How Do I Know If I’m in Menopause?
If menopause followed a clear script, this would be easy. Unfortunately, it’s less rom-com with a tidy ending and more prestige drama with plot twists.
Menopause is not diagnosed by a single blood test or one well-timed lab draw. It is a clinical diagnosis, based on your menstrual history, symptoms, and targeted lab work - all considered together.
The Textbook Definition (Yes, There Is One)
Traditionally, menopause is defined as:
Twelve consecutive months without a menstrual period, and
Blood work showing:
FSH greater than 35 on two separate occasions
Low estradiol, typically between 0–20
When possible, menopause should be diagnosed after one full year without bleeding, supported by these lab findings. Ordering additional hormone tests often creates more noise than answers.
Why Real Life Rarely Follows the Textbook
Bodies do not always follow the script.
Some women have symptoms long before labs change. Others have labs that suggest menopause while their bodies seem to be in a very different season.
If you’ve ever been told “everything looks normal” while feeling like your body is clearly doing something - you’re not imagining it. This is why menopause is not diagnosed by lab values alone. Context matters.
Common Menopause Symptoms
Menopause symptoms can include:
Hot flashes and night sweats
Mood changes such as anxiety, irritability, or low mood
Sleep disruption
Vaginal dryness
Painful intercourse
When these symptoms show up while periods are still happening, that usually points to perimenopause, not menopause.
So When Does Perimenopause Become Menopause?
Think of perimenopause as the long, unpredictable season before the series finale.
Menopause is typically determined by a combination of:
No menstrual periods for 12 consecutive months
FSH greater than 35 on two separate tests, with low estradiol (0–20)
Ongoing menopausal symptoms
Menopause is not one dramatic moment. It’s a transition - and it looks different for every woman.
If your body feels unfamiliar, your symptoms are real, and you deserve care that looks at the whole story, not just one lab value taken on one random day.