What Blood Tests Should I Get During Perimenopause? Hormone Testing, Iron, Thyroid, Cholesterol and More

If you think you are entering perimenopause, one of your first questions may be:

“Should I get my hormones tested?”

It makes sense.

If hormones are changing during perimenopause, checking estrogen and progesterone seems like the obvious way to find out what is happening.

But perimenopause blood work is more complicated than simply ordering an estrogen test.

And some of the most important blood work during perimenopause may have very little to do with directly measuring reproductive hormones.

For women looking for perimenopause blood testing in Ontario, Dr. Nicole Roberts, Naturopathic Doctor, takes a broader approach.

The question isn't simply:

“What are your hormone levels?”

It is:

“What information do we actually need to understand your current health and your future risk?”

Can a blood test tell if I am in perimenopause?

This is one of the most common perimenopause questions.

During the reproductive years, hormone levels naturally change throughout the menstrual cycle. During perimenopause, levels continue to fluctuate and eventually fall. 

That makes context incredibly important when interpreting reproductive hormone testing.

A single hormone result is one piece of information.

It is not your entire perimenopause story.

Do I need my estrogen tested during perimenopause?

Sometimes testing reproductive hormones can be useful.

Dr. Nicole's presentation identifies several situations where female hormone testing may provide useful information, including women who have had an ablation or use a Mirena IUD, women with a history of PCOS, situations where other causes of menstrual changes need to be ruled out, and when assessing efficacy or absorption of estrogen medication. 

The important point is that testing should answer a clinical question.

Dr. Nicole Roberts, Naturopathic Doctor, does not believe more testing automatically equals better healthcare.

The goal is useful information.

What blood work should women get during perimenopause?

This is where the conversation becomes much bigger.

Dr. Nicole's foundational perimenopause blood work framework includes a complete blood count, iron studies, a thyroid panel, blood sugar and insulin resistance markers, metabolic inflammatory markers, vitamin D, liver and kidney function, and cholesterol or lipid testing. 

Why?

Because symptoms do not exist in isolation.

Fatigue may be occurring during perimenopause.

But what is your iron status?

Poor concentration may be occurring during perimenopause.

But how are you sleeping?

Your weight or body composition may be changing.

But what is happening with blood sugar and insulin resistance?

Your menstrual cycle may be changing.

But have other potential causes been appropriately considered?

This is why Dr. Nicole Roberts, Naturopathic Doctor, approaches perimenopause care by looking at the whole person rather than simply looking for one abnormal hormone value.

Should iron be checked during perimenopause?

Iron status can be particularly important for women who continue to menstruate, especially if their periods become heavier.

A complete blood count and iron studies are included among the foundational investigations in Dr. Nicole's perimenopause presentation. 

If a woman is exhausted, struggling cognitively and experiencing heavier menstrual bleeding, it would be overly simplistic to assume that every symptom is hormonal.

Perimenopause may be happening.

Iron deficiency may also be happening.

Again, your body is allowed to have more than one thing going on.

Should my thyroid be checked during perimenopause?

A thyroid panel is another component of Dr. Nicole's foundational blood work framework for women moving through perimenopause and menopause. 

This matters because good perimenopause care should not mean automatically attributing every new symptom to changing estrogen.

Assessment should help determine what needs further investigation.

Why should cholesterol and blood sugar be checked during menopause?

Perimenopause and menopause care should not focus exclusively on whether you are having hot flashes.

There is a bigger health conversation happening.

Dr. Nicole's presentation defines cardiometabolic risk factors as interconnected cardiovascular and metabolic abnormalities that can increase the likelihood of developing type 2 diabetes, cardiovascular disease and stroke. These include abdominal obesity, high blood pressure, high blood sugar and abnormal lipids. 

This is why blood sugar, insulin resistance markers and cholesterol testing can become such an important part of the conversation.

Dr. Nicole Roberts, Naturopathic Doctor, specializes in cardiometabolic health as one of her major areas of clinical focus alongside perimenopause and menopause.

Her current Ontario practice specifically offers focused follow up care for women experiencing changes in cholesterol, blood sugar, blood pressure, abdominal weight or other cardiometabolic concerns during perimenopause and menopause. 

What about advanced testing during perimenopause?

Depending on the individual patient, Dr. Nicole's presentation also discusses going beyond foundational testing.

This may include more in depth cardiovascular risk markers such as Apolipoprotein B, adrenal hormones such as cortisol and DHEAS, testosterone, and vaginal pH or culture when clinically relevant. 

Again, the goal is not to order everything.

The goal is to determine what information is actually relevant to the woman sitting in front of you.

Where can I get perimenopause blood work assessed in Ontario?

For women searching for a naturopathic doctor specializing in perimenopause blood work in Ontario, Dr. Nicole Roberts provides individualized assessment and virtual care for Ontario patients.

Blood work is one tool.

Your menstrual history matters.

Your symptoms matter.

Your family history matters.

Your mental and cognitive health matters.

Your metabolic health matters.

Your cardiovascular risk matters.

And your goals matter.

The goal of perimenopause testing should never be to collect the largest possible pile of lab results.

It should be to collect the right information and know what to do with it.

That is the approach Dr. Nicole Roberts, Naturopathic Doctor, brings to perimenopause and menopause care for women across Ontario.