Understanding Hormone Testing After 40: A Deep Dive into Perimenopause

Turning 40 can feel like standing on the edge of a new chapter. For many women, this is when subtle, or not-so-subtle, changes begin: sleep feels lighter, moods swing harder, cycles become less predictable, and the body doesn’t respond the way it used to.

Often, these shifts are the early signs of perimenopause, the transitional stage leading up to menopause. But here’s the challenge: many of these symptoms overlap with thyroid conditions, stress, or just general midlife changes. That’s why hormone testing can be so useful - not as a crystal ball, but as a powerful tool to help you understand what’s really going on inside your body.

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The Stages of Hormonal Change

Hormonal changes don’t happen overnight. They unfold gradually, often across a decade or more.

• Reproductive years (20s–30s): Cycles are fairly regular; hormones follow a predictable pattern.
• Early perimenopause (early 40s): Periods start arriving closer together or further apart, PMS worsens, sleep gets patchy. Progesterone is usually the first hormone to dip.
• Late perimenopause (mid 40s–early 50s): Estrogen levels swing from very high to very low. You may have months of heavy bleeding followed by skipped cycles. Hot flashes, night sweats, brain fog, and mood changes often appear.
• Menopause (average age 51): Defined as 12 months without a period. Estrogen and progesterone settle at consistently low levels.
• Post-menopause: Symptoms may settle, but low estrogen continues to affect long-term bone, heart, and brain health.

The First Signs Things Are Changing

For many women, the earliest hormonal shifts are easy to miss. Common “first flags” include:

• Periods arriving closer together (shorter cycles)
• Sleep becoming more disrupted, especially mid-cycle
• PMS symptoms worsening (more intense mood changes, bloating, or breast tenderness)
• Feeling more anxious or wired, particularly before a period
• Changes in bleeding: heavier flow, clots, or spotting

These often reflect falling progesterone (from irregular ovulation), while estrogen is still relatively strong. That’s why early perimenopause can feel like an intensification before things eventually quieten down.

The Key Hormones to Consider

A typical hormone panel might include 8–10 different markers. Here’s what they do, and how they link to symptoms:

Hormone	Why It Matters in Perimenopause
FSH (Follicle-Stimulating Hormone)	Rises as ovaries become less responsive; signals perimenopause but fluctuates a lot
LH (Luteinising Hormone)	Works with FSH to trigger ovulation; irregular surges = irregular cycles
Oestradiol (Estrogen)	Swings high and low; drives both heavy bleeding and hot flashes
AMH (Anti-Müllerian Hormone)	Reflects ovarian reserve; useful for understanding overall fertility window but not diagnostic on its own
Progesterone	Drops early; linked to sleep, calmness, and lighter periods
TSH / Free T4 (Thyroid Hormones)	Rule out thyroid disease, which mimics menopause symptoms
Prolactin	High levels disrupt cycles; can be raised by stress or medication
Testosterone / DHEAS	Support libido, muscle tone, and mood; decline with age but relative excess can cause acne or hair changes
SHBG (Sex Hormone-Binding Globulin)	Affects how much “free” hormone your body can actually use

What This Really Means in Daily Life

• FSH & LH: When your ovaries become less sensitive, your brain shouts louder with FSH and LH. High levels often show up as irregular cycles, hot flashes, or brain fog.
• Estrogen (Oestradiol): Too much = bloating, heavy periods, sore breasts. Too little = hot flashes, vaginal dryness, low mood. The swings can be dramatic.
• Progesterone: The calming hormone. When it dips, sleep worsens, anxiety rises, and bleeding can become heavier.
• AMH: Think of it as a measure of “egg supply.” It steadily drops with age, but it doesn’t directly explain symptoms.
• Thyroid (TSH / Free T4): Low thyroid function looks very similar to perimenopause (fatigue, weight gain, mood dips). That’s why it’s crucial to test.
• Prolactin: Stress, certain meds, or benign pituitary issues can raise this - mimicking perimenopause by stopping periods.
• Testosterone / DHEAS: Support energy, libido, and muscle. Low = fatigue and low desire. High = chin hair, acne, or hair thinning.
• SHBG: Acts like a hormone “taxi.” If levels are off, it changes how much hormone is actually available for your body to use.

