Perimenopause Panel (E2, FSH, LH)
Test ID: A892
This test is targeted towards women who are around the age of perimenopause, and may be experiencing some of the common symptoms (e.g. hot flashes and interrupted sleep). Various factors influence the age of perimenopause, including genetics and smoking status. This test provides an analysis of three key hormones that change at perimenopause. Results from this test can be used in conjunction with other factors (e.g. medical history and symptoms) to determine if a woman has reached perimenopause. It provides women with a better understanding of the natural hormonal changes that can influence so many different symptoms.
Estradiol (E2) is a hormone naturally produced in both genders, with much higher levels in females. Estradiol is essential for female reproductive health, and also plays important functions in the skeletal system, skin health, nervous system, and cardiovascular system. During perimenopause, estradiol levels gradually decrease, although often in an irregular fashion. Fluctuating estradiol levels contribute to many of the symptoms associated with perimenopause.
Follicle-stimulating hormone (FSH) is a hormone produced in the pituitary gland in both males and females. It works with luteinizing hormone (LH) to regulate development, growth, pubertal maturation, and reproductive processes. FSH levels fluctuate during each menstrual cycle in women of reproductive age, gradually increasing with age, with a significant increase occurring during perimenopause.
Luteinizing hormone (LH) is a hormone produced in the pituitary gland in both males and females. In females, an “LH surge” triggers ovulation. Basal LH levels increase during perimenopause, although not to the same extent as FSH elevations.
How to order a test
What is Included?
Measurement of three important hormone levels with chemiluminescent microparticle immunoassays:
- Follicle-Stimulating Hormone
- Luteinizing Hormone
1 – 3 business days
The turnaround time is not guaranteed. The average turnaround time is 1 – 3 business days from the date that the sample arrives at the laboratory. Shipping time for the sample is not included. Additional time is required if the case requires confirmatory or reflex testing, or if the sample is insufficient, or if a recollection is required.
Additional Information and Resources
» All about follicle-stimulating hormone (FSH)
» What is estradiol?
» Perimenopause and postmenopause: what are they?
» The importance of luteinizing hormone (LH)
» Estrogen and progesterone: Why are they so important?
» What are the signs of high estrogen in females?
» Testing your estradiol level is quick and easy
Preparation Before Specimen Collection
50 μL in a microtainer
Microtainer (regular blood tube)
This test requires a blood sample from a finger prick. All supplies for sample collection are provided in the kit.
- First wash and dry hands. Warm hands aid in blood collection.
- Clean the finger prick site with the alcohol swab and allow to air dry.
- Use the provided lancet to puncture the skin in one quick, continuous and deliberate stroke.
- Wipe away the first drop of blood.
- Massage hand and finger to increase blood flow to the puncture site. Angle arm and hand downwards to facilitate blood collection on the fingertip.
- Drip blood into the microtainer tube.
- Dispose of all sharps safely and return sample to the laboratory in the provided prepaid return shipping envelope.
NOTES: Avoid squeezing or ‘milking’ the finger excessively. If more blood is required and blood flow stops, perform a second skin puncture on another finger. Do not touch the fingertip.
Maintain specimen at temperatures between 2°C and 30°C during storage and transport.
Blood samples can be refrigerated or kept at room temperature for up to 7 days.
Causes for Rejection
- Incorrect or incomplete patient identification
- Incorrect specimen collection
- Inappropriate storage and transport conditions
- Incorrect specimen volume
To measure estradiol, follicle-stimulating hormone, and luteinizing hormone levels in a blood sample to determine if the changes to your menstrual cycle may be due to approaching menopause..
- This report is not intended for use in medico-legal applications.
- These results should be interpreted in conjunction with other laboratory and clinical information.
- Correct specimen collection and handling is required for optimal assay performance.
- Assay interference may occur in specimens from individuals routinely exposed to animals or to animal serum products. Additional clinical or diagnostic information may be required for these specimens.
- False results may occur in specimens from individuals that have received preparations of mouse monoclonal antibodies for diagnosis or therapy. Additional clinical or diagnostic information may be required for these specimens.
- Results obtained from different assay methods should not be used interchangeably in serial testing.
Chemiluminescent microparticle immunoassays:
Alinity i Estradiol assay
Alinity i FSH assay
Alinity i LH assay
Normal menstruating females
– Follicular phase: 20 – 350 pg/mL
– Mid-cycle: 150 – 750 pg/mL
– Luteal phase: 30 – 450 pg/mL
Postmenopausal females: ≤ 20 pg/mL
These reference ranges were obtained from Pagana KD, Pagana TJ, Pagana TN. Mosby’s Diagnostic & Laboratory Test Reference. 15th ed. St. Louis, Mo: Elsevier; 2021.
Normal menstruating females
– Follicular phase: 2.0 – 12.0 mIU/mL
– Mid-cycle: 4.0 – 36.0 mIU/mL
– Luteal phase: 1.0 – 9.0 mIU/mL
Postmenopausal females: 26.7 – 133.4 mIU/mL
These reference ranges were obtained from the Alinity i FSH package insert and “Laboratory Reference Ranges” from the Endocrine Society.
Normal menstruating females1:
– Follicular phase: 1.0 – 18.0 mIU/mL
– Mid-cycle peak: 20.0 – 80.0 mIU/mL
– Luteal phase: 0.5 – 18.0 mIU/mL
Postmenopausal females2: 14.2 – 52.3 mIU/mL
These reference ranges were obtained from:
1 “Laboratory Reference Ranges” from the Endocrine Society.
2 Rifai N, Horvath AR, & Wittwer C. (2018). Tietz textbook of clinical chemistry and molecular diagnostics (Sixth edition.). St. Louis, Missouri: Elsevier.