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Menopause blood panel · London

Menopause blood panel - private in London.

FSH, LH, oestradiol and the wider panel that actually matters - interpreted against your symptoms by a BMS-accredited specialist, in line with NICE NG23.

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What is included

What a menopause panel typically covers.

Not every panel needs every marker. A well-designed one covers the hormones, the common overlaps and the pre-HRT baseline in one draw.

  • FSH (follicle-stimulating hormone)

    Raised in menopause. On two samples 4-6 weeks apart, an FSH above 30 IU/L supports the diagnosis - most useful under 45.

  • LH (luteinising hormone)

    Rises alongside FSH as the ovaries stop responding. Interpreted with FSH rather than alone.

  • Oestradiol

    Falls as ovarian function declines, but fluctuates widely in perimenopause. A single low reading rarely settles it.

  • Progesterone (if still cycling)

    Day 21 progesterone can confirm whether a cycle was ovulatory. Not needed once periods have stopped.

  • TSH (thyroid function)

    Thyroid disease mimics menopause: fatigue, mood, weight, temperature. Nearly always worth checking alongside.

  • Vitamin D

    A level below 50 nmol/L is deficient - supplement. Worth knowing before starting HRT.

  • Ferritin

    Low iron stores drive fatigue and brain fog. Heavy perimenopausal bleeding is a common cause.

  • HbA1c

    Baseline diabetes screen - relevant to cardiovascular risk when weighing HRT options.

  • Lipid panel

    Total cholesterol, HDL, LDL and triglycerides feed into a proper CV risk assessment.

  • Testosterone (with SHBG)

    Considered when low libido, energy or mood are prominent. Report total and free testosterone with SHBG.

  • DHEAS

    Added when androgen-deficiency symptoms are prominent, or when hair loss and acne need a fuller adrenal picture.

Important - NICE guidance

Blood tests are not usually needed over 45.

Per NICE guideline NG23, women over 45 with typical menopausal symptoms do not need blood tests to diagnose menopause. Symptoms alone are sufficient. Hormones fluctuate widely in perimenopause, so a single reading can mislead.

Testing is indicated when: you are under 45 and need to distinguish premature ovarian insufficiency from perimenopause; you have no periods (hysterectomy, coil, long-cycle absence) and the diagnosis is unclear; or a specific pathology is suspected - thyroid disease, androgen deficiency, iron depletion.

When testing helps

The scenarios where bloods actually change the plan.

If your situation is on this list, a panel is worth doing. If not, symptom review with a menopause specialist is a better first step.

  • Under 45 with symptoms

    Bloods matter more here. Premature ovarian insufficiency (POI) is diagnosed with two raised FSH results 4-6 weeks apart plus low oestradiol.

  • Low libido or fatigue

    Testosterone with SHBG, ferritin and TSH map the common causes - not oestradiol alone.

  • Hair loss or acne

    An androgen panel (testosterone, SHBG, DHEAS) helps sort menopause changes from PCOS or thyroid disease.

  • Irregular bleeding

    Bloods can support investigation, but new heavy or post-menopausal bleeding needs gynaecology, not a private panel.

  • Thyroid overlap

    TSH is nearly always worth doing alongside - it changes the answer often enough to be routine.

  • Vitamin D and iron

    Cheap, correctable, and often the reason symptoms feel worse than the hormone picture suggests.

  • HRT already started

    Monitoring is not usually needed on standard body-identical HRT - symptom response guides the dose.

  • No periods, unclear

    Hysterectomy, coil in situ or long-cycle absence - bloods help where the clinical pattern alone is not enough.

Interpretation

How the numbers are read.

  • FSH: an FSH above 30 IU/L on two samples 4-6 weeks apart supports menopause or POI. A single reading is rarely diagnostic.
  • Oestradiol: variable in perimenopause. A low reading fits the picture but does not confirm it.
  • Testosterone: reported as total and free (calculated) with SHBG - free testosterone is the meaningful number.
  • TSH: read against the lab reference range. An out-of-range TSH explains menopause-mimicking symptoms often enough to justify the test.
  • Vitamin D: below 50 nmol/L is deficient and worth supplementing - cheap, safe and often symptomatic.

