OQ-09: Can any test reliably tell where a person is in the menopause transition?
Status: open. Status as of . Version 1.0.
This page describes research, not your body. Talk to your own doctor about your situation.
What we can say today
No test can yet tell one person, with certainty, where they are in the menopause transition or when their final period will come. A blood marker called anti-Mullerian hormone (AMH) can help estimate timing, but only as probabilities across groups, not as a firm answer for an individual.
Why it matters
Many people want to know whether their symptoms belong to perimenopause. A clear test would also help researchers place study participants in the right stage.
For research, staging matters because results from one stage may not apply to another (see OQ-08).
What is known
- The 2012 executive summary of the Stages of Reproductive Aging Workshop + 10 (STRAW+10), published in Menopause, updates a staging system for reproductive aging that draws on bleeding patterns and markers such as AMH, inhibin B, FSH and antral follicle count. It also states that important knowledge gaps persist and names seven research priorities. [1]
- A 2020 analysis from the SWAN cohort, published in the Journal of Clinical Endocrinology and Metabolism, found that AMH helps estimate the timing of the final menstrual period, and does so better than follicle stimulating hormone (FSH). The results are probabilities, not individual certainty. [2]
- A 2026 review in Psychoneuroendocrinology describes limitations of STRAW+10 and states that standard terms and validated, prospectively tracked bleeding data are needed for more precise and reliable staging. [3]
- The NICE menopause guideline (NG23, section 1.3, 2015) recommends identifying perimenopause and menopause "without laboratory tests" in otherwise healthy people aged 45 or over who have menopause associated symptoms. Recommendation 1.3.4 reads: "Do not use the following laboratory and imaging tests to identify perimenopause or menopause in people aged 45 or over: anti-Müllerian hormone, inhibin A, inhibin B, oestradiol, antral follicle count, ovarian volume." Recommendation 1.3.6 reads: "Consider using the person's serum FSH level to confirm menopause only: in people aged 40 to 45 with menopause-associated symptoms, including a change in their menstrual cycle; in people under 40 in whom menopause is suspected." [4]
Why it is still open
A staging system is a shared language. That is useful for research and for conversations, but it rests on consensus rather than on a test checked against an outcome in a trial. Its own authors list knowledge gaps, and a 2026 review still calls for validated staging methods.
The AMH finding comes from one cohort. It shifts the odds for a group, but does not give a specific woman her date. A probability is a statement about many people, and any one person can land on either side of it. The NICE guideline, for its part, does not use AMH to identify perimenopause in people aged 45 or over. [4] The two answer different questions: timing in a research cohort [2] versus how a stage is identified in care [4].
Under our rules, a staging system and one cohort are not enough to call this partly answered, so the status is open.
What would answer it
A systematic review, or a large study across several cohorts and countries, that tests markers against the actual date of the final period and reports how often the prediction is right for an individual, in women of different ages and backgrounds.
Sources
1. Harlow, et al. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. Menopause. 2012. https://doi.org/10.1097/gme.0b013e31824d8f40 PMID 22343510. Verified on 2026-10-12, rechecked 2026-10-13.
2. Finkelstein, et al. Antimullerian Hormone and Impending Menopause in Late Reproductive Age: SWAN. J Clin Endocrinol Metab. 2020. https://doi.org/10.1210/clinem/dgz283 PMID 31965189. Verified on 2026-10-12.
3. Huibregtse, et al. Considerations and practical recommendations for identifying perimenopause in longitudinal research. Psychoneuroendocrinology. 2026. https://doi.org/10.1016/j.psyneuen.2026.107748 PMID 41576711. Verified on 2026-10-13.
4. NICE. Menopause: identification and management (NG23), recommendations 1.3.1, 1.3.4 and 1.3.6. 2015. https://www.nice.org.uk/guidance/ng23/chapter/Recommendations Verified on 2026-10-13.
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Status history
| Date | From | To | Reason | Source |
|---|---|---|---|---|
| (none) | open | Page created, status set | (none) |
Cite this page
MenoDerm Open Question OQ-09, version 1.0, , /open-questions/can-a-test-show-where-you-are-in-perimenopause.
MenoDerm explains research. It does not give medical advice and is not a clinic. Talk to your own doctor about your situation. The status describes the research, not your situation.