TRUTH

No fluff. No fear. No judgement. Just the knowledge you need to make the best decisions for yourself.

The Truth About Hormone Testing in Menopause

menopause 101 menopause in the news menopause industry menopause treatment Oct 09, 2025

Chalkboard with "Hormones" written across the top lying on a desk with eyeglasses and a stethoscope nearby

Let's talk about hormone testing in menopause, because if you've spent more than five minutes online looking for answers about your symptoms, you've probably been told you need to "know your numbers."

There's a slick at-home test kit with your name on it, a subscription service promising to decode your hormonal mysteries, and approximately seven thousand influencers swearing it changed their lives.

But here's the question nobody seems to be asking: Do you actually need it?

The Clinical Reality

Here's what might surprise you: In most cases, you don't need hormone testing to diagnose menopause, despite how much money is being made convincing you otherwise.

If you're experiencing classic symptoms like hot flashes, night sweats, irregular periods, mood changes, and sleep disruption during, your doctor can diagnose perimenopause based on your symptoms alone. No blood draw required.

The North American Menopause Society, the American College of Obstetricians and Gynecologists, and basically every major medical organization agree: For most women, hormone testing isn't necessary for diagnosis. Your symptoms tell the story that your hormones are living and testing offers no reliable way to determine what treatments will work nor how well.

When Hormones Testing is Warranted

There ARE legitimate reasons to test hormone levels, but they're more specific than "because you're in your 40s and feel like garbage."

Valid reasons for hormone testing include:

You're under 40 and experiencing menopausal symptoms (testing for premature ovarian insufficiency)
Your symptoms are ambiguous or atypical, and your doctor needs to rule out other conditions like thyroid disorders
You're considering or currently on hormone replacement therapy and your doctor wants to monitor your levels
You've had specific medical treatments (like cancer therapy) that might have affected your ovaries

Notice what's NOT on that list? "Because a wellness brand or an influencer with a million followers on Instagram told me I should know my numbers."

The Problem with Hormone Testing (Especially at Home)

Hormone levels during perimenopause are about as stable as a toddler on a sugar high. They fluctuate wildly, sometimes within the same day. You could test on a Monday and get one set of numbers, then test on Wednesday and get completely different results. Both would be "accurate" snapshots of that specific moment, but neither would give you the full picture.

This is especially true for at-home tests. While the technology itself can be accurate (most measure hormones in saliva, urine, or blood from a finger prick), the interpretation is where things get dicey. These tests give you a number, but that number is virtually meaningless without context. The context of your symptoms, your cycle (if you still have one), your medical history, and frankly, the fact that your hormones are doing the cha-cha.

FSH (follicle-stimulating hormone) might be the most commonly tested hormone, and it's also the perfect example of why testing can be misleading. FSH rises as your ovaries slow down, so high FSH often indicates perimenopause or menopause. But FSH levels can spike and then drop again during perimenopause. A single elevated result doesn't necessarily mean you're done having periods, and a normal result doesn't mean you're not perimenopausal.

The At-Home Testing Industry: Innovation or Exploitation?

Let's be real. The at-home hormone testing industry has exploded because there's money to be made from women who are suffering and desperate for answers. I get it, I’ve done them myself. When you feel terrible and your doctor dismisses your symptoms or tells you “It’s just stress," the promise of concrete data feels empowering.

But here's the uncomfortable truth. These companies are often selling you expensive data you don't need, paired with supplement recommendations you probably don't need, wrapped in language that makes you feel like you're taking control of your health. It's marketing genius, but it's not necessarily good medicine.

Some at-home testing companies charge $150-$400 for tests that your doctor probably wouldn't order because they won't change the treatment approach. Then they'll suggest you retest in a few months (ka-ching) and maybe try their proprietary supplement blend (ka-ching again). It's a business model built on anxiety and information gaps.

When Testing Might Actually Be Helpful

I'm not saying hormone testing is NEVER useful, just that it's not the universal answer it's marketed to be. Testing can be genuinely helpful when:

You're starting HRT: Some doctors like baseline levels to help determine dosing, though many treat based on symptoms alone
Your HRT isn't working: Testing can help your doctor adjust your dose or delivery method
You have complex medical history: Multiple conditions can muddy the diagnostic waters
You need documentation: Some workplaces or insurance companies require proof for accommodation requests

What to Do Instead

Rather than spending hundreds on tests that might not tell you much, here's what I'd suggest:

Track your symptoms. Keep a detailed log of what you're experiencing and when. This information is often more useful than a hormone panel.
Find a knowledgeable provider. A doctor or nurse practitioner who specializes in menopause care can diagnose and treat you based on your symptoms.
Focus on what you can control. Whether your FSH is 15 or 50, the interventions are largely the same: lifestyle modifications, possibly HRT, symptom management strategies, and support.

Tracking doesn’t have to be fancy. You can download an app or just use your notes app on your phone. Or you could go really old school and use a pen and notebook. Personally, I track using an Excel spreadsheet.

Likewise, you don’t have to stick with a doctor that isn’t trained in menopause. Sadly, most OB/GYNs get very little training on menopause and the menopause transition so seeking out a doctor that has specialized training is valid. I mean, we don’t question going to a cardiologist or even a podiatrist. This is no different.

Focusing on what you can control is good advice not just for hormone testing but for all of the menopause transition and beyond. We cannot control when we go through menopause or how severe the symptoms will be. We can, however, make informed decisions based on what is best for our short-term and long-term health given the time and resources we have available to us at the time.

The Bottom Line

Hormone testing in menopause isn't inherently bad, it's just not the prerequisite for care that the wellness industry wants you to believe it is. For most women, it's an unnecessary expense that provides more confusion than clarity.

Your symptoms are valid even without the lab work to prove them. You deserve treatment even without "abnormal" test results. And you're not being a difficult patient by asking for help based on how you feel rather than what your hormones measured at 2 PM last Thursday.

If you want to test your hormones, by all means, do it. But do it because YOU want to, not because someone is selling you fear disguised as empowerment. And definitely don't do it instead of getting actual medical support for your symptoms.

At the end of the day, save your money. If you're going to invest in your menopause journey, consider spending that $300 on a few sessions with a certified menopause-trained coach, a really good fitness program designed for this life stage, or quality sleep gear. These will probably serve you better than knowing your estradiol level on one random Tuesday.