When Is the Right Time to Test?

This is one of the most common (and most confusing) questions.

• Cycle day matters (if cycles are regular):
• FSH, LH, and estrogen are best tested on day 2–5 of your cycle.
• Progesterone is best tested about 7 days before your period.
• But in perimenopause: Cycles can be all over the place. Sometimes a “spot check” is still useful, even if it’s not on an exact day. Doctors will look for patterns rather than single numbers.
• If your periods are irregular or absent: A hormone panel can help rule out thyroid issues, premature menopause, or other conditions.

Signs it’s time to consider testing:

• Cycles shorter than 24 days or longer than 35 days
• Noticeably heavier or lighter bleeding
• Hot flashes or night sweats before age 45
• Sudden anxiety, sleep disruption, or mood changes out of sync with your usual pattern
• Fatigue that doesn’t improve with rest or lifestyle changes

What Testing Can (and Can’t) Tell You

What it can do:

• Explain why symptoms are happening
• Rule out other causes like thyroid or prolactin issues
• Give you a baseline to track changes over time
• Help guide decisions about HRT or lifestyle support

What it can’t do:

• Predict the exact year you’ll reach menopause
• Capture every fluctuation (hormones change daily, even hourly)
• Replace the bigger picture of your health and medical history

Next Steps After Testing

• Discuss HRT (Hormone Replacement Therapy): If symptoms are disruptive, HRT can restore hormone balance.
• Make lifestyle adjustments: Nutrition, exercise, and stress management all affect hormones.
• Retest later: A year on, or sooner if symptoms change significantly.
• Seek specialist care: At-home testing services like Hertility offer personalised panels and reports, designed with women’s midlife health in mind.

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What sets Hertility’s Advanced At-Home Hormone & Fertility Test apart?

A Personalised, Clinically Sound Approach

Rather than a one-size-fits-all panel, Hertility starts with a brief Online Health Assessment of your symptoms, cycle, lifestyle, and goals. From there, they tailor a test that checks up to 10 key hormones (like AMH, FSH, estrogen, thyroid markers, testosterone, SHBG, prolactin, DHEAS) based on what your body needs.

This customisation ensures you’re not tracking unnecessary markers, only what’s clinically relevant to your stage of life.

Fast, Convenient, and Supportive

• Testing turned around in just 6 days. Need clarity fast? Hertility delivers results quickly, no long waits.
• All done at home. No hospital visits or invasive appointments, just a finger-prick test that you can complete with ease.
• A full expert follow-up. Your results come with a doctor-written report, a personalised Care Plan, and a Clinical Result Review Call included at no extra cost.

Built On Clinical Rigor and Real Impact

Hertility operates under clinical standards and certifications. It’s UKAS-certified, CE-marked, and aligned with regulatory expectations for medical tests.

They’ve already helped hundreds of thousands of women gain insight into symptoms like fatigue, irregular cycles, and hormonal imbalances, delivering clarity, diagnoses, and next steps in a compassionate way.

• Around 74% receive a potential diagnosis based on their test panel and symptom profile.
• Trustpilot reviews highlight how clear, supportive, and empowering the experience is. For instance: “Results were clear—plus that follow-up call made everything crystal.”

A Thoughtful, Whole-Body Perspective

Unlike narrow kits that only check a few hormones, Hertility takes a holistic view: examining thyroid, ovarian reserve, and reproductive balance together. That broader lens means you’re not missing a potentially more relevant answer.

Why This Matters

Yvidét stands for clarity, confidence, and caring wellness - not quick fixes or buzzwords. Hertility matches that spirit:

• Evidence-based approach, not guesswork. Clinical grade testing + expert analysis = solid insight.
• Empowerment over overwhelm. It offers answers, not anxiety, with support every step of the way.
• Tailored for midlife. Recognising perimenopause, changing fertility, thyroid, and stress-related changes - all in one place.

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Yvidét Edit

Hormone testing after 40 isn’t about chasing perfect numbers. It’s about understanding your body’s unique rhythm as it moves through perimenopause. The right test, at the right time, can bring clarity, rule out other issues, and help you make empowered choices about the years ahead.