Why At-Home Menopause Tests Aren’t Accurate

Women are used to peeing on a stick to find out if they’re pregnant or swabbing their noses to detect COVID-19. In fact, it seems like there’s an at-home test for every health condition under the sun. Now, you can add perimenopause and menopause to the list. Using a small sample of urine, blood, or saliva, these tests claim to measure hormone levels to determine if a woman is in perimenopause or menopause. 

But are menopause test kits accurate? According to experts, it’s debatable whether these kits can accurately test hormones at home and provide women with valuable information. 

One big reason why: “The diagnosis of menopause is actually clinical, not done by a lab or a urine test,” says Cielo Gnecco, M.D., FACOG, an OB-GYN at Orlando Health. While hormone levels can provide information, menopause is defined as going 12 months without a period. “We need to make sure patients are aware of that, and they can’t really consider themselves menopausal just because of a urine test.”

Here’s what else we know about menopause test kits. 

About the Experts

Cielo Gnecco, M.D., FACOG, is an OB/GYN at Orlando Health who specializes in gynecologic surgery.

Jim Staheli, D.O. is the medical director of Broad Health, Hone Health’s affiliated practice. He specializes in metabolic and nutritional medicine, anti-aging, and functional medicine.

Nanette Santoro, M.D., is a professor and E. Stewart Taylor Chair in the Department of Obstetrics and Gynecology at the University of Colorado School of Medicine who specializes in menopause, infertility, and reproductive medicine.

What Are Menopause Test Kits?

Although tests vary from brand to brand, they all work similarly: They test levels of particular hormones in urine, blood, or saliva that may be markers of menopause. 

In practice, this means you pee on a stick, prick your finger, or swab the inside of your cheek to collect saliva. Some tests provide a result immediately, while others require you to mail the sample to a lab. Many tests have a companion app that will store and analyze your results—and even provide recommendations for supplementation, diet, and exercise to mitigate symptoms. 

Prices of the tests you can purchase online or in a pharmacy vary, ranging from $30 to more than $200. 

What do menopause test kits measure?

Most menopause test kits measure follicle-stimulating hormone (FSH). The pituitary gland in the brain releases FSH, which signals the follicles in the ovaries to mature and release an egg every month. As follicles grow, they release estrogen and progesterone into the blood (1).

As women approach menopause, fewer follicles are made. Estrogen levels decrease, causing FSH levels to rise (1).

Can an estrogen test reveal menopause status?

FSH, estrogen, and other hormones are tough to measure because they can rise and fall frequently, particularly during perimenopause, when hormone levels are inconsistent. Plus, certain medications, stress, sleep, and other factors can also affect hormone levels (2).

Lab testing vs. at-home menopause test kits

Some people don’t get regular periods, so it can be hard to tell if irregular or missed periods are due to menopause or another reason. Menopause tests may be useful in these cases, though lab tests ordered by your doctor will likely be more accurately collected, processed, and analyzed. 

For example, thyroid issues can induce hot flashes. So a test looking at FSH and other hormones may be able to rule out other conditions that could be causing menopause-like symptoms, Gnecco says (3).

“These are more useful for women who do not get periods because they have had a hysterectomy, an endometrial ablation, or use an IUD that causes them not to have periods,” Nanette Santoro, M.D., says. 

“However, most women having irregular periods and menopausal symptoms means they’re perimenopausal, while not having periods for a year means they’re menopausal. Rarely are blood tests needed to confirm these states,” Santoro adds.

More Menopause

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Are Menopause Test Kits Accurate? 

Generally, no. Remember, menopause is diagnosed when a woman doesn’t have a period for an entire year, not what her hormone levels are. 

But these tests can give you a peek at what’s going on inside during a time that can feel uncomfortable and unpredictable. 

“Some consumers may find value and validation in linking key symptoms that are bothering them to their hormones,” Santoro says. “But this does not always mean the hormones are causing the symptoms.” 

One example, she says, is migraines. Hormone fluctuations during perimenopause don’t necessarily cause migraines, but they can make them worse.

If symptoms crop up at an earlier age than a woman expects, the tests may be able to provide some insight into what’s going on in her body. 

Why is menopause difficult to test for?

Menopause tests may accurately capture what’s happening in your body at the moment the urine, blood, or saliva sample was gathered—but those hormone levels will likely change over time. 

“They do not provide definitive answers,” says Jim Staheli, D.O., medical director of Broad Health, Hone Health’s affiliated practice. “Laboratory testing to determine a woman’s stage of menopause is filled with potential challenges. FSH levels can vary significantly both from cycle to cycle and day to day throughout a menstrual cycle. While a very high FSH can indicate that a woman is likely in menopause, a normal or low FSH is not conclusive.”

Menopause biomarker lab tests

Some kits test hormones in addition to FSH: 

• Estrone (E1G): The weakest of the three types of estrogen and the only one the body keeps producing after menopause. Tests measure E1G levels because they remain high in people during or post-menopause as the other forms of estrogen levels decrease (4).
• Progesterone (PdG): Produced in the ovaries, levels of this hormone decline with age and are tied to many of the symptoms of menopause, like hot flashes (5).
• Luteinizing hormone (LH): A partner hormone to FSH, LH is released by the pituitary to regulate ovulation. Like FSH, levels of LH increase as estrogen and progesterone levels decline (6).
• Testosterone: T levels drop as we age, significantly so for women during menopause (7).
• Cortisol: A “stress” hormone that can increase during menopause (8).
• DHEA: A hormone produced in the adrenal gland that helps to make estrogen and testosterone (9).

Other tests to take during perimenopause or menopause

Experts say they diagnose menopause by looking at a combination of factors. A lab test of FSH and other hormones may be ordered as one of these, but it won’t tell the entire story.

“The comprehensive package of information goes beyond what a typical menopause test kit provides and can lead to a more accurate diagnosis,” Staheli says. 

Staheli lists the information clinicians gather to make this determination: 

• Age
• Medical history
• Menstrual history: whether periods are irregular, coming early or late, or missed altogether
• Other symptoms: hot flashes, insomnia, vaginal dryness, pain during intercourse, more frequent urinary tract infections, mood swings, hair loss, weight gain

Whether you invest in a test or simply pay attention to changes in your mood and body, there are many treatment options for the symptoms of menopause and perimenopause.

“Menopause is, many times, overlooked,” Gnecco says. “So many symptoms can occur, and patients may not be getting the appropriate treatment. It’s always good for patients to advocate for themselves.”