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Perimenopause & Hormone Testing

When Does Perimenopause Start?

Perimenopause typically begins in a woman’s 40s—the 10 years leading up to menopause. Symptoms like mood changes, poor sleep, weight gain, and anxiety are often linked to declining estrogen, progesterone, and testosterone.

Perimenopause Graphics

Understanding hormone imbalance

Think of your hormones like a symphony—when even one note is off, the whole body feels it. During the menstrual cycle, hormones shift, and testing them at the right time (usually days 19–21) helps identify imbalances.

Cycle stages & testing timing

  • Days 1–14: Follicular phase (egg develops)
  • Days 14–28: Luteal phase (hormones peak)
  • Best testing days: Days 19–21 (when PMS is often worst)
If you’ve had a hysterectomy but still have ovaries, test when you feel your worst emotionally or physically.

FSH & menopause

A Day 3 FSH test helps indicate if you’re in menopause. However, results can vary, so it’s just one piece of the puzzle.

Hormone fluctuations

During perimenopause, hormone levels can swing—too low one month, too high the next. This causes unpredictable symptoms, including skipped periods or emotional changes.

Birth control considerations

The pill suppresses natural hormones, which may worsen symptoms as you age. If you’re no longer planning to have children, non-hormonal birth control options may allow for better hormone evaluation and symptom relief.

Treatment Options

Adding bio-identical progesterone after testing often relieves symptoms. A full evaluation—including hormones, vitamins, and lifestyle—can help make perimenopause more manageable and balanced.

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