Do I Need A Test To Know If I Am In Perimenopause?

First off, what is Perimenopause?

Perimenopause is when women’s hormones start to change around our 40s as we approach Menopause. For some women this is just a couple of years and for others it can last many years. The primary hormones that change are Estrogen and Progesterone (but many others are impacted). Some women don’t have many symptoms during this time but most do. It can feel like you are losing your mind when you don’t understand what is going on. Symptoms range from insomnia, to anxiety, to heavy bleeding, to short cycles, to weight gain, and more. Hormone changes start off slowly and increase in intensity as you move towards menopause. For many women, this is the more turbulent time.


What most people do not understand about Perimenopause and Menopause is

  1. Hormones in Perimenopause and into Menopause typically change in a methodical order. Progesterone dropping first, followed by estrogen fluctuating up and down erratically for a period of time, then estrogen dropping. Each scenario comes with unique symptoms. When we understand the order and what is happening we can better find the right tool to help (and feel less crazy!).
  2. There is a lot we can do to minimize and mitigate these symptoms and improve how we feel and age.

So, do I need a test to confirm I am in Perimenopause?

In a nutshell, no. If you are in your 40s or 50s and start to feel things change, while still cycling (aka getting your period) you can assume you are in Perimenopause (after of course you rule out other more serious issues with your provider). There is no test needed to confirm Perimenopause itself. Some people test for FSH (follicle stimulating hormone) but this is fluctuating wildly during this time and most practitioners do not value this marker unless you are looking to see if you are in Menopause itself.

Some women enjoy looking at A Dutch Test to dig into cortisol, progesterone, estrogen, hormone metabolites, melatonin, testosterone, and more. This can be helpful to get an idea how your adrenals are functioning, how you are metabolizing estrogen (phase 1 and phase 2 detox), to monitor if you are doing bioidentical hormone replacement therapy, to see how much progesterone and estrogen you are producing, to check in on testosterone, and learn how best to impact your hormones. But there is a ton you can do before this and it is not necessary just to confirm Perimenopause. (find more on other midlife lab tests here)


What can I do to improve how I feel in Perimenopause?

There is a lot we can do to improve how we move through Perimenopause and then Menopause (and don’t wait for symptoms, these tricks work best over time). First off, we want to work on ovulating as long as we can to keep progesterone flowing while it can. This might include getting specific nutrients, improving digestion, reducing stress, or more. Then we want to take clear steps to keep our body functioning best and replenished so when hormones do change we ease through as best we can. This could include reducing chronic inflammation, getting certain nutrients, becoming metabolically flexible, etc. We also want to work on all the systems that impact our hormones including detoxification, our microbiome, digestion, toxins, and our nervous system. Then we can use herbs and foods or medications to ease symptoms as they come. And finally, it is also incredibly powerful to spend time leaning into the energy of midlife and how we want our wiser years to feel and look, because this can be an incredible and powerful transition.


So why did I use the picture I did for this post?

When my pal and I were out on the trail recently, not quite in fall, not quite in winter, struggling along the way as we cycled, it reminded me exactly of Perimenopause. Perimenopause is not quite our prime reproductive years, nor are we in our wise years yet, it is the often tumultuous time in between phases, while we still cycle and often struggle. This day on my bike was exactly that! These are the things that run through my mind on the trail:) And let’s be honest, these are the things we love to talk about together.


Are you feeling any changes in your 40s and 50s? What are you doing to improve how you transition? I would love to hear about it!!

The Women’s Hormone Club is 6 weeks every Jan/Feb (changing to 8 weeks!!). Join the fun and feel your best. We will dig into everything you need to know and do to ensure your perimenopause and menopause are smooth and empowering.


Janel Ferrin Anderson NC FNLP DNM

It is my mission to help people understand their body better, how it works, how it changes, how it is impacted by our world and how we can improve symptoms and function while preventing future health issues. I use science, education, food, lifestyle, herbs, and nutrients, to shift the body towards better function. I focus on midlife mountain women but am happy to work with anyone who wants to take charge of their health.

The Women’s Hormone CLub
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