What Hormones To Test For In Menopause – A Personal Journey

“Deal with it sugar, this is what it’s like to be a woman.”

That feels like the message we’ve been receiving since our first period cramp. 

And so we soldier on, ignoring our bodies’ cries for help.

Accepting exhaustion.

Accepting depression.

Accepting feeling like shit.

Accepting pain.

Accepting metabolism shifts.

Accepting tissue atrophy. Face or vagina. You pick it.

Accepting lack of sexual desire.

MenoPAUSE. Are you kidding me? MenoFULL-STOP.

no one wants to win on this card

We survive and thrive through life and end up here in our 40’s and beyond with a foggy mind, mood swings, hot flashes, vaginal dryness, and our clothes are tight. When we look for help our health care provider tells us our test results are in “normal range” and you are in menopause. 

So that’s it? 

First of all, we are not old, we are not done and we sure as hell don’t deserve to feel like crap. We are at this magical moment when we get to “pause”. We get to sit back and reflect on all of our triumphs and failures. We get to feel great about it all and set forth on this new era with all of the lessons we have cultivated and choose what we want to do with it all. Who do we want to be now? What do we want our lives to look and feel like now? 

It’s a second (or third or fourth depending on your path) act. It is a time for reflection and reinvention.

But do you know what we need to “pause” and ponder and choose? 

Energy. 

A clear mind.

An ability to connect to our partner and/or people in our lives.

Not to feel dead inside.

Before the moment of the desperate reach out to our doctor we have been “dealing” with some crazy making changes inside of us.

My Story

For me, I was fooled by an “easy” experience of one hot flash and strange occurrences of irregular menstrual periods until they just stopped. I had my last period and I thought, “ huh so easy, I’ve got this!”

But I didn’t.

When I think back after the disappearance of my period, I remember a year or two of insane migraines. I saw all of the doctors in the medical and naturopathic worlds. I had our house tested for mold. I went down every path to uncover the source of my grueling pain. 

Reflecting back, was it hormone imbalance? No one even brought it up as a possibility. Let me report that I am currently doing HRT pellets and when my hormone balance gets low, I get a migraine. It is definitely a symptom that would have me suggesting to you to have your blood levels checked – oh and by someone who believes that menopause is supportable!

Next, I went through an emotionally stressful and depleting year. That shut down my system and I ended up 2+ sizes up in my clothes what felt like overnight. That hurt my being, my confidence, my sexiness. 

Add to it a drying vagina, painful sex, a loss of wanting to have sex all together and the shakiness of trying to explain what was happening to me to my “but I still want you and think you are gorgeous”, loving husband. I felt broken, listless, and dead inside.

Then we moved and I set up a new house and I blamed my lack of energy, inspiration, and mojo on all of the stress and excitement of that chapter. And my crazy sleep disturbance? I blamed that on everything BUT my hormonal changes and menopause transition.

I had no idea that what I was experiencing was not normal. 

I was suffering.

I didn’t have to.

Neither do you.

I was embarrassed and confused about what was happening inside of me and in my relationship. I felt lost and I was struggling quietly. When I opened up the conversation to some close friends I realized they were suffering quietly too. I was upset that we were all doing this hard journey alone and that’s when Kimby and I started talking about all things Midlife. 

No more going it alone. No more suffering quietly. 

Finally I landed at a woman doctor’s office who said do you feel like…. 

Everything she said was everything I was dealing with. She had the experience of these symptoms and of relieving them for herself and the knowledge on how to get through it. It was like she lit a match inside of me. I felt seen, supported, and hope for my situation filled my being which had been missing for too long. 

She suggested it would be a good idea to get a blood sample to test my progesterone levels, estradiol levels, my free testosterone, testosterone levels, and a whole bunch of other stuff. My hormone production levels were hardly enough to even register on my blood work. Scary. 

She asked how I even got out of bed in the morning! She explained that my low levels put me at higher risk for a whole bunch of terrible things. A woman’s body needs the hormones to keep her heart and bones strong and not having your levels balanced out correctly could even lead to breast cancer and… I think I missed the rest of the list. I was convinced this was important. I no longer felt I was crazy and dead inside. Now I felt I had a treatable health condition. I was relieved.

