Oestrogen falls during menopause, and you see that mainly in two blood values: a lower oestradiol and a higher FSH. Yet menopause is usually established on symptoms and your cycle, not on one blood result. Hormones swing strongly in this phase, so a doctor always reads your values together with your age and your story.
Honestly? This is exactly the phase where a single snapshot can put you on the wrong track. Below you will read what oestrogen does and which values genuinely give insight.
For the bigger picture, read which hormones you can have tested in a blood test.
What is oestrogen and what does it do?
Oestrogen is the collective name for the main female sex hormones. Oestradiol (E2) is the most active form during your fertile years. It steers your menstrual cycle, protects your bones and influences your skin, mood and blood vessels (Carlson & Vadakekut, StatPearls).
Your ovaries produce most of it. When they wind down during menopause, your oestradiol falls.
Men also have a little oestradiol, formed from testosterone. In this article we stick to the female side.
Which blood values belong to menopause?
Menopause is a years-long process in which your hormones change gradually. Internationally this is described with the STRAW+10 stages, where a rising and fluctuating FSH is one of the early signals (Harlow et al., 2012, PMID 22344196). Reference values differ per laboratory and per testing moment.
| Phase | Oestradiol (indication) | FSH (indication) |
|---|---|---|
| Fertile years, follicular phase | About 70-500 pmol/L | Low to normal |
| Around ovulation | Temporarily high (peak) | Brief peak |
| Perimenopause | Strongly fluctuating | Variable, often rising |
| After menopause | Usually low (often below ~100 pmol/L) | Clearly raised |
See how strongly the values swing in perimenopause? That is exactly why one measurement says little in this phase.
When is testing for oestrogen useful?
In women over 45 with typical menopausal complaints, a blood test is usually not needed: the diagnosis follows from your symptoms and your cycle. Testing can be useful for questions at a younger age or when the picture is unclear.
- Symptoms before age 40 - to rule out or confirm an early menopause
- Irregular or absent periods - to weigh up other causes
- Unclear complaints - when the picture does not fit your age
The guideline of the Dutch College of General Practitioners (NHG-Standaard De overgang) stresses that in older women the diagnosis rests on the symptom pattern, not on hormone measurements. In doubt? Then discuss it with your GP.
Oestradiol, FSH and LH: how they connect
Your brain drives your ovaries with FSH and LH. When your ovaries make less oestradiol, your brain raises FSH production to spur them on. So FSH rises while oestradiol falls.
That combination is what makes the story clear. A low oestradiol with a high FSH fits menopause, while LH helps to distinguish other causes.
If you want these values measured, at Vital Check you can do a menopause blood test. You can read the male counterpart to this story in our article on testosterone in men.
Frequently asked questions
Can you establish menopause with a blood test?
Not always. Over 45 the diagnosis rests mainly on your symptoms and cycle. A blood test can support it, but hormones fluctuate strongly, so one result is rarely decisive.
On which day of my cycle should I test oestradiol?
If you still menstruate, oestradiol is often measured in the early follicular phase, around days 2 to 5. Your doctor decides the best moment for your situation.
What does a high FSH mean?
A high FSH can fit a declining ovarian function, such as in menopause. The value only gains meaning together with your oestradiol, age and symptoms.
Do I need to fast for this test?
Fasting is usually not needed for oestradiol and FSH. The moment in your cycle matters more than whether you have eaten.
References
- Harlow SD, Gass M, Hall JE, et al. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab. 2012;97(4):1159-1168. PMID: 22344196.
- Carlson K, Vadakekut ES. Menopause. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026. NCBI Bookshelf: NBK507826.
- Nederlands Huisartsen Genootschap. NHG-Standaard De overgang. Utrecht: NHG.
Every blood test result at Vital Check includes a professional assessment from a BIG-registered doctor. A blood test does not make a diagnosis. For treatment decisions, discuss your results with your GP.
Frequently asked questions
Can you establish menopause with a blood test?
Not always. Over 45 the diagnosis rests mainly on your symptoms and cycle. A blood test can support it, but hormones fluctuate strongly, so one result is rarely decisive.
On which day of my cycle should I test oestradiol?
If you still menstruate, oestradiol is often measured in the early follicular phase, around days 2 to 5. Your doctor decides the best moment for your situation.
What does a high FSH mean?
A high FSH can fit a declining ovarian function, such as in menopause. The value only gains meaning together with your oestradiol, age and symptoms.
Do I need to fast for this test?
Fasting is usually not needed for oestradiol and FSH. The moment in your cycle matters more than whether you have eaten.
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