Blood tests for menopause and perimenopause

When are blood tests useful?

If you’re over 45 and your symptoms fit perimenopause or menopause, you don’t need a blood test to confirm it. Hormone levels swing from day to day during perimenopause, so a single result can look completely normal while you feel anything but.

This is in line with NICE guidance and the British Menopause Society. You can start HRT without a blood test.

There are times, though, when testing really does help. We may recommend blood tests if:

• You’re under 45 with symptoms, and we need to look at early menopause or Premature Ovarian Insufficiency (POI)
• You’re thinking about testosterone, where we check a baseline level first and then monitor it
• You’re on HRT and still have symptoms, and we want to check how well your oestrogen is being absorbed
• Tiredness, low mood or brain fog could have another cause, such as thyroid problems, low iron, B12 or vitamin D
• You’ve noticed hair loss or thinning, which can be linked to iron, thyroid or hormone levels
• You’d like an overall picture of your health in midlife, so you know where you stand and can plan ahead
• We want a fuller picture of your heart and metabolic health as your risk changes after menopause
• Your health history is more complex and testing will help guide your care

We’ll only suggest tests that will make a difference to your care. If you don’t need them, we’ll tell you.

What we test, and why

Each test tells us something different. Here’s what they show in plain English.

What about progesterone? We don’t routinely test progesterone in perimenopause or menopause. The tests can be unreliable, and there’s no good evidence on what an “optimal” level looks like at this stage. If you’d like it checked, we can add it on at your request.

Our blood test panels and prices

Your clinician will recommend the panel that fits your situation, so you don’t need to choose on your own. Prices cover laboratory processing and your clinician reviewing your results.

Single tests

Phlebotomy fee

On top of your panel, there’s a phlebotomy fee for having your blood taken:

• At your in-person appointment with us: £30
• At a Nationwide Pathology clinic: usually £35 to £55
• Home visit from Nationwide Pathology (where available): usually £50 to £65

Nationwide Pathology fees are paid directly to them, and they’ll confirm the exact cost when you book.

How it works

1. We talk it through. At your consultation, your clinician will explain whether tests would help, which panel fits and what it costs. You decide whether to go ahead.
2. You pay for your panel. We take payment for the blood test and lab fees, then send your request form to the lab.
3. You have your blood taken. If you’re seeing us in person, we can usually take it at your appointment. Otherwise, call Nationwide Pathology on 01858 571322 to book. They have over 150 clinics across the UK, and home visits are available in some areas.
4. The lab processes your sample. Results go straight to your clinician.
5. We share your results. Your clinician emails them to you, usually within 7 days, with their comments and any recommendations.

Why have your bloods done through us?

There are lots of online blood testing companies. Booking through us with Nationwide Pathology means:

• You have the tests you need. Your clinician chooses them based on your symptoms and history, so nothing important is missed and you don’t pay for what you don’t need.
• Your results come with expert comments. Your menopause specialist looks at them in the context of your symptoms and any hormone treatment you’re on.
• Your results come straight to us. No forwarding reports or chasing paperwork.

Having bloods before an appointment? Results often arrive within 2 to 3 working days, but busy periods and bank holidays can slow things down. Please allow at least a week.

Before your test

Already arranging a test with us? Our guide for existing patients explains how to book your blood test and get your results.

Timing. Your clinician may recommend having your bloods taken at a particular point in your cycle. If so, we’ll let you know when.

If your blood test is to check your HRT, a little timing makes your results much more meaningful. Here’s what to do.

All other medicines and supplements can be taken as normal. Not sure? Just ask us.

Your results

Numbers on their own don’t tell the full story. Your clinician looks at your results alongside your symptoms, history and treatment, then shares them with you by email, usually within 7 days, with comments and any recommendations.

We’ll talk them through in more detail at your next review appointment. If you’d like to discuss them sooner, you can book a short telephone call (£90).

Results may lead us to adjust your HRT dose, suggest a supplement, or recommend a next step with your GP. With your consent, we can share them with your GP too.

Haven’t heard back within 10 days of your test? Please contact us and we’ll look into it.

Your questions, answered

Do I need a blood test before starting HRT?

Usually not. If you’re over 45 with typical symptoms, NICE and British Menopause Society guidance is clear that you can start HRT without one.

Should I have an FSH test to confirm menopause?

Not if you’re over 45. FSH levels go up and down during perimenopause, so your symptoms and cycle changes are a better guide. FSH is helpful if you’re under 45 and early menopause is possible.

How much do blood tests cost?

Our panels range from £60 to £180, and single tests start from £37.05. There’s also a phlebotomy fee for having your blood taken, which depends on where you have it done.

Do I have to come to Manchester to have my blood taken?

No. Nationwide Pathology has over 150 clinics across the UK, and home visits are available in some areas.

Can my GP do these tests instead?

Sometimes. If we think you need tests for another health condition, we may ask you to speak to your GP. We don’t ask GPs to monitor HRT levels while you’re under our care, as many areas can’t access the tests needed.

Why do I need tests before testosterone?

We check a baseline level before you start, then monitor it on treatment. This follows British Menopause Society guidance and keeps your levels within a safe, female range.

I’ve had blood tests elsewhere. Can you look at them?

Yes. Interpreting results we haven’t requested starts from £30.

What if my results show something unexpected?

We’ll explain clearly what it means and what to do next. That might be a change to your treatment, a repeat test, or a referral back to your GP.