I am sharing this to say if you are having any of these symptoms or any off things happening in your body, please reach out and gather the information about your body that you need to make the right choices for you. Of course, rule out anything other than menopause with your doctor, but if you end up with the “Sugar it’s menopause and just deal with it” diagnosis… please don’t.

Below are some important things to check for in your blood to gather information. Remember not all doctors read the “ normal range ” the same. Make sure you are speaking with a healthcare provider who specializes in Menopause as ranges are vastly different in different practices. Find a health care practitioner who you feel seen and heard by and can support you in the way you need it.

Menopause Is A Date, Not A Process

Menopause marks the end of a woman’s reproductive years. It occurs when a woman’s ovaries stop producing eggs and her levels of the hormones estrogen and progesterone decline.

Menopause is considered to have occurred when a woman has not had a menstrual period for 12 consecutive months. The average age of menopause is 51 years old, but it can occur as early as the mid-30s or as late as the early 60s.

menopause: the date you are 12 months without a period

The transition to menopause, known as perimenopause, is the process of reaching that date of menopause and can start several years before the final menstrual period and can last for several years after.


Common Symptoms DURING Perimenopause, Continuing AFTER Menopause

Hot Flashes
Read about hot flashes and they’re described as “sudden feelings of warmth that spread over the face and upper body”. Well doesn’t that sound cozy and comforting? The reality is you feel dangerously close to spontaneously combusting due to the Chernobyl meltdown happening in your core. The subsequent outpouring of sweat is equally delightful.
Night Sweats
Night sweats are hot flashes that occur during sleep, leading to drenching sweats, difficulty sleeping, and the need to invest in a few extra sets of sheets so you’re not doing the laundry EVERY day.
Vaginal Dryness
Estrogen helps to keep the vagina moist and elastic. During menopause, decreased estrogen levels can cause the vagina to become dry and less elastic. I love when this is described as leading to “discomfort during sex”. More like vaginal rope burn. 
Mood Changes
Menopause and perimenopause can cause changes in mood, including feelings of irritability, anxiety, and depression. Many doctors rush to just prescribe an SSRI. That does work for many. But also, adjusting your hormones may bring equal, if not greater relief.
Changes In Sexual Function Item
Decreased estrogen levels can cause changes in sexual function, including a decrease in libido, and difficulty achieving orgasm. Don’t be surprised if your labia seem to shrink to pre-pubescent volumes. In other words, not DTF.
Sleep Problems
Hot flashes and night sweats can disrupt sleep and lead to insomnia or other sleep problems. And guess how well you cope with stress, anxiety, and depression when you haven’t been sleeping well?
Changes In Hair And Skin
Menopause and perimenopause can cause changes in hair and skin, including dry skin, thinning hair, and hair loss. Fun! Don’t we feel pretty.
Weight Gain
Some women may gain weight during menopause and perimenopause due to changes in metabolism and hormone levels. Some women report an increase in belly fat. Yay!
Memory Problems
Some women may experience memory problems or difficulty concentrating during menopause and perimenopause.

Hormone Testing – Menopause Testing

This list is compiled based on the testing we here at The Midlife went through. Use this as anecdotal evidence to start a conversation with your doctor about checking your levels for these common hormones. If you meet with resistance about this conversation or if you fall in “normal” ranges, but know you don’t feel right, don’t hesitate to interview a new practitioner. Many doctors are stuck in the dark ages when it comes to willingness to proactively help women feel not just better, but amazing in Midlife.

And you are entitled to “amazing”.

