Reviewed by the Eve Biology Nutrition Team, specialists in women’s health, midlife metabolism and hormone-supportive nutrition.
Noticing heavier periods, brain fog, low mood or sleep issues and wondering if a perimenopause test could confirm what’s going on? You’re not alone. Many women look for a simple blood test or home kit to give them answers, but fluctuating hormones make this more complicated than it seems.
In this guide we explain what happens to your hormones, which tests are (and aren’t) useful, when you should speak to a doctor, and how targeted nutrition and lifestyle changes can help you feel more like yourself again.
Your Menstrual Cycle Before Perimenopause
During your reproductive years, four key hormones work together to run your menstrual cycle: oestrogen (estrogen), progesterone, follicle-stimulating hormone (FSH) and luteinising hormone (LH).
FSH (Follicle-Stimulating Hormone)
FSH is released by the pituitary gland and tells your ovaries to grow follicles and produce oestrogen. When oestrogen levels are adequate, FSH release is dialled down.
LH (Luteinising Hormone)
LH surges mid-cycle to trigger ovulation — the release of an egg. After ovulation, the ovary produces progesterone and oestrogen to support a potential pregnancy.
Oestrogen and Progesterone
Rising oestrogen and progesterone switch FSH and LH down. If pregnancy doesn’t occur, hormone levels drop and your period starts, beginning a new cycle.
What Is Perimenopause?
Perimenopause is the transition phase before menopause, when your ovaries start to slow down and hormone levels become more erratic. It can last several years. The average age for perimenopause is around 46, while menopause (defined as 12 months without a period) typically occurs at about 51–52.
You can still ovulate and get pregnant during perimenopause, but cycles often become less predictable.
Common Perimenopause Symptoms
Because perimenopause symptoms develop gradually, they’re often mistaken for stress, a busy life or other health issues. Typical symptoms include:
- Changes to your periods (heavier, lighter, closer together, further apart, missed periods)
- Hot flushes and/or night sweats
- Weight gain or body shape changes (especially around the waist)
- Worsening PMS, mood swings, anxiety or low mood
- Sleep disruption and fatigue
- Bloating or digestive changes
- Brain fog, forgetfulness or difficulty concentrating
- Vaginal dryness or discomfort
Some of these symptoms continue into menopause, as oestrogen levels fall further.
Can You Test for Perimenopause?
This is the key question. Many women expect a definitive perimenopause test, but for most women over 45, diagnosis is based on your symptoms and period changes, not a single blood result.
Is There a Reliable Perimenopause Test?
Hormone levels (especially FSH and oestrogen) can rise and fall significantly from day to day in perimenopause. A “normal” result on one day doesn’t rule it out, and a raised FSH on one test isn’t always conclusive on its own.
For women aged 45 and over with typical symptoms, many guidelines advise that routine hormone blood tests are not usually needed. Instead, your healthcare professional will look at:
- Your age
- Changes in your menstrual cycle
- Typical perimenopause symptoms
- Medical and family history
When Hormone Blood Tests May Help
Blood tests may be considered when:
- You are under 45 with menopausal-type symptoms
- Your periods stop unexpectedly or become very irregular at a young age (possible early or premature menopause)
- Your clinician needs to rule out other causes of symptoms, such as thyroid problems, iron deficiency or other conditions
What Hormone Tests Measure
- FSH and LH: Often raised as the ovaries slow down, but can fluctuate.
- Oestradiol (oestrogen): May be low or variable in perimenopause.
- Progesterone: May be lower due to less frequent ovulation.
- Thyroid function: To check thyroid health when symptoms overlap.
How Hormones Change in Perimenopause (and What Tests Capture)
This diagram shows how oestrogen and progesterone levels fall as FSH rises during perimenopause — one reason a single perimenopause test only offers a snapshot.
At-Home and Private Perimenopause Test Kits
Several companies offer home blood tests or finger-prick kits to check hormone levels. These can provide a snapshot of what your hormones are doing on the day of the test and may be accompanied by medical comments. However:
- Results can be affected by where you are in your cycle.
- Single readings do not always confirm or rule out perimenopause.
- Your GP or menopause specialist may not rely solely on private or OTC results.
