How do your hormone levels change throughout your menstrual cycle?
Your hormone levels follow a recognisable pattern throughout the cycle: oestrogen and progesterone rise and fall at set moments, with a sharp LH peak around ovulation. Bear in mind that there are large differences between women, and that the pill largely suppresses this pattern.
The most pronounced hormonal movements are those of oestrogen, LH and FSH. In the first half of the cycle (the follicular phase, from menstruation to ovulation) oestrogen rises steadily, while LH and FSH are still low. Just before ovulation, both undergo a sharp peak: these are the trigger signals that induce ovulation, after which oestrogen briefly dips.
After ovulation, progesterone takes centre stage. In this second half of the cycle (the luteal phase) both progesterone and oestrogen rise again, with progesterone as the dominant hormone. Towards the end of the luteal phase, both drop off quickly, which triggers menstruation. It is precisely this fall in oestrogen just before menstruation that appears to trigger menstrual migraine: oestrogen influences pain sensitivity in the brain, and it is the fluctuations that matter, not a persistently high or low level.
Around ovulation, androgens (testosterone and DHEA) are also slightly elevated compared to the menstruation period. In the premenstrual phase they fall again. These are small shifts. Prolactin does fluctuate throughout the cycle, but follows no recognisable pattern and appears to be independent of the other hormonal movements. DHEA-S, an adrenal hormone, shows no cyclical change at all.
Despite all these fluctuations, no measurable differences in athletic performance, sleep or recovery between cycle phases were found in trained women. This is partly because hormone levels can vary considerably between women and even within each phase. Women who use the combined contraceptive pill see these fluctuations largely disappear: their oestrogen, progesterone and testosterone remain virtually stable throughout the entire pill cycle.
Smoking is associated with disrupted hormone levels during the cycle: both active and passive smoking were in eight studies linked to higher oestradiol and LH levels and elevated progesterone values later in the cycle. This is an association, not a proven cause, and the shifts are not always in the same direction. Nevertheless, it is a reason for caution, especially for women who already experience hormone-related complaints.
This answer is based on two extensive literature reviews and several smaller studies in humans. The patterns of oestrogen, progesterone, LH and FSH are consistent and well documented. The androgens and adipokines are less thoroughly mapped; the researchers themselves point to large variation in hormone levels within each phase (coefficients of variation of 28 to 95%), which makes firm statements about individuals difficult. The evidence on smoking and hormones is limited and not fully consistent in the direction of the disruptions.
How do you get your hormone levels tested during perimenopause?
Hormone tests during perimenopause are difficult to interpret: AMH is the most practical option, but does not reliably predict your fertility. Always have results interpreted with the guidance of a doctor.
What are normal hormone levels for women, and how do you get them tested?
There is no universal standard for hormone levels in women: they depend on age, cycle phase, and measurement method. Always have testing guided by a doctor who takes that context into account, especially for testosterone.
How can you tell you are in perimenopause from your hormone levels?
In perimenopause, FSH rises first and inhibin B falls, while oestradiol initially remains normal or even elevated. A single blood test says little due to the enormous fluctuations; only a sustained pattern or 12 months without menstruation provides reliable guidance.
Which hormone levels are tested during menopause?
During menopause, the hormones measured most commonly are FSH, LH, oestradiol, progesterone, testosterone and AMH; elevated FSH combined with reduced oestradiol (below 20 pg/ml) is the most reliable sign that menopause has begun, but always have your results explained by your doctor, as body weight and background influence reference values.
How do I know whether my mood swings are hormonal or something else?
The cyclical pattern of your symptoms is the best distinguishing factor: if they occur only in the two weeks before your period and disappear afterwards, a hormonal cause is most likely. Track your symptoms over several cycles, and if they persist outside that window, discuss this with your GP.
What does pregnancy do to your hormone balance in the long run?
Pregnancy and breastfeeding bring measurable, sometimes long-lasting hormonal changes, of which the genital and urinary complaints caused by oestrogen loss are the best documented. Knowing what to expect makes it easier to talk about these issues and seek help.