testing to prepare for hormone replacement therapy
  • ESTRADIOL/ESTROGEN: Your level of estrogen is really the gold standard of menopause. Estrogen is a hormone produced by the ovaries that plays a role in the development of female secondary sexual characteristics and the regulation of the menstrual cycle. Low levels of estrogen can cause menopausal symptoms such as hot flashes and vaginal dryness.
  • PROGESTERONE: Progesterone is a hormone produced by the ovaries that helps to regulate the menstrual cycle and prepare the uterus for pregnancy. Low levels of progesterone can cause irregular periods and menopausal symptoms such as hot flashes and mood changes.
  • FOLLICLE STIMULATING HORMONE (FSH): FSH is a hormone produced by the pituitary gland that helps to regulate the menstrual cycle and stimulate the ovaries to produce estrogen. High levels of FSH may be a sign of menopause or other hormonal imbalances. 
  • LUTENIZING HORMONE (LH): LH is a hormone produced by the pituitary gland that helps to regulate the menstrual cycle and stimulate the ovaries to release an egg. High levels of LH may be a sign of menopause or other hormonal imbalances.
  • Testosterone: Testosterone levels in women decline as they age, including during menopause. Low levels of testosterone can result in decreased energy, decreased sex drive, and decreased muscle mass, among other symptoms. Checking testosterone levels in menopausal women can help determine if low testosterone levels are contributing to these symptoms and if testosterone therapy might be beneficial. Managing levels is imperative so you don’t suffer unwanted side effects like hair growth and acne.
  • Ferritin: Ferritin is a protein that stores iron in the body. During menopause, women are at increased risk for iron-deficiency anemia, which can result from the decreased levels of estrogen. Checking ferritin levels can help determine if you are iron deficient and if you might benefit from iron supplementation. Additionally, low ferritin levels can also be a sign of other underlying health conditions, so measuring ferritin can provide important information about your overall health status.
  • TSH: Thyroid-stimulating hormone (TSH) levels can be a key indicator of thyroid function and can impact menopausal symptoms such as fatigue, weight changes, and mood swings. Abnormal TSH levels can indicate hypothyroidism or hyperthyroidism, which can mimic or worsen menopausal symptoms, so it is important to check TSH levels when testing hormones during menopause.
  • Pregnenolone: Pregnenolone is a hormone that is produced by the adrenal glands and is considered a “parent hormone” because it can be converted into other hormones, including estrogen and testosterone. Checking pregnenolone levels can help determine if your adrenal glands are producing adequate amounts of this hormone and if hormone replacement therapy, including pregnenolone, might be beneficial. Additionally, pregnenolone levels can provide important information about your overall hormonal balance and adrenal function.
  • Thyroglobulin Antibodies & Thyroid Peroxioxidase Antibodies: These are markers of autoimmune thyroid disease, including Hashimoto’s thyroiditis, which is a common cause of hypothyroidism. During menopause, women are at increased risk for autoimmune diseases and thyroid problems, and checking for TG antibodies can help determine if autoimmune thyroid disease is present. Elevated levels of TG antibodies indicate the presence of an autoimmune response against thyroglobulin, a protein produced by the thyroid gland, which can cause damage to the thyroid and lead to hypothyroidism. Measuring TG antibodies can therefore provide important information about your thyroid health during menopause and help guide the decision about whether or not to pursue further testing or treatment for thyroid disease.
  • T4 (Thyroxine): Thyroxine is a hormone produced by the thyroid gland that plays an important role in regulating metabolism. We know how well that’s going in menopause…
  • T3 (Triiodothyronine): T3 a hormone produced by the thyroid gland that plays an important role in regulating metabolism. T3 is the more active form of thyroid hormone, and it is responsible for many of the metabolic effects of thyroid hormone in the body. During menopause, women are at increased risk for thyroid problems, including hypothyroidism, and checking T3 levels can provide important information about a woman’s overall thyroid function. Measuring T3 levels along with T4 levels can give a more complete picture of a woman’s thyroid function during menopause and help guide the decision about whether or not to pursue further testing or treatment for thyroid disease. Additionally, monitoring T3 levels can help monitor the effectiveness of any thyroid hormone replacement therapy a woman may be receiving.

It is important to note that hormone levels can fluctuate and may not always be indicative of menopause or a hormonal imbalance. Your doctor will consider your symptoms and medical history, as well as the results of your hormone tests, to determine the best course of treatment for you.

Ask Your Doctor To Check These Nutrients

During menopause, it is important to maintain overall good health, which includes getting enough of certain nutrients. When getting your blood work done these are some vitamins and minerals that are particularly important for menopausal women to have checked for the levels available in their blood.

