Most women do not need hormonal blood tests to diagnose the menopause.
If you are aged 45 or over and you have menopausal symptoms, you do not need any hormonal blood tests to confirm the diagnosis. Your GP may want to arrange blood tests to check for other conditions such as thyroid problems. Hormone levels fluctuate a lot so perimenopausal women may have normal hormone levels on the day of the test but would still benefit from HRT.
If you are under 40 it is important to confirm a diagnosis of premature ovarian insufficiency (POI). A series of hormonal blood tests may be needed. If still having periods, you need a blood test to check oestradiol and FSH levels during your period (on day 1 -3 of your cycle) and 6 weeks later. If having infrequent periods, the tests can just be done 6 weeks apart. These blood tests can also be useful if you are aged 40 – 44, although normal levels do not exclude the diagnosis of perimenopause.
If you are interested in adding testosterone to your HRT, blood tests are needed before initiation. You will then need monitoring blood tests after 6 to 8 weeks on testosterone or after any dose change and then at least annually once stable.