How to Read Your Bloodwork in Perimenopause (Without Losing Your Mind)

Let’s be real: staring at a blood test feels a lot like reading a foreign language. Numbers, ranges, acronyms... What does it all mean, and how do you know what’s “normal” when you don’t feel normal?

If you’re in your 30s, 40s, or early 50s and feeling off — tired, moody, bloated, anxious, foggy — your hormones are probably shifting hooray! You’re likely in perimenopause, and bloodwork can MAYBE help give you clues. But spoiler alert: even if your labs come back “normal,” that doesn’t always mean everything is actually fine. And we wonder why this things is so challenging...

• First, What Even Is Perimenopause?

Perimenopause is the transition phase before menopause. It can start as early as your mid-30s (yep) and last for years (upto 10 years). Hormones like estrogen and progesterone start to fluctuate wildly, which can cause symptoms even when bloodwork is still in the “normal” range. You can even be in perimenopause long before you start having challenges with your monthly cycle. So how do you know...

Think of all this fun, like hormonal puberty... in reverse. 😅 Ok, please don't hate me I was trying to be funny...

The Hormones to Pay Attention To

Progesterone:

The chill pill hormone.

• If it’s low, you might feel anxious, can’t sleep, or want to punch people pre-period.

• It drops first in perimenopause, your body definitely notices.

Estradiol (Estrogen):

The diva.

• When it’s high: bloating, mood swings, maybe crying over a commercial.

• When it’s low: hot flashes, dryness, and nope in the libido department.

• In perimenopause, it can be BOTH. (Because hormones love drama.)

FSH & LH:

The “hellooo?!” texts from your brain to your ovaries.

• High = your ovaries aren’t picking up the call.

• Good to track if you’re wondering, “Am I there yet?

Testosterone

• Your a female, you still got it! This matters more than you think...

• Low = tired, low libido, muscle loss, the "blah" vibe

  
  

Ok wait... You just mentioned all these things about my labs... But my doctor said my labs were “Normal” and I STILL Feel Awful?

Welcome to the hormone twilight zone. Bloodwork doesn’t always reflect the wild swings that happen day-to-day in perimenopause. Many women feel dismissed because their labs look “fine.”

That’s why you should always look at your symptoms. You know your body better than anybody, so if something feels off, it probably is. Best to look into it before it's so off you want to bite your husband's head off, or worse off your bosses... So look at labs over time, is there a difference, maybe you are still in the range, but your "normal" range is different than the average persons.

Other Labs to keep an eye out for

If you’re trying to get a full picture, here are a few other labs to look out for:

• Thyroid (TSH, Free T3, Free T4): Thyroid symptoms often mimic hormone issues.

• Vitamin D, B12, and Magnesium: Low levels can make perimenopause symptoms worse.

• Insulin and A1C: Blood sugar crashes = hormone chaos.

• CRP and Ferritin: Inflammation and iron levels can affect energy and mood.

Bonus Tips

• If you test your hormones at the same time of cycle (days 19-21) you will get more consistent results.

• Track symptoms and labs — you’re not just numbers.

• Don't settle for "you're just getting older" — your body deserves better.

  
  

Perimenopause isn’t just hot flashes and missed periods. It’s a full-body shift that starts before the “official” menopause diagnosis. And learning to read your bloodwork is one way to take back control and give yourself the support you need and deserve.

Wanna go deeper (without the medical jargon)?

Come hang out in my FB group where we decode all this stuff in normal human language. No white coat required — just messy buns, real talk, tea, and maybe sometimes even something harder.

👉 Perimenopause Support Group