What laboratory tests are recommended for diagnosing menopause (perimenopause or postmenopause)?

For menopause diagnosis and management, the primary lab test recommended is follicle-stimulating hormone (FSH), which typically rises above 30 mIU/mL during menopause. This test should be combined with an assessment of symptoms and menstrual history, as FSH levels alone can fluctuate during perimenopause. Additional useful tests include estradiol levels (which decrease in menopause), thyroid function tests (TSH and free T4) to rule out thyroid disorders that may mimic menopausal symptoms, and a comprehensive metabolic panel to assess overall health. For women considering hormone therapy, it's important to check lipid profiles, liver function tests, and sometimes a DEXA scan to evaluate bone density. If abnormal bleeding is present, endometrial assessment may be necessary. These tests help distinguish menopause from other conditions with similar symptoms and guide appropriate treatment decisions. No single test definitively confirms menopause, so clinical judgment considering age, symptoms, and test results together provides the most accurate assessment. Testing should be individualized based on each woman's specific symptoms, medical history, and treatment considerations.