Limits

What bloods do not tell you.

Being clear about what the test cannot do is as important as running it.

  • They do not predict timing

    No blood test tells you when menopause will happen precisely. AMH gives a rough ovarian reserve marker, not a date.

  • They do not decide HRT

    The decision to start HRT is clinical: symptoms, risks, preferences. Numbers inform it, but do not make it.

  • They do not screen HRT safety

    A hormone panel does not exclude breast, cardiovascular or VTE risk. That is a proper history and, where relevant, imaging.

What matters more

The four things that actually move the plan.

A blood test is one input. These are the others - and they matter more than most numbers on the report.

  • Symptom assessment

    A structured score - vasomotor, sleep, mood, cognitive, urogenital - not a vague chat.

  • HRT trial per NICE

    Treat symptoms, not blood tests. A time-limited trial is often the fastest route to an answer.

  • Cardiovascular risk

    A proper CV risk assessment shapes route (transdermal vs oral) and preparation choice.

  • BMI, lifestyle, family history

    Weight, smoking, alcohol and family history of breast cancer, VTE and osteoporosis all inform the decision.

Indicative cost

What a private menopause blood panel costs in London.

Add a GP or menopause specialist consultation to interpret the report: typically £150-£350.

Panel Indicative range
Single FSH £45-£85
Full menopause panel (FSH, LH, oestradiol) £180-£350
Comprehensive (adds thyroid, vitamin D, HbA1c) £250-£450
Panel + specialist consultation £400-£800

Where to get it

London providers we work with.

Menopause-literate clinics with UKAS-accredited laboratory partners and, where appropriate, BMS-accredited specialist review.

  • Randox Health
  • Medichecks (postal)
  • London Medical
  • Nuffield Health
  • The Menopause Clinic Marylebone
  • Newson Health Menopause Centre
  • HCA Wellington Women's Health
  • Chelsea and Westminster Private Menopause

Newson Health guidance

The Newson Health approach is aligned to British Menopause Society standards: individualised HRT choice, consideration of testosterone add-back for persistent low libido, and regular review rather than one-off tests. It is a useful benchmark for what good menopause care looks like in London.

Frequently asked

Menopause blood panel - your questions.

  • Do I need to fast for a menopause panel?

    Not for hormones. If HbA1c or a lipid panel is included, an overnight fast is usually preferred for the lipids - HbA1c does not require fasting.

  • When in my cycle should I be tested?

    If you are still cycling, FSH and LH are typically checked on day 2-5. Progesterone, if included, is taken 7 days after ovulation (day 21 in a 28-day cycle). Once periods have stopped, timing does not matter.

  • Does insurance cover a menopause panel?

    Screening bloods are usually self-funded. Where symptoms are severe or POI is suspected, some insurers cover consultation and investigations - we check with your insurer before you book.

  • Why do hormones fluctuate so much in perimenopause?

    Ovarian function does not switch off in a straight line. FSH and oestradiol can swing week to week, which is why a single reading is often misleading and NICE prefers a symptom-based diagnosis over 45.

  • Will a blood test tell me the right HRT dose?

    No. HRT is titrated to symptoms. Oestradiol monitoring is occasionally useful on transdermal HRT if response is poor, but standard practice is to treat symptoms, not numbers.

  • I am over 45 - do I really not need any tests?

    Per NICE NG23, women over 45 with typical menopausal symptoms do not need blood tests to diagnose menopause. Tests are still worth doing to check thyroid, iron, vitamin D and cardiovascular risk before HRT - but not to confirm menopause itself.

Ready when you are

Bloods, interpreted properly - and HRT if it fits.

Tell us what is going on. We match you to a BMS-accredited menopause specialist and confirm cost and timings within one working day.

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