A hormone panel with honest interpretation — including when the result doesn't change the diagnosis at all.
Referred by a GMC-registered GP, results reviewed by the same doctor
Taken at a partner site near you
Results explained in plain English, not just a number
Your NHS records in the room, with your consent
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This panel measures the hormones governing the menstrual cycle, fertility and the menopausal transition.
One thing needs saying at the top, because it saves a great many people money and disappointment. If you are over 45 with menopausal symptoms, UK guidance is clear that menopause is a clinical diagnosis and blood tests are not needed. FSH and oestradiol fluctuate so wildly during perimenopause — sometimes day to day — that a single normal result excludes nothing at all. Being told your hormones are normal on one sample is not a meaningful exclusion, and it stops the conversation at exactly the wrong point.
Where this panel genuinely helps is set out below.
Oestradiol — the main oestrogen. Varies enormously across the cycle, which is why timing matters.
FSH and LH — pituitary signals to the ovaries. A persistently raised FSH suggests declining ovarian function, and a raised LH-to-FSH ratio is one pointer towards PCOS.
Progesterone — taken around day 21 of a 28-day cycle, this confirms whether ovulation has occurred, which is a different question from the rest of the panel.
Prolactin — raised levels disrupt periods and fertility, and can occasionally indicate a pituitary adenoma that needs identifying rather than working around.
Testosterone, SHBG and free androgen index — raised free androgens support a PCOS picture and explain excess hair growth and persistent acne.
Thyroid function is usually added, and deliberately: an underactive thyroid produces symptoms nearly indistinguishable from perimenopause, and it is treatable in a completely different way.
Where it is usually not needed: straightforward menopausal symptoms over 45. In that situation the symptom history is the diagnosis, and HRT can be started without it. We would rather tell you that than sell a test.
Included: oestradiol · follicle stimulating hormone · luteinising hormone · progesterone · prolactin · testosterone · sex hormone binding globulin · free androgen index.
Thyroid function is usually added, because an underactive thyroid produces symptoms very similar to perimenopause and is far easier to treat.
1. Consultation. We establish whether testing will actually add anything, and if so, when in your cycle the sample should be taken. This is the step that determines whether the result is interpretable.
2. Referral. To a Randox Health clinic, timed to your cycle rather than to the first available slot.
3. The sample. If you still have periods, the sample is usually taken on days 2 to 5 of your cycle, counting day 1 as the first day of proper bleeding. Progesterone, if being measured to confirm ovulation, is taken separately around day 21. Hormonal contraception suppresses these hormones and makes results uninterpretable — tell us what you take, because it may mean testing is not worth doing at all while you remain on it.
4. Results review. A GP interprets the panel against your symptoms and cycle, distinguishes thyroid from hormonal causes, and — where the picture fits — discusses treatment. A symptom diary kept over three cycles is frequently more informative than the bloods, and we will say so.
If you still have periods, the sample is usually taken on days 2 to 5 of your cycle. Hormonal contraception affects results — tell the GP what you take.
If you are still having periods, hormones must be measured on days 2 to 5 of your cycle — counting day 1 as the first day of proper bleeding.
Oestradiol, FSH and LH swing enormously across a cycle, and a mid-cycle sample produces numbers that look abnormal but simply reflect where you were. Timing is the difference between a usable result and a confusing one.
Perimenopause is diagnosed on symptoms, not on blood tests — and UK guidance is explicit that women over 45 with typical symptoms do not need hormone testing at all.
Hormones fluctuate wildly during perimenopause, sometimes reaching premenopausal levels one month and postmenopausal the next. A normal FSH does not rule perimenopause out, and thousands of women are told they are "fine" on precisely that basis while their symptoms continue.
If you are over 45 with hot flushes, disrupted sleep, mood change and irregular periods, the diagnosis is already made, and you can start HRT without any blood test.
Thyroid disease and iron deficiency produce almost exactly the perimenopausal symptom picture — fatigue, low mood, poor concentration, feeling cold, hair thinning — and both are common in women of this age.
Which is why we check them alongside rather than attributing everything to hormones.
During perimenopause, hormones can swing from premenopausal to postmenopausal levels within a single month. One sample captures one moment.
A normal FSH does not exclude perimenopause — and this specific misunderstanding causes real harm, because it is routinely used to refuse treatment to women whose symptoms are unmistakable.
The combined pill, the progestogen-only pill, the implant, the injection and the hormonal coil all affect these results, some substantially.
If you are already on HRT, these tests are not usually useful either — dose is adjusted on symptoms, not levels, with a few exceptions.
Salivary hormone testing and "hormone balancing" panels have no validated basis, and are used almost exclusively to sell compounded bioidentical hormones — which are not regulated, not recommended by the British Menopause Society, and not something we will prescribe.
Regulated body-identical HRT is available on the NHS and does the same job with actual evidence behind it.
If you are over 45 with typical menopausal symptoms, you probably do not need this test at all. UK guidance says so explicitly, and we would rather tell you that than take the fee.
The consultation is the useful part. The blood test frequently is not.
NHS GPs prescribe HRT, and hormone testing is free where it is indicated.
And the HRT prepayment certificate is worth knowing about: a single annual payment covering all your HRT prescriptions for twelve months. For most women it is a substantial saving, and it is under-claimed because nobody mentions it.
If you are over 45 with typical symptoms, no. UK guidance is explicit: the diagnosis is clinical, and you can start HRT without any blood test.
Hormones fluctuate too much during perimenopause for a single sample to settle anything, and a normal result should never be used to refuse treatment.
No — and this is the most damaging misunderstanding in menopause care.
FSH swings substantially month to month during perimenopause, and can be entirely normal in a woman with unmistakable symptoms.
Your symptoms are the diagnosis. A normal blood test does not overrule them.
Days 2 to 5, counting day 1 as the first day of proper bleeding, if you are still having periods.
Testing mid-cycle produces numbers that look alarming and mean nothing.
Not usefully. Hormonal contraception suppresses the hormones being measured, so the results reflect the medication rather than you.
This includes the implant, injection and hormonal coil. Worth discussing before booking rather than after.
No. Nothing predicts this reliably, including AMH, which is often marketed as though it does.
Thyroid disease and iron deficiency, most commonly — and both produce almost exactly the same picture of fatigue, low mood, poor concentration and hair thinning.
Both are common in women of this age, and both are easily missed when everything is attributed to hormones. We check them alongside.
It has no validated basis and we do not use it.
It is used almost entirely to sell compounded bioidentical hormones — unregulated, unlicensed, and specifically advised against by the British Menopause Society. Regulated body-identical HRT does the same job, with evidence, on the NHS.
Yes, considerably — and testing genuinely matters here.
Premature ovarian insufficiency needs proper diagnosis and specialist referral, because untreated it carries meaningful bone and cardiovascular consequences. PCOS, thyroid disease and raised prolactin also need excluding.
Less than most people expect. The HRT prepayment certificate covers all your HRT prescriptions for a year for a single payment.
For most women it saves a considerable amount, and it is under-claimed simply because it is not well publicised.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 23, 2026
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Told when a test isn’t needed
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20 minutes
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£40 for 20 minutes
Varies by practice
Typically 10 minutes
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
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If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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