Menopause Profile

What is the Menopause?

The menopause is a natural event in a woman’s life when her monthly menstrual periods have stopped for 12 consecutive months. Menopause generally occurs between 45 and 55 years of age and indicates the end of a woman’s ability to conceive a baby. It is caused by the natural decline in hormone production as a woman ages, but can be due to medical treatment and surgery.

Natural menopause occurs in three stages: perimenopause (the time before menopause), menopause (the point at which menstrual periods stop), and postmenopause (the time after menopause). The most common symptoms include hot flushes, night sweats, sleep difficulties, emotional changes (mood swings), vaginal dryness, irregular menstrual periods, and memory problems. These are primarily experienced during the perimenopause, sometimes continuing for a few years into postmenopause.

What is a Menopause Profile?

A Menopause Profile measures five hormone levels, including:

• Follicle Stimulating Hormone (FSH): a ‘sex hormone’ produced in the anterior pituitary gland. FSH regulates the menstrual cycle, stimulates growth and maturation of egg-containing follicles in the ovary, and prepares the eggs for ovulation (egg release from the ovary)
• Luteinising Hormone (LH): a sex hormone produced by the anterior pituitary gland. LH regulates the menstrual cycle, triggers the ovaries to produce hormones such as oestrogen and progesterone, peaks before ovulation, and triggers ovulation
• Oestradiol-17-beta: another sex hormone produced mostly by the ovaries and the main form of oestrogen. Oestradiol maintains the menstrual cycle and bone health. Oestradiol levels increase before ovulation, are maintained at lower levels after ovulation, and fall if there is no pregnancy.
• Thyroid Stimulating Hormone (TSH): stimulates the thyroid gland to produce Free Thyroxine (Free T4). It regulates Free T4 production and the level of Free T4 in the blood.
• Free Thyroxine 4 (Free T4) is an active thyroid hormone. Abnormal levels can indicate thyroid disorders and can impact menstrual cycles, mimicking or worsening menopausal symptoms.

Why is a Menopause Profile important?

The Menopause Profile provides an assessment of hormonal changes associated with menopause. The Profile can be useful alongside symptoms to determine if a woman has started to transition to menopause (entered perimenopause) or has reached menopause. Since each test represents a ‘snapshot’ in time, a more accurate picture may be given by a few tests over several months along with keeping a symptoms diary.

The Profile can help diagnose early menopause (menstruation stops permanently) and Premature Ovarian Insufficiency (POI; loss of normal ovarian function), where a woman younger than 40 years is experiencing menopausal symptoms. Menopausal hormonal changes limit fertility, reduce bone density, and increase cardiovascular disease risk. Knowing these issues exist provides an opportunity to make early decisions regarding fertility and overall health.

Insight into hormonal changes may also be helpful to a healthcare professional when making treatment decisions and advising changes to lifestyle. The Menopause Profile provides baseline hormone levels that can act as reference points for future monitoring, and may be used when considering type (e.g., tablet, patch, spray) and dose of hormone replacement therapy (HRT).

Many symptoms of the perimenopause are shared with other conditions so the Profile can help to eliminate these, particularly when used together with a full blood test. For example, fatigue and exhaustion may also be caused by an underactive thyroid gland or iron-deficiency anaemia (due to heavy menstrual periods); and bodyweight gain can also indicate thyroid dysfunction or prediabetes.

Who should have their Menopause Profile investigated?

The Menopause Profile is appropriate for any woman:

• Experiencing irregular menstrual periods and other menopausal symptoms, such as hot flushes, night sweats, vaginal dryness, sleep difficulties, emotional changes (mood swings), and memory problems
• Younger than 40 years and experiencing menopause symptoms to help diagnose POI and guide treatment
• Wishing to establish if she is perimenopausal, has reached menopause or is postmenopausal
• Monitoring her reproductive capability
• Considering HRT to guide treatment choices
• With uncertain symptoms or symptoms that can be caused by other health conditions
• Checking thyroid function as well as reproductive hormones

How to take the blood sample for the Menopause Profile?

The test involves a small blood sample that can be collected at home using a specially designed finger prick kit sent by The Online Clinic. The sample and test kit is then sent to the laboratory in a prepaid envelope for analysis. The results are interpreted by a doctor, and you receive the laboratory report and an explanation of the findings from the doctor. If you prefer, The Online Clinic can arrange for a healthcare professional to take the blood sample from a vein in your arm at a clinic.

If you are having menstrual periods, the best time to take your blood sample is on day 2 to day 5 of your menstrual cycle, i.e., on the second day to the fifth day of your menstrual bleed. This is because hormone levels are most stable during this time in the menstrual cycle, particularly increasing the accuracy of FSH and oestradiol levels. If menstrual periods are absent, blood can be taken anytime.

It is important to inform the doctor if you are using HRT or hormonal contraception as these will affect your FSH and oestradiol results, making your Menopause Profile unreliable for interpretation. Inform the doctor what HRT you take and when. Timing of the blood test is important and will depend on how the HRT is taken. You must also avoid taking the sample from an area where an HRT cream has already been applied.

What are normal Menopause Profile results?

