Do you need a blood test to diagnose perimenopause?

“there is still very commonly in the medical field this misconception that the labs have to match up with the symptoms and that is just really not true.”

“the menopause society, which is kind of the leading society on menopause and perimenopause, as well as ACOG, … and then several other major societies clearly state that for women over 45 presenting with perimenopausal symptoms, which are some of the ones we go over, those routine hormone tests … be that FSH, LH, estradiol, those are not recommended.”

“And certainly we can do them if a patient wants. You have every right to ask for whatever lab you want to. But the fact is they just don't provide any diagnostic credibility or criteria for us. And a big reason for that is that our levels of those fluctuate like roller coasters during the day but also during perimenopause in general.”

“So you could have normal levels one day and completely off-range the next.”

“But perimenopause is a clinical diagnosis. It is not based on labs. It is not based on a certain number. I can't look at your estrogen and say you're in perimenopause. If you tell me your series of symptoms, regardless of your labs, that is how that diagnosis comes.”

“testosterone is the only lab that we absolutely do need to monitor. … at six to eight weeks after being on a consistent dose, that's when testosterone is going to hit its kind of steady state in the blood.”