Which hormone levels are tested during menopause and what do the results mean?
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.
FSH (follicle-stimulating hormone) is the most reliable marker of menopause. FSH can start rising as early as your 40s while you are still having regular periods. After the last menstrual period, FSH is markedly elevated, reflecting the loss of ovarian function. LH (luteinising hormone) also rises, but less prominently than FSH.
Oestradiol, the principal form of oestrogen, falls after the last menstrual period to low or undetectable levels, below 20 pg/ml. This deficiency is responsible for hot flushes, vaginal dryness, bone loss and an unfavourable cholesterol profile. Progesterone falls alongside it as ovulation becomes more irregular or ceases altogether, contributing to irregular bleeding. Testosterone also declines, but moderately; after surgical removal of the ovaries it falls further.
Inhibin B is an early signal of declining ovarian function. This hormone, which normally suppresses FSH, falls before menstrual irregularities even appear. AMH (anti-Müllerian hormone) reflects how many follicles remain in the ovaries and declines steadily towards menopause. An undetectable AMH has a comparable diagnostic accuracy to a markedly elevated FSH (above 22.3 mIU/ml) for establishing menopause. AMH below 8 pmol/L points, with high sensitivity and specificity, to premature ovarian insufficiency (POI) in women with irregular menstruation.
AMH cannot accurately predict the exact timing of menopause in an individual. In women under 40 the uncertainty margin can range from 2 to 12 years; as menopause draws closer, the prediction becomes more precise. In addition, body weight and ethnic background play a role: they can influence hormone results, meaning that standard reference values do not apply equally well to everyone. Always discuss results in conjunction with your symptoms and personal circumstances.
Claims are based on multiple published studies (PMID: 8735351, 2667871, 15705379, 14602797, 36651193, 34594304, 40410629, 41054364). The AMH prediction and the association with symptoms are based on observational and partly small-scale research.
Does my weight and metabolism change during menopause?
During menopause, your body composition changes profoundly: more abdominal fat, less muscle and a lower resting metabolic rate. Exercise and nutrition demonstrably help, and discuss hormone therapy with your doctor as an additional option.
Is hormone therapy for the menopause safe and worthwhile?
Hormone therapy works excellently against hot flushes and vaginal symptoms, but whether it is safe for you depends on your age, the type of therapy and how long you use it. Discuss timing, route of administration and risk factors carefully with your 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 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 does menopause do to your risk of cardiovascular disease?
Menopause demonstrably increases your risk of cardiovascular disease, primarily through unfavourable changes in fat distribution, cholesterol, and blood pressure. If you experience early menopause or are considering hormone therapy, discuss your personal risk profile with your doctor.
Can low progesterone levels cause symptoms before menopause?
Low progesterone levels can cause symptoms well before menopause, such as an increased risk of uterine cancer, more abdominal fat and lower bone density. If you notice irregular cycles or other signs, discuss them with your GP.