Are there any blood tests to diagnose perimenopause (perimenopausal transition)?

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Last updated: May 21, 2025 • View editorial policy

From the Research

There is no single definitive blood test to diagnose perimenopause, and diagnosis is primarily based on a woman's age, menstrual cycle changes, and symptoms like hot flashes, sleep disturbances, and mood changes. Doctors may measure follicle-stimulating hormone (FSH) levels, which typically rise during perimenopause, but these levels fluctuate significantly during this transitional phase, making a single test unreliable for diagnosis 1. Estradiol (a form of estrogen) levels may also be checked, as they generally decline during perimenopause, but these too can vary widely from day to day. Anti-Müllerian hormone (AMH) testing, which reflects ovarian reserve, may provide some insight but isn't specifically diagnostic. Thyroid function tests are often performed to rule out thyroid disorders that can mimic perimenopausal symptoms.

Key Points to Consider

  • Perimenopause is a transitional phase, and its diagnosis is complex
  • Blood tests, such as FSH and estradiol levels, are not reliable for diagnosis due to fluctuating levels during this phase
  • AMH testing and thyroid function tests may provide some insight but are not definitive
  • Diagnosis is primarily based on age, menstrual cycle changes, and symptoms ### Diagnostic Approach Tracking menstrual cycles and symptoms over time provides more valuable diagnostic information than any single blood test. A comprehensive diagnostic approach should include:
  • Medical history and physical examination
  • Menstrual cycle tracking
  • Symptom assessment (e.g., hot flashes, sleep disturbances, mood changes)
  • Ruling out other conditions that may mimic perimenopausal symptoms (e.g., thyroid disorders) According to the most recent study 2, hormone therapy may be effective in improving sexual function in perimenopausal and postmenopausal women, but the evidence is not strong enough to support its use as a diagnostic tool. Therefore, a combination of clinical evaluation and symptom tracking is the most effective approach to diagnosing perimenopause.

References

Research

Hormone therapy for sexual function in perimenopausal and postmenopausal women.

The Cochrane database of systematic reviews, 2023

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