How is menopause diagnosed?

For many women, signs like hot flushes, irregular periods, mood swings, or brain fog start to appear in their 40s, but menopause doesn’t follow a strict timeline. Some experience symptoms earlier, others later, and not everyone has the same signs. So how do you know when it’s actually menopause? Is it something a blood test can confirm? Or can your GP tell just from your symptoms?

The answer is both simpler and more complex than you might think.

It starts with your symptoms

For healthy women, trans men, and non-binary people assigned female at birth who are 45 or older, menopause is usually diagnosed based on symptoms alone. If you’re having hot flushes, night sweats, or mood changes, and your periods are changing in frequency or intensity, you may be entering perimenopause, the transitional stage before menopause officially begins.¹

Menstrual patterns vary from person to person. Your cycle may shorten to just two or three weeks, stretch out for months, or become heavier or lighter than usual. The key sign of menopause itself is going 12 consecutive months without a period, while not being on hormonal contraception.¹ In people who’ve had a hysterectomy, diagnosis is based on symptoms alone.

This natural process doesn’t always follow a clear pattern. For many, it’s more of a slow drift than a sudden shift.

Can I test for menopause?

Whether you’re noticing symptoms or just want to understand where your hormone levels stand, a blood test can offer valuable insight. While FSH (follicle-stimulating hormone) is often used to assess menopause (especially in women under 45), other key markers such as your vitamin and thyroid levels can be measured to give a broader view of your hormonal health.¹

Because hormone levels fluctuate, a single result might not be able to give you a definitive diagnosis.¹ That’s why tests are most useful when combined with your symptoms and medical history. They can also help rule out other conditions, such as thyroid disorders, that can mimic menopause.

If menopause is suspected under age 40 (known as premature ovarian insufficiency), more detailed testing and referral to a specialist may be recommended.

It can be tricky to spot in some circumstances

For people using hormone-based treatments like the contraceptive pill or hormone replacement therapy (HRT), menopause can be trickier to spot. These treatments can mask or alter symptoms, making diagnosis less clear-cut. In such cases, your GP may look at your broader health picture and help you plan ahead.¹

Ethnicity and underlying health conditions can also influence when menopause begins. For example, people with Down’s syndrome or certain autoimmune conditions may experience menopause earlier than average.¹

Why getting a menopause diagnosis matters

Knowing where you are in the menopause journey can help you plan for the future. It allows you to weigh up options for symptom management, including HRT, lifestyle changes, and nutritional support, and can also guide decisions around contraception, bone health, and long-term wellbeing.

The numan take

If you’re getting to the average age of the onset of menopause and you’re not sure why you’re not feeling quite like yourself, then having a menopause blood test can pinpoint you towards the next steps. Importantly, diagnosing menopause requires keeping track of your symptoms and checking in with a healthcare provider, as this can help you make sense of the changes  and feel more in control.

References

Diagnosis of menopause and perimenopause. Org.uk. https://cks.nice.org.uk/topics/menopause/diagnosis/diagnosis-of-menopause-perimenopause/ [Accessed 15th July 2025].