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Rajeev Agarwal: Is There a Blood Test for Perimenopause?
Rajeev Agarwal/LinkedIn
Nov 7, 2026, 18:22

Rajeev Agarwal: Is There a Blood Test for Perimenopause?

Rajeev Agarwal, Director of Renew Healthcare, shared on LinkedIn:

” ‘My FSH is normal. Can I still be in perimenopause?’

Yes. This is one of the most common questions in my Perimenopause Unfiltered clinic. It usually comes from a woman of 42 or 43. Her sleep is broken. She has night sweats or new anxiety.

Her periods are still regular, her FSH came back ‘normal’, and she has been told it is too early.

Why a normal FSH does not settle it:

  • FSH is a hormone that goes up and down from month to month in these years. One result tells us very little.
  • Symptoms can start several years before periods change.

What guidelines say:

  • Over 45: perimenopause is diagnosed from symptoms and changing periods. No blood test is needed.
  •  40 to 45: an FSH test can be considered, but a normal result does not rule perimenopause out.
  • Under 40: it is a different question. Periods stopping this early need proper tests to check whether the ovaries are slowing down too soon.

What I check instead, because these change treatment:

  • Thyroid
  • Haemoglobin and iron stores
  • Sugar and cholesterol
  • Breast imaging from 40
  • A scan first, if bleeding is heavy, irregular or in between periods

Two things to remember:

  1. Regular periods do not rule out perimenopause.
  2. If you are under 50, you still need contraception until 2 years after your last period.”

Rajeev Agarwal: Is There a Blood Test for Perimenopause?

Other articles featuring Rajeev Agarwal on Fertility News.

blood test Fertility Fertility News FSH Haemoglobin OB-GYN Perimenopause Rajeev Agarwal reproductive health Reproductive Medicine Women’s Health
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