Menopause blood tests, without the guesswork.

The average age of menopause in the UK is 51, but the transition that leads up to it, perimenopause, can start a decade earlier and is where most of the confusion lives. Cycles change, sleep breaks, mood shifts, night sweats arrive, and the same symptoms could equally be thyroid, iron or simple exhaustion. Blood tests will not answer every question here, but used well they answer some important ones, and the guides below are honest about which is which.

The key markers are FSH and LH, the pituitary signals that rise as the ovaries wind down; oestradiol, the main oestrogen; AMH, the ovarian reserve marker; and progesterone, which confirms ovulation. NICE guidance (NG23) is clear that women over 45 with typical symptoms do not need a blood test to diagnose menopause, because hormones fluctuate too much day to day to be definitive. Under 45, and especially under 40, testing matters much more, and an FSH result can be the first step towards a diagnosis of early menopause or premature ovarian insufficiency.

Where testing earns its keep in midlife is ruling out the look-alikes and setting a baseline. Thyroid dysfunction, low iron and vitamin D deficiency all mimic or amplify perimenopausal symptoms, and all are testable. If you are considering or already using HRT, baseline and monitoring bloods have a defined role too, particularly for testosterone and for oestradiol absorbed through patches or gel.

At-home testing works with a finger-prick kit posted to a UKAS-accredited UK laboratory, with results reviewed by a qualified clinician, usually within days. Timing matters for cycle-dependent hormones, so check the timing guide before you draw. And a home test informs a conversation rather than replacing one: symptoms that disrupt your life belong with your GP or a menopause specialist, whatever the numbers say.