What To Ask Your Gynaecologist For Accurate Diagnosis of Perimenopause
If you’re feeling off ….tired, moody, forgetful, suddenly hot and sweaty for no reason, and like your body is staging a quiet rebellion … you’re not imagining it. I see you!
Welcome to (probably) perimenopause, the transitional phase before menopause that can last up to 10 years (yes, really).
After having a baby last year, I started to feel some of these symptoms and getting tired of being dismissed as ‘baby/mom brain’, I Googled and asked ChatGPT what I could do. I am also lucky to have a great Gyna who I went to and asked about the tests I wanted, and he ran them.
The problem for most women? Many are told they’re “too young” or “just stressed.” But if you suspect your hormones are shifting, it’s time to advocate for yourself …and that starts with knowing what to ask your gynaecologist.
First: Track Your Symptoms
Before your appointment, jot down a list of what you’ve been experiencing. Common signs of perimenopause include:
Irregular periods (you can track in an app like this or on your phones calendar)
Mood swings, anxiety, or low mood
Sleep problems
Night sweats or hot flashes
Brain fog
Weight gain (especially around the middle)
Vaginal dryness or discomfort
Reduced libido
Fatigue
Bringing this list helps your doctor see the full picture, not just a snapshot.
What to Ask During Your Appointment
Here’s a checklist of smart questions to ask your gynaecologist to ensure you get the right tests and support:
🧪 “Can we check my hormone levels?”
Perimenopause is all about hormonal fluctuations, and while testing is not always 100% conclusive, it can still offer helpful clues.
Ask to test:
FSH (Follicle Stimulating Hormone): High levels can indicate that your ovaries are slowing down.
LH (Luteinising Hormone): Often measured alongside FSH.
Estradiol (a form of estrogen): Levels may drop in perimenopause.
Progesterone: Can become imbalanced in early perimenopause.
Testosterone: Often overlooked, but can impact energy and libido.
💡 Tip: Hormone levels can fluctuate daily, so it’s helpful to track your cycle and test on specific days if you’re still menstruating. My Gyna asked me to check on day 1 of my period, and you might need to do this for a few months.
🩺 “Can you check my thyroid function too?”
Thyroid issues (especially hypothyroidism) can mimic perimenopause symptoms. Ask for:
TSH (Thyroid Stimulating Hormone)
Free T3 & Free T4
Thyroid antibodies (if you suspect autoimmune issues)
🩸 “Can I get a full blood workup?”
Some symptoms might be caused or worsened by low iron, B12, or vitamin D. A good panel includes:
Complete Blood Count (CBC)
Iron/ferritin
Vitamin B12
Vitamin D
Blood glucose or HbA1c
Lipid panel (cholesterol)
Once you get your results, your doctor can go through them all with you. I also used ChatGPT to help me understand them and the ranges that are considered normal at different points of your menstrual cycle.
“Is this perimenopause or could it be something else?”
Perimenopause is common, but other conditions (like PCOS, thyroid disease, or depression) can look similar. It’s fair to ask your doctor to rule out other causes and talk you through the possibilities.
What Next
“Can we talk about treatment options — HRT or alternatives?”
If tests and symptoms point to perimenopause, you may want to explore:
Hormone Replacement Therapy (HRT): Talk through risks, benefits, and options (patch, gel, oral, etc.)
Non-hormonal options: Supplements (I have a blog on this for taking supplements to support perimenopause and one for your cycle to relieve symptoms), lifestyle changes, cognitive therapy
Support for sleep, mood, and energy
Don’t Be Dismissed
It’s your body. If you feel off, you know it, and you deserve to be heard and treated with respect. If your current provider isn’t helpful, it’s okay to seek a second opinion or a menopause-informed doctor.
Perimenopause doesn’t need to be confusing or overwhelming… but it does require you to be your own best advocate.
In Summary — Your Test Checklist:
✔ Hormones: FSH, LH, estradiol, progesterone, testosterone
✔ Thyroid panel: TSH, Free T3, Free T4
✔ Full blood work: iron/ferritin, B12, vitamin D, CBC
✔ Glucose & cholesterol
✔ Symptom tracking
✔ Treatment discussion: HRT or alternatives
You’ve Got This!
The more informed you are, the more empowered you’ll feel during this transition. Now take this list, book the appointment, and start asking the right questions.
