Measuring Perimenopause Hormone Levels

Navigating the changes in your body during perimenopause can feel like embarking on a complex journey. Understandably, many people look to hormone level testing to try to get more information about their menopause experience—but this data is not as straightforward as it can seem. In this post, we’ll delve into what a chart of perimenopause hormone levels includes, how to interpret it, and what it means for you.

What is a Perimenopause Hormone Levels Chart?

A perimenopause hormone levels chart is a visual representation of the fluctuations in hormone levels that occur during the transition to menopause. It typically includes measurements of key hormones such as estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). These hormones play pivotal roles in regulating the menstrual cycle and various bodily functions.

Understanding Your Hormone Levels

A perimenopause hormone levels chart may look confusing at first, so we recommend breaking it down line by line. Each hormone is represented by a line, with time on the horizontal axis and hormone levels on the vertical axis. Fluctuations in hormone levels over time are depicted by the rising and falling of the lines. 

You’re likely to see these hormones on a chart:

FSH (Follicle-Stimulating Hormone)

FSH is often cited as a key player in menopause testing. The claim is straightforward: as a woman approaches menopause and estrogen levels decline, FSH levels should rise. This is because the body attempts to stimulate the ovaries to produce more estrogen, resulting in elevated FSH levels. FSH levels elevate and stay elevated after menopause, when someone has gone 12 consecutive months without a period. 

LH (Luteinizing Hormone)

Like FSH, LH is produced by the pituitary gland. LH levels may also increase during menopause. The reasoning behind this is that LH is involved in triggering ovulation, and as a woman’s ovaries become less responsive to LH, the body may produce more in an attempt to stimulate ovulation.

Estrogen

Some tests measure estradiol, a form of estrogen. Estrogen levels are expected to decrease as a woman progresses through menopause because the ovaries produce less estrogen.

What Should My Hormone Levels Be in Perimenopause?

While all women experience these changes around the menopause transition, the ups and downs on each person’s hormone chart will look slightly different. While trends can serve as guidelines, there’s no one-size-fits-all answer to this question. 

In general:

• FSH levels increase and stay high
• Estrogen should decrease and stay low

However, what exactly happens to hormone levels between pre- and postmenopause is not a steady, straight line. While hormone testing has become more accessible, several factors make it hard to get value out of these numbers. For this reason, most physicians discourage testing of hormone levels in perimenopause. 

If you’re considering hormone testing, consider these factors that can affect its usefulness: 

Hormones fluctuate

FSH, LH, and estrogen levels can fluctuate from day to day, even from hour to hour. So, while hormone testing gives accurate data about the blood or urine that it measures, this data only provides insight into the moment in time when the test was taken. Trends over time provide a more accurate picture, but it would take many data points to provide insight about trends.

Not all women have the same hormonal patterns

Everyone’s body is unique, and the timing and severity of menopausal symptoms can differ significantly. Some women may experience hormonal changes associated with menopause earlier or later than others, making a one-size-fits-all interpretation challenging.

Other factors beyond menopause can influence hormone levels 

Conditions like PCOS or thyroid disorders can affect hormone levels, leading to potential misinterpretation of test results.

Symptoms matter

Menopause is not solely defined by hormone levels. It encompasses a range of physical and emotional symptoms, which should be considered alongside hormone measurements for a comprehensive assessment. 

While hormone testing is not recommended for most perimenopausal women, one notable exception is people who have had a hysterectomy and no longer have menstrual bleeding. In these cases, hormone levels are the only pieces of data that are available to estimate their menopause stage. If you fall into this group, experts recommend waiting for at least three months after surgery before testing, and testing multiple times under the supervision of a clinician who is familiar with your medical history. 

Unfortunately, there is insufficient research on menopause staging for people with irregular menstrual cycles due to polycystic ovarian syndrome (PCOS) or hypothalamic amenorrhea (loss of a regular period due to low body weight and/or high physical stress). 

Gaining insights into your body and hormones is an important part of understanding your health. However, hormone testing data is not always as valuable in understanding your menopause journey as many would hope. While these tests can offer valuable insights for some people, they do not offer meaningful or reliable information on their own to determine your menopausal stage. 

A holistic approach, considering both hormonal data and the physical and emotional symptoms you experience, is the key to a more accurate assessment. When you start to notice changes in your menstrual cycles and suspect you may be entering perimenopause, meet with your provider to discuss these changes. 

Midday uses a scientific tool, validated using hormonal measures and expert assessments, to calculate your menopause stage based on the information you provide during onboarding and monthly symptom surveys. It is a gold-standard tool for understanding where you stand on your menopause journey and tracking your progress toward reaching menopause. You’ll never be blindsided and always know what to expect next with Midday’s support.