it is, nor will supplementing one’s way to “balanced hormones” change the fact of life that menopause is for all female-born individuals.
What viable options are available to confirm impending menopause to women in midlife?
If women in menopause can’t balance their hormones, what can they do to seek relief from symptoms?
Let’s explore!
What makes hormone levels so hard to pin down?
Testing female hormone levels is, to put it frankly, a useless endeavor since hormone fluctuations can be tough to predict, especially for women going through the menopause transition. Without going into the details of the menstrual cycle and how estrogen, progesterone, luteinizing hormone (LH) and follicular stimulating hormone (FSH) ebb and flow throughout it, we can generally recognize and acknowledge that where a woman’s hormone levels are at can and will very much depend on the day.
Perimenopause adds an additional layer of complication in that:
Cycle lengths may become less predictable
Fluctuations of each hormone may be happening at different times in light of cycle lengths becoming less predictable
Ovulation may no longer be occurring each cycle
So, can a blood test tell me if I'm in menopause?
Not reliably. Because hormone levels fluctuate significantly depending on the day of your cycle — and even more so during perimenopause. Considering all of these variables, would it make sense that a single snapshot in time would be able to confidently tell a woman that she’s in perimenopause? Not a chance!
The one exception: AMH testing
There is one potential caveat to this conversation though: Anti-Müllerian Hormone (AMH) testing. AMH is a hormone that is produced by granulosa cells in the ovaries and can be tested in women under 40 who may be at risk of early menopause. The amount of serum AMH present can determine ovarian reserve.*
So How Do You Actually Know If You're in Perimenopause?
For the vast majority of women, unless they are willing to participate in a long term study undergoing daily blood draws and urine samples over the course of several months (I personally don’t know a single woman in midlife who has the time for that!), your best bet is to simply pay attention to and track how they are feeling.
The current standard of care for menopause established by The Menopause Society is a symptom-based approach exactly because it is one that can be far more telling and trustworthy than test results that cannot accurately capture the full picture of what a woman is going through.
Track your symptoms — here's how:
But how exactly do I determine symptoms that often feel so hard to pinpoint? You–alone or in collaboration with your doctor–might ask yourself questions such as:
What symptoms am I experiencing (both good and not-so-good, or downright bad)?
Do they follow a pattern — tied to my cycle, stress, sleep, or food?
What makes them better? What makes them worse?
This exercise can lay out all of the changes that you are seeing and, especially if done alongside your trusted medical professional, can do what lab testing cannot: validate your lived experience.
Not sure where to start with symptom tracking? This is exactly the kind of work we can do together as Menopause Coaching Specialists to help you make sense of what your body is telling you.
Can Menopause Hormone Therapy (MHT) Help?
It may, or it may not. As nutrition coaches, it isn’t within our scope of practice to speak to whether or not our clients should explore MHT–you guessed it, this is a conversation to be had with your doctor–yet we can inform on the goals of MHT implementation:
What MHT can do
Alleviating symptoms of perimenopause
Lowering disease risk
Improving overall quality of life
What MHT can’t do
And also what MHT implementation doesn’t do:
Balance hormones (there’s no such thing)
Ensure a zero percent disease risk
That being said, lifestyle factors can absolutely play a role in achieving those same goals as well (which is where we come into the picture for support, education, and guidance!)
As convenient as it would be to be able to have a single test tell us about our hormonal status as it relates to our personal menopause timeline, and as assuring as it would be to be able to simply “interlock” our hormones to “balance” them perfectly, the empowerment that comes from naming symptoms and taking action to respond accordingly to each is unmatched. As women, we have the ability to grow even more attuned to our bodies as we grow in years, even when the territory is uncharted.
The Bottom Line
A single hormone test rarely “confirms” perimenopause. Hormone levels shift day to day, and fluctuations are even more unpredictable in midlife.
For most people, the most reliable approach is symptom-based: track patterns in sleep, mood, cycles, hot flashes, and what makes symptoms better or worse.
AMH testing can be useful in specific cases (especially for concerns about early menopause/ovarian reserve), but it’s not a universal menopause “yes/no” test.
You can’t “balance hormones” into stopping menopause, but you can focus on evidence-based support (nutrition, movement, sleep, stress management, and - when appropriate - medical care).
While we’ve talked a lot about what is out of scope for a coach and more in doctor territory, there is still so much we can focus on as nutrition coaches to help our clients minimize confusion through the menopause transition! Nutrition, movement, sleep patterns, stress management, and mindset and behavior change interventions around the new challenges are all things we can focus on in order to maximize how you feel in and about your body.
*For further reading on AMH testing for menopause
Tired of guessing what’s going on?
If you're looking for personalized support through the menopause transition — from symptom tracking to nutrition, movement, and mindset — we'd love to help. Find out more about our personalized approach.
Jilda Lamb
Business owner, dog mom, and certified menopause coach, helping overwhelmed professionals and busy athletes simplify their nutrition and feel their best, both physically and mentally.
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