Use them as part of the picture, not the full story, and always discuss concerning results or symptoms with a healthcare professional.
Quick Comparison: Perimenopause Testing Options
| Test Type | What It Measures | Best For | Limitations |
|---|---|---|---|
| GP / Menopause Clinic Assessment | Symptoms, cycle history, targeted bloods if needed | Women 45+ or with complex symptoms | May not offer routine hormone tests if symptoms are clear |
| Hormone Blood Test (FSH, LH, Oestradiol) | Snapshot of hormone levels | Suspected early menopause, unclear cases | Fluctuations can make results misleading |
| At-Home Blood / Urine Tests | Varies by provider | Curious about baseline data | Shouldn’t replace clinical assessment or guideline-based advice |
How Nutrition Can Support You During Perimenopause
While tests can sometimes help, your everyday choices — especially what you eat and drink — have a major impact on symptoms, long-term health and how you feel. This is where our Eve Biology nutritionists see real, practical wins for women.
Top Nutritionist-Backed Tips for a Healthy Perimenopause & Menopause
Eve Biology Consultant nutritionist Clare advises women who are struggling with excess weight should drop their carb intake 'As oestrogen levels drop, the body becomes more sensitive to insulin, making storing fat around the midsection easier. Reducing free sugars can help maintain stable blood sugar levels and support healthy weight management."
- Keep alcohol within recommended guidelines. Alcohol can worsen hot flushes, sleep, mood swings and weight gain and is linked with increased breast cancer risk.
- Maintain a healthy weight & waistline. Prioritise protein, fibre and balanced meals. Consider meal replacements as structured support.
- Reduce saturated fat. Choose lean proteins, olive oil, nuts, seeds and oily fish more often than red meat to support cholesterol and heart health.
- Review your caffeine. Caffeine may trigger hot flushes, palpitations and anxiety; consider reducing intake if symptoms worsen.
- Move in ways that protect muscle, bone and mood. Include cardio, strength training and weight-bearing exercise weekly.
- Prioritise calcium and vitamin D. Bone loss accelerates around menopause; include dairy or fortified alternatives, leafy greens and safe sun or supplementation.
- Protect your sleep. Build a calming bedtime routine, balance evening meals and keep caffeine and alcohol moderate.
- Eat high-fibre, plant-rich meals for gut and hormone health. Fibre supports digestion and the clearance of excess hormones.
Where Supplements Fit In
- Vitamins B6, B12 and folate for energy, mood and nervous system support.
- Vitamin D, vitamin K2, calcium and magnesium for bones, muscles and immunity.
- Omega-3 fats for heart, brain and inflammation support.
- Adaptogens and prebiotic fibres for stress response and gut health.
Eve Biology shakes are formulated by health specialists to support weight management, gut health, energy, mood and sleep with a 100% plant-based blend. See Shake Benefits
Other Treatment Options to Discuss with Your Doctor
- Hormone replacement therapy (HRT)
- Low-dose hormonal contraception or an IUS (e.g. Mirena)
- Vaginal oestrogen for dryness and discomfort
- Non-hormonal medications for mood, hot flushes or sleep
Perimenopause Test FAQs
Can a blood test confirm perimenopause?
Blood tests alone rarely give a definitive answer in women over 45. Diagnosis is usually based on symptoms and menstrual changes, with tests used selectively.
Are home perimenopause test kits accurate?
They measure hormones such as FSH but can’t capture daily fluctuations or rule out other causes. Use cautiously and follow up with a healthcare professional.
What hormone levels indicate perimenopause?
Higher FSH with lower or variable oestrogen can suggest the transition, but single results can be misleading.
Can diet help manage perimenopause symptoms?
Yes. A diet rich in plants, fibre, adequate protein and healthy fats, plus movement and good sleep, can support hormone balance, weight, mood and energy.
The Bottom Line
There is no single perfect perimenopause test for every woman. The best insights often come from your symptoms, cycle pattern and overall health picture, supported by targeted testing when appropriate.
Smart nutrition, movement, sleep and, where needed, medical treatments work together to support you through this transition.
This article is for information only and is not a substitute for personalised medical advice.
