If we feel it is clinically necessary, and will be helpful to guide our management, we can arrange private blood tests
This can be done locally in at a Guildford clinic, or at locations over the UK using Nationwide Pathology, or you can arrange a venous blood sample through Medichecks. If you choose to use medichecks we will advise you which profile to order.
Blood tests can be useful at times, but are often not necessary. They are required in younger women, and can be useful to exclude other diagnoses, and may be helpful in guiding oestrogen dosing with HRT, but bear in mind that in perimenopause the hormones fluctuate wildly and we cannot be sure the tests will be helpful.
It is important to consider oestradiol blood tests carefully. There is a wide variation in absorption of oestrogen through the skin ( for example using patches, gels or sprays) from person to person, and this can vary in the same individual if there is a difference in temperature or hydration. There is no actual level we are aiming for, usually it will be in the female physiological range and in order to bring relief of symptoms and give protection to bone.
There is in some people benefit to taking a blood test, but in others the results are not helpful. It is not possible to compare results from different labs which may use different assays.
It is also important to consider oestrogen receptors in the body, how sensitive they are, for example, and to consider how effective the processing and elimination is oestrogen. Lots of factors can affect this like genetics, nutrition (including supplements) , stress, thyroid and insulin resistance, inefficient breathing, trauma and exercise for example.
We do monitor blood tests when we prescribe testosterone, to make sure your level of testosterone is kept in the female range. We test before starting testosterone, to make sure you do not already have high levels and then we repeat tests at 3 months and annually according to recommendations.
Blood tests at Guildford clinic
It is possible to have a blood test taken at the Surrey Cardiovascular clinic, you book this with them and we can give you the required form in order to do this. Payment is taken by them and they send the results to us so we can inform you.
Blood tests arranged by you with advice from us using Medichecks
This is an online provider who can help you by offering set profiles, and you can visit one of their clinics to have your blood profile taken. You pay them for the profile cost and the additional blood letting cost, and the results are sent to you, which you can share with us.
We will advise you in your clinic letter which profile to book, and discuss cost for you. Examples are:
Female hormone blood test: £79 – 9 biomarkers including: oestradiol, testosterone, FSH, LH, SHBG, prolactin, thyroid function (TSH and free thyroxine)
Testosterone, free testosterone and oestradiol blood test: note this is in the male blood test section – £69 – 5 biomarkers but we want to see total testosterone, oestradiol and SHBG
Free and total testosterone blood test: £55 – note this is in the male blood test section – total testosterone, free testosterone, albumin and SHBG
Menopause blood test: £69 5 biomarkers – FSH, LH, oestradiol, TSH, free thyroxine
Blood tests are often not necessary and certainly are not very helpful in perimenopause, due to your own hormonal fluctuations, we can advise you of this.
Thank you for your support to help us care for you at Rowena Health. Dr Carys Sonnenberg