  • VITAMIN D: Vitamin D is important for bone health and may also play a role in reducing the risk of certain diseases, including heart disease and certain types of cancer. Many menopausal women may be at risk for vitamin D deficiency due to reduced sun exposure and decreased vitamin D production in the skin.
  • CALCIUM: Calcium is important for bone health and may also help to reduce the risk of osteoporosis, a condition that can occur during menopause due to decreased estrogen levels and an increase in bone loss.
  • IRON: Iron is important for carrying oxygen in the blood and supporting immune function. Menopausal women may be at risk for iron deficiency due to decreased estrogen levels, which can cause irregular periods and increased blood loss.
  • VITAMIN B12: Vitamin B12 is important for nerve function and the production of red blood cells. Menopausal women may be at risk for vitamin B12 deficiency due to decreased stomach acid production, which can interfere with the absorption of this vitamin.
  • DHEA (dehydroepiandrosterone) is a hormone produced by the adrenal glands, ovaries, and testes. It can be converted into other hormones, including estrogen and testosterone, in the body. Some studies have suggested that DHEA supplements may have potential benefits for menopausal women, including reducing menopausal symptoms such as hot flashes and improving sexual function.

If you are found to be deficient in any of these nutrients, your doctor may recommend supplements or dietary changes to help you meet your recommended daily intake. It is important to talk to your doctor before taking any supplements, as they can interact with certain medications and have potential side effects.

Some Of Your Treatment Options

Menopausal hormone replacement therapy (HRT) involves taking hormones to replace the hormones that are no longer being produced by the ovaries. HRT can be used to treat menopausal symptoms such as hot flashes, night sweats, and vaginal dryness. There are several different types of HRT available, including:

  • ORAL HORMONE THERAPY: This type of HRT involves taking hormones in the form of a pill. Oral HRT is available in combination (estrogen and progesterone) or single-hormone (estrogen only) formulations.
  • TRANSDERMAL HORMONE THERAPY: This type of HRT involves applying hormones in the form of a patch, gel, or cream to the skin. Transdermal HRT can be more effective at relieving menopausal symptoms than oral HRT because it avoids the liver and delivers a more consistent level of hormones to the body.
  • VAGINAL HORMONE THERAPY: This type of HRT involves using hormones in the form of a cream, suppository, or ring to treat vaginal symptoms such as dryness and pain during sex. Vaginal HRT is usually used in combination with other HRT methods.
  • PELLET THERAPY: Pellet therapy involves the insertion of small, rice-sized pellets made of hormones under the skin. The pellets release a consistent, low dose of hormones over a period of several months. This is what Kimby and I are trying. The results have been excellent for us.

It is important to talk to your doctor about the potential risks and benefits of HRT before starting treatment. Your doctor can help you determine the best treatment approach for your menopausal symptoms.

Menopausal hormone replacement therapy (HRT) is a treatment option for women experiencing menopausal symptoms such as hot flashes, night sweats, and vaginal dryness. HRT involves taking hormones, usually in the form of a pill, patch, or cream, to replace the hormones that are no longer being produced by the ovaries.

Does HRT Give You Cancer?

Our mother’s generation was all gung ho on the HRT. Then they were all told to stop immediately because of a spike in cancer, heart attacks, clots, and strokes. As HRT and specifically bioidentical HRT has made it’s way back into the conversation, many of us are understandably skeptical.

Here’s the deal. The initial study had huge design flaws in the age and health status of the sample participants AND the type and combinations of HRT used.

 Some experts have argued that the study was not representative of the general population of postmenopausal women, as the participants were older, like 10+ years post menopausal, and had a higher risk of chronic disease to begin with.

Additionally, the type of HRT used in the study (a combination of estrogen and progestin) is not representative of all types of HRT, and some experts have argued that this combination may increase the risk of cancer and other health problems compared to other types of HRT, such as bioidentical hormones.

It’s important to keep in mind that the association between HRT and cancer risk is complex and varies based on individual factors, such as age, medical history, and lifestyle. 

Talk to your doctor, but much of the research shows you can begin BHRT as early as onset of symptoms, even if that means in your 30’s, and that even women who started taking BHRT after 60 received benefit. 

Our Best Advice

Bottom line, this is a very personal decision to be made by you and your doctor. Our best advice is to be armed with questions and research and don’t take “no” for an answer until you find a course of treatment that works for YOU, even if that means interviewing lots of different doctors.

We hope that by sharing our experiences and creating a safe space for more women to share their journey, we will learn from the hive mind and all thrive.

If you have any questions or comments about this topic or any other facet of Midlife, feel free to join our private Facebook group Muddling Through The Midlife, come hang our with us on Wednesdays on The Midlife Podcast when we have a LIVE audience and you can chat directly with us (sign up here for the link), or email us directly at tracyandkimby@themidlife.co


Download our handy hormone checklist to start the discussion with your doctor.