How do you get your hormone levels tested during perimenopause?

During perimenopause, hormones change in a surprisingly irregular way. Estradiol (the female sex hormone) is paradoxically elevated, while progesterone is low. FSH (follicle-stimulating hormone) rises. That combination makes a snapshot difficult to interpret: a single measurement says very little.

The most practical option is AMH (anti-Mullerian hormone), a substance produced by the ovaries. The advantage: you do not need to wait for a specific day in your cycle. As menopause draws closer, the AMH value becomes a more precise predictor. But be aware: in women who are still far from menopause, the uncertainty margins run from two to twelve years. AMH therefore tells you something about ovarian reserve, not about exactly when you will reach menopause.

An alternative is FSH measured on day three of your cycle. This has been used for a long time, but is less accurate than AMH for assessing ovarian function. An elevated FSH above 22.3 mIU/ml does provide a signal, comparable to an undetectable AMH, in the diagnosis of early menopause.

If you have a family history of early menopause, an extremely low or undetectable AMH may point to premature ovarian insufficiency. Discuss this with your doctor.

Be cautious with self-tests available for purchase online. Of the websites selling AMH tests, 74% claim that the result says something about your chances of becoming pregnant. That is incorrect: four larger studies show that women with a low AMH (below 0.7 ng/ml) have comparable chances of pregnancy to women with a normal AMH. Such a self-test can cause unnecessary anxiety or, conversely, provide false reassurance. In addition, results can differ between laboratories, because measurement methods are not yet standardised everywhere. Always have results interpreted with the guidance of a doctor.