Menopause Profile blood tests are not very reliable on their own and symptoms should also be considered.

Despite symptoms, blood test results can be ‘normal’ (i.e., as expected). This happens because hormone levels fluctuate significantly during the perimenopause, being as expected on one day and considered ‘menopausal’ on another. As such, perimenopause is best diagnosed based on symptoms rather than blood test results alone.

The results of FSH, LH, and oestradiol must be taken together to confirm menopause; taken alone, results of any one of these hormones is insufficient to confirm menopause. High FSH, increased LH, and low oestradiol strongly suggests menopause.

The five hormones measured in the Menopause Profile are:

• FSH: FSH levels are typically below 10 IU/L during premenopause (before perimenopause); 10–25 IU/L during perimenopause; and above 25–30 IU/L during late perimenopause/menopause when maintained.
  Increased FSH levels can indicate a reduced supply of eggs within the ovaries (at menopause egg supply is exhausted).
• LH: During a typical menstrual cycle, LH levels fluctuate between about 1 and 17 IU/L; postmenopause, LH levels range from about 19 to 100 IU/L.
  LH levels are also elevated during perimenopause due to the natural decline in ovarian function.
• Oestradiol: Oestradiol levels are typically above 200 pmol/L during premenopause; 100–200 pmol/L during perimenopause; and below 100 pmol/L at menopause when maintained.
  Low levels of oestradiol are a strong indication of menopause, and are responsible for many menopausal symptoms.
• TSH: Normal levels are typically 0.3–4.5 mIU/L.
  Abnormal TSH levels usually mean a problem with the thyroid gland but can indicate an issue with the pituitary gland in the brain.
• Free T4: Normal levels of Free T4 range from 10.0–22.0 pmol/L.
  Problems with the thyroid gland affect Free T4 production. Issues with the thyroid gland can resemble or worsen menopausal symptoms. Elevated Free T4 with low TSH suggests primary hyperthyroidism; low Free T4 with elevated TSH suggests hypothyroidism; normal Free T4 with abnormal TSH suggests borderline hypo/hyperthyroidism; low Free T4 with low/normal TSH may suggest secondary hypothyroidism.

Lifestyle advice during the Menopause

During all stages of the menopause there is an increased risk of certain medical conditions (e.g., osteoporosis and heart disease) due to declining oestrogen levels. The NHS recommends key lifestyle changes to help you during this time:

• Eat a healthy balanced diet, including calcium-rich foods (e.g., milk, yoghurt, kale) for the bones
• Regular exercise, including weight-bearing activities to increase strength and protect against weakened bones
• Enough rest and a regular sleep routine
• Relax with yoga, tai chi or meditation
• Talk about menopause with others going through it (e.g., your family and friends)
• Discuss with a doctor HRT to alleviate symptoms; hormonal contraception if required (HRT is not contraception); and herbal supplements or complementary medicines before taking them (e.g., St John’s wort; they may interfere with HRT and other medicines)
• Stop smoking and limit alcohol intake as they can worsen menopause symptoms.

References

Cleveland Clinic. Luteinizing Hormone. Last updated: 29 Apr 2025. Available at: https://my.clevelandclinic.org/health/body/22255-luteinizing-hormone Accessed 05 Aug 2026.

Lumsden MA, Dekkers OM, Faubion SS, et al. European society of endocrinology clinical practice guideline for evaluation and management of menopause and the perimenopause. Eur J Endocrinol. 2025;193(4):G49-G81.

Lagom Clinic, May Wellness Centre, Bristol. Menopause blood test: What to test, what results mean, and when you actually need one. Available at: https://thelagom.co.uk/2026/05/05/menopause-blood-test/ Accessed 05 Aug 2026.

Mayo Clinic Health System. Menopause: A natural part of aging. 26 Apr 2023. Available at: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/menopause-ensuring-a-tranquil-transition Accessed 05 Aug 2026.

NHS The Newcastle upon Tyne Hospitals. Free T4, serum. Last updated 24 Dec 2024. Available at: https://laboratories.newcastle-hospitals.nhs.uk/test-directory/free-t4-serum/ Accessed 05 Aug 2026.

NHS The Newcastle upon Tyne Hospitals. TSH (Thyroid Stimulating Hormone), serum. Last updated 10 Sep 2025. Available at: https://laboratories.newcastle-hospitals.nhs.uk/test-directory/tsh-thyroid-stimulating-hormone-serum/ Accessed 05 Aug 2026.

NHS. Things you can do to help menopause and perimenopause symptoms. Reviewed 19 May 2026. Available at: https://www.nhs.uk/conditions/menopause-and-perimenopause/things-you-can-do/ Accessed 05 Aug 2026.

NHS. What are menopause and perimenopause? Reviewed 19 May 2026. Available at: https://www.nhs.uk/conditions/menopause-and-perimenopause/what-are-menopause-and-perimenopause/ Accessed 05 Aug 2026.

Santoro N, Roeca C, Peters BA, et al. The Menopause Transition: Signs, Symptoms, and Management Options. J Clin Endocrinol Metab. 2021;106(1):1-15.