Blood test for menopause: when you need one and what it shows

Do you need a blood test for menopause?

If you’re wondering whether a blood test can show you’re in menopause, it’s a good question to ask. If you’re 45 or over with typical symptoms, a doctor can usually tell from your symptoms alone, without a blood test ^[1]. But that doesn’t mean blood tests have no place. They play a big part in ruling out other problems that cause similar symptoms, such as a thyroid problem or low iron.

It also helps to know that during perimenopause, the stage leading up to menopause, hormone levels can rise and fall a lot, which can bring on symptoms ^[2]. That’s one reason any results need reading in context ^[2].

Key points

• If you’re 45 or over with typical symptoms, a doctor can usually tell you’re in perimenopause or menopause without a blood test
• A blood test is still useful to rule out other causes of your symptoms, such as a thyroid problem, low iron or low vitamin B12 or folate
• An FSH blood test may help if you’re 40 to 45 with a change in your periods, or under 40 if menopause is suspected
• Hormone levels rise and fall in perimenopause, so results need reading in context

How menopause is diagnosed

Menopause is a natural part of life, when your ovaries stop releasing eggs and your periods come to an end ^[2]. It usually happens between the ages of 45 and 55, though it can happen earlier ^[3].

If you’re 45 or over, doctors diagnose menopause once you’ve gone 12 months in a row without a period, as long as you’re not using hormonal contraception ^[1]. Along the way, you might notice symptoms of menopause such as hot flushes, night sweats, mood swings, brain fog, poor sleep, joint pain, and low mood or depression ^[4].

While we’re talking about periods, there’s one thing that’s really important to know. Once you’ve gone 12 months without a period, any bleeding needs checking by your GP, even if it’s only spotting or happens just once ^[4]. It’s not usually serious, but it can be a sign of cancer, which may be easier to treat if it’s found early ^[4]. And if you still have periods but start bleeding more rather than less than before, see your GP too ^[4].

When a blood test can help

So when is a blood test worth having? If you’re 40 to 45 and your symptoms include a change in your periods, your doctor may suggest a blood test for follicle-stimulating hormone, or FSH ^[1].

Sometimes menopause seems to be happening before 40, and this has its own name: premature ovarian insufficiency. Doctors diagnose it from your symptoms, including no periods or infrequent periods, together with a raised FSH level in 2 blood tests taken 4 to 6 weeks apart ^[1]. One test on its own isn’t enough ^[1].

You should also know that if you’re on some types of hormonal contraception, an FSH test can’t confirm menopause ^[1]. And if you’re 45 or over, NICE advises doctors not to use oestradiol, anti-Müllerian hormone or inhibin tests to identify perimenopause or menopause ^[1].

Ruling out other causes

Even when you don’t need a test to diagnose menopause, a blood test can still be valuable. In clinic, we often check your thyroid, iron, vitamin D, vitamin B12 and folate before putting symptoms down to menopause. That’s because menopause can sometimes be what doctors call a diagnosis of exclusion, which means ruling other things out first.

Thyroid problems are a good example. They can cause symptoms, such as tiredness and mood changes, that can be mistaken for menopause ^[5]. Your doctor may check your thyroid with a blood test for thyroid-stimulating hormone (TSH) if they suspect a thyroid problem ^[5].

Low iron is another. It can cause tiredness, a lack of energy and a noticeable heartbeat, which can feel a lot like menopause, and it can sometimes cause hair loss too ^[4][6]. The same blood test, a full blood count, also checks for anaemia caused by low vitamin B12 or folate ^[6].

What the hormone results show

If you do have a blood test, here’s what the main hormones are doing. During menopause, doctors commonly see two hormones rise, FSH and LH (luteinising hormone), while oestradiol falls ^[7].

FSH and LH

FSH is one of the hormones that help control your monthly cycle. Its level tends to rise as you approach menopause, because your ovaries are working less ^[7]. LH rises too, as there’s less oestrogen to hold it down ^[7].

If you have an FSH test, bear in mind that each lab sets its own range.

Oestradiol

As you go through menopause, your oestradiol level usually falls ^[7]. That fall can bring symptoms such as hot flushes, mood changes and a lower sex drive ^[4].

