Are You or Aren't You? Lab Testing for Menopause Hormones

Can Lab Tests Diagnose Menopause?

Scientist pipetting samples into eppendorf tubes. Credit: Morsa Images / Getty Images

It’s easy to understand why women would want to know whether menopause is under way. They want to know when they will be done with periods, whether they can forget about birth control, and whether menopause can explain why they are feeling certain ways. And it should be as easy as going out and getting a home menopause test to find the answer, shouldn’t it?

Unfortunately, it isn't. We have been spoiled by being able to get quick results with over-the-counter tests.

If you thought you were pregnant, you’d probably go out to a drug store and buy a pregnancy test. They are pretty accurate, and they offer you the relief (or panic) of knowing whether you are pregnant or not. Or at least they give you a very good idea of whether you are or aren’t.

Like everything about menopause, the answer is not so black and white. There are tests that can be run, both at home and at the doctor’s office, which will give you clues about whether you are in menopause. But lab tests don’t tell the whole story, and their results have to be considered in a larger picture of symptoms, medical history, family history, and general health. If you are hoping that lab tests can tell you whether you are in perimenopause or have finished menopause, here are some things to consider.

Which Hormones to Measure

Several hormones give clues about whether you are still fertile, and how far you might be into perimenopause.

They include:

  • Follicle Stimulating Hormone (FSH). This is the most common hormone measured to determine your menopause phase. This hormone is produced by your pituitary gland, and its purpose is to get an egg (follicle) ready for conception each month. As our eggs age, the pituitary responds by producing more FSH to kick start the follicle cycle. Therefore, as estrogen and other hormones drop, FSH climbs.
  • Estrogen is another hormone that can be measured, and low levels usually mean that something is wrong with ovarian production. Menopause is one of many reasons estrogen can be low, along with premature ovarian failure, smoking, chemotherapy, menstrual disorders and too little body fat.
  • Other hormones. Your doctor may order levels for several other hormones, including testosterone, progesterone and thyroid hormones to get a picture of what is going on.

What Else is Going On?

In order to make sense of hormone levels and lab tests, it helps to know what else is going on. Your healthcare provider will want to know:

  • What symptoms you are having. If you are having other symptoms of menopause, such as hot flashes, changes in your cycle, mood problems, sleeplessness, vaginal dryness, weight gain,and others, it will help create an overall diagnosis. If you keep a symptom calendar, it can help paint the picture.
  • What else is going on in your life. There are many reasons why hormones might fluctuate, or that you may be having symptoms. Are you under more stress than usual? Have you lost or gained weight? Have you been exercising a great deal? Are you a smoker? Any of these can affect your hormones.
  • Your family history. Did your mother go through menopause at an early age? Did she have thyroid problems? Did she smoke when she was pregnant for you? These can affect you as an adult and can impact your menopause.

Should You Use a Home Test Kit?

There are FDA approved home test kits that will show positive for an FSH level on the high side. But getting a positive test result does not mean you are past menopause. If you are curious about whether your FSH levels are high, the test is a very rough indication. But it doesn’t mean that you are or are not in menopause, even when you get two positive readings in a row.

FSH tests are available both in drug stores and over the internet. The ones approved by the FDA are urine tests, so beware of any that say that you can test saliva to tell whether you are in menopause. These have not proven to be reliable.

How Can You Get a Menopause Diagnosis?

A good diagnosis always considers many factors. Often it is a combination of:

Symptoms + Lab Tests + Medical History = Diagnosis

If you want to know whether you are in perimenopause, or whether you have finished with menopause, lab tests can help confirm the diagnosis. But hormone levels vary so much that you’ll probably need several readings to see whether it’s a trend or a normal variation for you. So, for example, your doctor might look for:

Symptoms (no period for several months, hot flashes, etc.)+
High FSH (Usually over 40mIU/mL for 2 separate readings)+
No other medical conditions that would explain your symptoms =

Every woman is different, and your hormone levels are more significant when you compare them to your own previous levels, not to a standard formula. If you do a home test and find that your FSH is “positive” (which is usually over 25mIU/mL for most test kits) this is a clue, but it is not a diagnosis. You need to look at the whole picture to determine when your menopause occurs.

Remember -– don’t use a home menopause test kit to decide whether it’s safe to stop using birth control. Perimenopause is famous for surprising women with pregnancy after many months without a period. Assume that it’s possible to get pregnant and use birth control until you have a reliable diagnosis of menopause. Some physicians recommend using some sort of birth control, or keeping emergency contraception on hand until 24 months after your last period. If you really don’t want a pregnancy, play it safe.


Randolph, JF, Crawford, S, Dennerstein, L, Cain, K, Harlow, SD, Little, R, Mitchell, ES, Nan, B, Taffe, J. and Yosef, M. “The Value of Follicle-Stimulating Hormone Concentration and Clinical Findings as Markers of the Late Menopausal Transition” The Journal of Clinical Endocrinology & Metabolism Vol. 91, No. 8 3034-3040, 2006.

Harlow SD, Crawford S, Dennerstein L, Burger HG, Mitchell ES, Sowers MF; ReSTAGE Collaboration. “Recommendations from a multi-study evaluation of proposed criteria for staging reproductive aging,” Climacteric, Vol.10, No. 2: 112-9, April, 2007.

United States Food and Drug Administration, Center for Devices and Radiological Health / CDRH.“Home-Use Tests – Menopause.”

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