Do You Need a Blood Test to Diagnose Menopause?

Many women entering their 40s and 50s begin to experience changes that can feel confusing, frustrating—and at times, overwhelming. Hot flushes, mood swings, low energy, sleep disruption, and unexpected weight gain are just a few of the symptoms associated with menopause and perimenopause.

But how do you know for sure if you’re going through “the change“? And how can you feel confident that your treatment plan is right for your body?

That’s where blood testing comes in. While it’s not always offered as standard in NHS menopause care, private menopause clinics like Bodyline have found that blood testing can play a vital role in understanding hormonal changes and tailoring treatment more effectively.

Why Blood Tests Aren’t Always Offered for Menopause Diagnosis

If you’re over 45, the NHS usually diagnoses menopause based on your age, menstrual changes, and common symptoms like:

• Hot flushes and night sweats
• Mood changes or anxiety
• Irregular or stopped periods
• Fatigue or brain fog
• Vaginal dryness or discomfort during sex

Because these symptoms are considered classic signs of menopause, blood testing is typically skipped—especially in NHS settings where guidelines (like those from NICE) recommend clinical judgement over lab testing.

However, this can lead to a one-size-fits-all approach to HRT and menopause treatment and support, leaving many women with unanswered questions and treatment that doesn’t feel quite right.

How Blood Tests Can Help During Menopause

Even if you’re showing typical signs of menopause, blood tests can still offer valuable insights—particularly in complex cases, or when symptoms overlap with other health conditions like thyroid disorders, PCOS, or chronic fatigue.

What Can Blood Tests Reveal?

• FSH (Follicle Stimulating Hormone): High levels typically indicate menopausal transition.
• Oestradiol (a form of oestrogen): Helps assess hormone decline.
• Testosterone and DHEA-S: Linked to libido, energy, and mental sharpness.
• TSH (Thyroid Stimulating Hormone): Rules out thyroid dysfunction, which shares symptoms with menopause.
• Vitamin D & B12: Low levels can worsen fatigue, brain fog, and low mood.
• SHBG and FAI (Free Androgen Index): Indicate how effectively your body is using its hormones.

Together, these results help build a clearer picture of what’s going on inside your body, especially when symptoms don’t tell the full story.

When Is Blood Testing Essential?

Women Under 45

If you’re younger than 45 and experiencing menopause-like symptoms, blood testing is often essential to confirm the diagnosis and rule out other causes.

What About Women Already on HRT?

Even if you’re already taking HRT, blood tests can still be useful in many cases. While oestrogen and progesterone levels might be altered by treatment, testing can:

• Check if your hormone levels are within an optimal range
• Detect imbalances like oestrogen dominance, which can mimic deficiency symptoms
• Guide adjustments to your dosage or delivery method

Why More Women Are Turning to Private Clinics for Menopause Testing

NHS care often lacks baseline hormone testing, partly due to budget constraints and partly because of outdated guidelines. This can lead to:

• Poorly matched HRT plans
• Longer trial-and-error periods
• A lack of confidence in treatment outcomes

In contrast, private clinics like Bodyline take a data-led, personalised approach that prioritises the individual—not just the average.

Our patients often tell us that having blood test results in hand helps them feel more informed, more in control, and more confident in their treatment journey.  Bodyline has life changing success stories of patients that are supported and treated on a personalised basis. 

Can a Blood Test Explain Menopause Weight Gain?

Yes—and no. While hormones aren’t the only reason women gain weight during perimenopause and menopause, they play a huge role.

Fluctuating oestrogen and progesterone levels affect:

• Fat distribution, especially around the midsection
• Muscle mass, which influences your metabolism
• Cravings and satiety, impacting how much and what you eat
• Energy levels, making exercise feel harder

By testing your hormone levels, vitamin deficiencies, and even insulin resistance, we can better understand what’s holding you back from weight loss—and create a treatment plan that works with your body, not against it.

Explore menopause and weight gain solutions with Bodyline.

Your Hormones, Your Health, Your Way

Whether you are in early perimenopause or dealing with long-term symptoms post-menopause, blood testing can help validate your experiences and unlock more effective treatment.

At Bodyline, our CQC-registered clinics and nurse-led teams provide safe, supportive, and expert menopause care and treatment. And if you’re looking for even more structure, you can opt into The M Plan, our signature personalised menopause support programme.

 Start your journey today with a hormone blood test and consultation at Bodyline either in clinic or via an online consultation in the comfort of your own home.  Call 0800 995 6036 or complete an online enquiry form for a call back.

 Bodyline works. Bodyline cares.

Contact Bodyline today to find out more about our Hormone Replacement Therapy Treatments