Reading your results

Hormone results are only one part of the picture. It’s best to go through them with a doctor, who can read them alongside your age, your periods, your general health and your symptoms.

Getting a menopause blood test in the UK

If you’d like a test, start with your NHS GP, who can arrange blood tests if you need them. Private clinics and home finger-prick kits are other options.

Clinic and home tests

In a clinic, the sample is taken from a vein in your arm, which is the standard way to test hormones. Home kits are convenient: you prick your finger to collect a small sample and post it to a lab for testing.

If you’re thinking of using a home kit, there are a few things worth knowing first. Ask whether the lab has checked its kit for the hormones you want measured, as some collection tubes can lower oestradiol and testosterone results ^[8]. Follow its collection and posting instructions carefully.

As we mentioned, some types of hormonal contraception stop an FSH test from showing menopause, so check with your doctor before you buy a kit ^[1]. If you use a hormone gel or cream, keep it away from the finger or arm the sample is taken from. Traces on the skin can falsely raise the level of that hormone ^[9].

Preparing for your test

The clinic will tell you if you need to fast. It’s also a good idea to mention any hormonal contraception or hormone treatment you use. Biotin, which is often in hair supplements, is worth mentioning too, as it can upset some blood test results, including thyroid tests ^[5][10].

The test itself usually takes about 10 minutes. You’ll feel a scratch as the needle goes in, which may be a bit uncomfortable ^[11].

Hormones and hair loss at Hair GP

If your hair has been changing too, hormones may not be the only reason. Hair loss can have other causes, such as low iron ^[12]. At Hair GP, your hair and your hormones are looked at together. Dr Amy is dual-trained in hair restoration and general practice, so she can consider hormonal causes of hair loss in the same consultation.

We can arrange blood tests at our clinic as part of your consultation.

The bottom line on menopause blood tests

If you’re 45 or over with typical symptoms, you usually don’t need a blood test to confirm perimenopause or menopause ^[1]. But a blood test is still really important to rule out other problems that can mimic menopause, such as a thyroid problem, low iron or a vitamin deficiency. If you’re younger, a test can also help your doctor work out what’s going on ^[1]. Not sure whether you need one? Your GP is the place to start. And if your hair has been changing too, mention that as well, so your doctor can look at it at the same time.

References

1. National Institute for Health and Care Excellence. Menopause: identification and management (NG23). Last updated 15 April 2026. PMID:
2. Santoro N, Roeca C, Peters BA, Neal-Perry G. The menopause transition: signs, symptoms, and management options. J Clin Endocrinol Metab. 2021;106(1):1-15. PMID: 33095879
3. NHS. Menopause and perimenopause. Accessed 9 November 2026. PMID:
4. NHS. Menopause and perimenopause: symptoms. Page last reviewed 19 May 2026. PMID:
5. National Institute for Health and Care Excellence. Thyroid disease: assessment and management (NG145). Last updated 12 October 2023. PMID:
6. NHS. Iron deficiency anaemia. Page last reviewed 26 January 2024. PMID:
7. Madden-Doyle L, Bowers K, Sherlock M, O'Reilly MW. Approach to the patient: investigation of postmenopausal androgen excess. J Clin Endocrinol Metab. 2026;111(9):2664-2677. PMID: 42216566
8. Vasavan T, Timpson A, Woolley T, O'Neill HC, Getreu N. Systematic reduction in estradiol and testosterone measurements due to serum separator gel in blood collection tubes: implications for at-home fertility testing. J Appl Lab Med. 2025;10(4):779-792. PMID: 40314381
9. Sato T, Tachibana M, Hiraga H, Yokoyama E, Watanabe Z, Saito M. Topical estradiol gel leading to laboratory error in serum estradiol measurement: a diagnostic pitfall. Clin Case Rep. 2025;13(10):e71077. PMID: 41040826
10. Li D, Radulescu A, Shrestha RT, et al. Association of biotin ingestion with performance of hormone and nonhormone assays in healthy adults. JAMA. 2017;318(12):1150-1160. PMID: 28973622
11. NHS. Blood tests. Accessed 9 November 2026. PMID:
12. NHS. Hair loss. Page last reviewed 24 January 2024. PMID: