date posted: 8/4/2025
At 49, I’m deep in perimenopause. With the average age of menopause being 51 (the one day that marks 12 consecutive months without a period), I’m leaning into hormone testing to better understand what’s happening in my body, now, before my hormones decline further.
Many conventional doctors (and plenty of online sources) say there's no need to test during perimenopause, especially if you're still getting periods, even if they're irregular. They'll tell you age and symptoms are enough to confirm you are in the transtion. And technically, they are right. There is no single test for perimenopause.
But testing can still be incredibly valuable. It can show how your hormones are shifting behind the scenes, long before things go completely off the rails.
If you’ve ever wondered how to test your hormones in midlife, or what labs to ask for, this post will walk you through what I’m learning and why it matters.
Perimenopause symptoms aren’t always loud. Sometimes they’re subtle:
You might not connect the dots at first, but they’re often your body’s way of signaling a deeper shift.
My first perimenopause symptom happened in my early 40s, and I had no idea it was related. I noticed my cycles had started getting shorter, instead of 28 days, they were fluctuating between 25-26. I asked my OB about it and she said it was normal, but never mentioned it was a an early sign of perimenopause.
What I didn’t know then was that declining progesterone often shows up as shorter cycles, years before estrogen changes. While estrogen is getting the spotlight right now, most women don’t realize progesterone is the first hormone to decline. And when it tanks, like I’m feeling now, it can throw off the entire system, long before estrogen takes a nosedive. That’s why I chose to test now, not because I feel terrible, but because I want a proactive roadmap for what’s ahead.
Unless you’re working with a provider that specializes in midlife hormones, your regular check-up won’t usually include a full hormone workup. After discussing my goals and what I’ve been noticing, my provider recommended we run the following blood labs:
This full spectrum of labs will give me and my provider a clear picture of how my hormones are interacting with my thyroid, metabolism, and overall health.
My last blood draw showed my thyroid is starting to slow down. This is common in midlife and can trigger a cascade effect on all of your hormones.
In addition to blood labs, I’m doing a DUTCH Complete Test, a urine-based hormone test that offers deeper insights. I’ve been wanting to do this for a long time, and it’s the test I’m most excited about.
Unlike bloodwork, the DUTCH test shows how your body is processing and clearing hormones, not just how much you’re producing. It also highlights your cortisol patterns, which has a direct effect on how you feel day to day. It covers:
This kind of testing is especially helpful when symptoms are vague or when you're trying to connect the dots between hormone levels and how you actually feel. I also like it because it can point to specific ways to support your body with targeted supplements.
Here’s what I tell my clients: you can’t out-supplement or out-prescribe a poor foundation. Before considering menopause hormone therapy (MHT), the basics must be dialed in:
Hormone therapy is a tool, not a magic fix. If your foundation is shaky, adding hormones can backfire. I see it often, women jump into MHT before addressing lifestyle, and it often makes things worse before they get better.
Not every woman wants, or can, use hormone therapy. And that’s okay. You’re not stuck.
You can (and should) still support your body through perimenopause with:
These strategies can improve sleep, mood, energy, and weight stability, no prescription required.
At 49, I have minimal symptoms. I credit that to consistently focusing on the foundations: movement, nutrition, stress and sleep. While not perfect, that focus has undoubtedly kept the peskier symptoms at bay.
Here’s one more truth worth repeating: Hormones shift the playing field, but they don’t change the rules.
Fat loss still comes down to the basics, daily choices around food, sleep, movement, and stress. Hormones can make those choices seem harder, but they don’t override them.
If you’re not sure where to start, begin by getting clear on what’s actually going on in your body. Build your foundation. Seek a provider who understands midlife hormones and will offer you the testing you deserve.
And know that you don’t have to figure this out alone.
If any of this resonated with you, I’d love to hear from you. What have you noticed in your own midlife transition? Come find me on Instagram @kariannbowles. I’d love to connect it the DMs.
welcome!
I’m Kariann — a Women’s Midlife Health Coach, and I’m so glad you found your way here. Think of this space like a cozy corner where we talk about the real stuff that comes with life after 40. It’s warm, it’s honest, and hopefully a little inspiring too. Whether you're here for tips, stories, or just a reminder that you’re not alone — you’re in the right place.
