From the Research
Perimenopausal laboratory testing should prioritize assessment of cardiovascular risk and bone health, rather than relying solely on hormonal levels, as the most recent evidence suggests that clinicians should diagnose perimenopause based on menstrual history and age without relying on laboratory test results 1. The diagnosis of perimenopause is primarily clinical, based on menstrual history and age, rather than laboratory testing. However, certain laboratory tests can be useful in assessing cardiovascular risk and bone health, which are important considerations during the perimenopausal transition.
- Key laboratory tests to consider include:
- Lipid profile to assess cardiovascular risk, as the loss of ovarian hormones during perimenopause can lead to adverse changes in lipids and lipoproteins 2
- Fasting glucose to assess the risk of developing type 2 diabetes mellitus, which is increased during perimenopause 2
- Vitamin D levels to assess bone health, as vitamin D deficiency is common in perimenopausal women and can contribute to osteoporosis 3
- Thyroid-stimulating hormone (TSH) to rule out thyroid disorders, which can mimic perimenopausal symptoms 1
- Additional tests, such as follicle-stimulating hormone (FSH) and estradiol, may be considered in certain cases, but are not necessary for the diagnosis of perimenopause and may not accurately reflect hormonal status due to fluctuations during this transition 4.
- Serial testing over 3-6 months may be necessary to establish hormonal patterns, but this should not be the primary focus of laboratory testing during perimenopause.
- The most recent and highest quality study, published in 2024, highlights the importance of assessing quality of life and cognitive functions in perimenopausal and postmenopausal women, and correlates these assessments with serum vitamin concentrations 3.