Peri & Pause The Podcast

Women often hear conflicting information online about estrogen, progesterone, and hormone testing. Jamie explains why hormone levels fluctuate dramatically during perimenopause, why a single blood test rarely tells the full story, and why symptoms often provide more useful information than lab values alone.
This episode also covers stopping birth control pills in midlife, hormone testing after pregnancy, when hormone testing is appropriate, and why some women may still benefit from lab work in specific situations.
If you've ever wondered whether hormone testing can confirm perimenopause or menopause, this episode will help you understand what hormone tests can, and can't, tell you.

00:00 – Welcome back to Perimenopause the Podcast
00:25 – Listener questions about hormone testing
00:55 – Should women routinely check hormone levels?
01:15 – Why hormone levels fluctuate so dramatically
01:40 – Understanding hormone changes during perimenopause
02:00 – Why symptoms matter more than a single lab test
02:15 – Stopping birth control in your 40s: what to expect
02:40 – How birth control affects hormone testing
02:55 – Could birth control be masking menopause?
03:10 – Hormone testing after pregnancy and childbirth
03:35 – When hormone testing may be appropriate
03:50 – Testosterone monitoring and hormone therapy
04:10 – New research on estrogen and bone health
04:35 – Why hormone testing is trending online
04:50 – The better question to ask about your symptoms
05:15 – Final thoughts and listener questions

Creators and Guests

Host
Jamie Gallagher DNP, FNP-C, MSCP
Jamie is a doctoral-prepared, board certified family nurse practitioner and a Menopause Society Certified Practitioner. She is the owner and founder of Peri & Pause. She has served as a nurse practitioner in the Triangle area of North Carolina since 2009 in family medicine, urgent care and women's health. She is an active member of The Menopause Society, the HERmedicine Provider Alliance, the National Association of Nurse Practitioners in Women's Health, and the International Society for the Study of Women's Sexual Health. She is also a proud military spouse, mother of four and grandmother of three.

What is Peri & Pause The Podcast?

The Peri & Pause Podcast is for women in midlife who know something in their body has changed—but haven’t been given real answers, or have been left overwhelmed by conflicting information.

Hosted by Jamie Gallagher, DNP, FNP-C, MSCP, a nurse practitioner specializing in perimenopause and menopause care, the show explores hormones, metabolism, mental health, sleep, sex, weight changes, and chronic conditions through an evidence-based, deeply practical lens. We unpack the physiology of midlife alongside the lived experience of women navigating careers, relationships, finances, and identity during this transition.

Every woman deserves this conversation—and the clarity, language, and confidence to advocate for better care.

Because “Your Labs Are Normal” Is Not the Whole Story.

11 - Per & Pause
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Speaker: [00:00:00] Welcome back to Perimenopause the podcast, where we help women connect the dots during perimenopause, menopause, and everything that comes with this stage of life. I'm Jamie Gallagher, board certified family nurse practitioner, menopause specialist, and owner of Perimenopause the Menopause Center.

Today's episode is the second part of our Ask Us Anything series. Today we're answering questions from Melanie in Dakota, and before we continue with that, here's a shout-out to Joanie from Bowman, North Dakota.

Is it Joanie or Joni? We had a couple questions about hormone lab testing. While we are nurse practitioners, this is not medical advice specifically for you, our listeners. It's for education only. We do encourage you to see your clinician for specific advice.

Melanie asks, "I'm stopping oral birth control since I'm in my mid-40s and I likely won't need it anymore. When should I have my estrogen and progesterone levels checked to see where they really are?" Dakota also asks, "At what age should we ha- start having our hormones checked, and should we have them [00:01:00] checked after having a baby?"

The short answer is that for most women, we don't routinely check hormone levels during perimenopause. The reason is this: hormone levels fluctuate dramatically from day to day and even throughout the same menstrual cycle. A single blood test doesn't tell us much about what's really happening. It's like chasing a moving target, right?

Your estrogen could be 17 one day, and a couple of days later be in the 600s. Seriously. This especially occurs in perimenopause with things like LOOP events that occur in our bodies. What is a LOOP event? It's called a luteal out of phase event, but that's for a whole other podcast. Google it if you're curious.

Instead, we typically diagnose and treat perimenopause based on symptoms and menstrual cycle changes, things like hot flashes, night sweats, disrupted sleep, mood changes, anxiety, brain fog, um, irregular periods or even regular periods with other associated symptoms, and vaginal dryness. They often give us more useful information than a hormone level drawn on a random Thursday morning.

for women [00:02:00] stopping birth control pills, it's important to remember that hormones in the pill literally suppress your body's natural hormone production.

It's in control, birth control. If you're curious about where your hormones are, it's reasonable to wait several weeks after stopping the pill before considering any testing, but even then, symptoms are usually more informative than hormone levels. So if you don't resume regular periods after stopping the pill, you may already be in menopause, and the pills are just masking that.

If you do resume periods, regular or irregular, then you're not likely in menopause, so that same, those same thoughts apply, um, trying to assess a big picture while the target is still constantly moving. After pregnancy, hormone levels change dramatically in the days, weeks, and months following your delivery.

Um, routine hormone testing is generally not recommended unless there's, like, a specific concern, such as absent periods, you're having difficulty with milk production, you have thyroid concerns, or just persisting symptoms. Um, also, any suspected hormonal disorders, that would be a reason to do, um, labs and hormone testing.

The [00:03:00] postpartum period is a time of significant hormonal adjustment, and most women don't need routine hormone testing then because, just because they recently had a baby. Now, there are some situations where hormone testing can be helpful. For example, in post-menopausal women with persistent symptoms despite hormone therapy use, women using a variety of compounded hormone formulations, um, women using testosterone definitely, uh, n- need levels checked so we're not getting too high there, certain cancer survivors, or when we're evaluating a s- you know, a specific medical concern.

But for most women, whether they're in perimenopause, menopause, postpartum, we treat the patient and her symptoms, not necessarily the lab values, since it is so erratic. Labs are information that can help us understand certain conditions or symptoms, but they are not the sole value we should treat, especially from here.

Also, there is some emerging evidence that, that's coming out that's showing certain estrogen levels are impacting bone loss or stopping bone loss, or even some evidence showing, improvement in bone [00:04:00] loss. When studies are done, we need something measurable, and bone density is pretty measurable. So whether we can translate this into other health benefits when we reach certain levels of estrogen in women's bodies is to be determined, but that's why you're probably hearing buzz on the internet about checking hormone levels.

It just needs to be in context. So if you're wondering whether you should have your hormones checked, the better question is, what symptoms am I experiencing, and what are they telling us?

So that's usually where the most helpful information comes, but it's not unreasonable to have them checked. It, it just may not be helpful in the bigger picture, depending upon where you are in the pre-, peri-, or post-menopausal stage. So we hope this helps answer your question and makes you feel more informed if you're listening and you have a question, just go to our Facebook page and put it up under one of the comment sections of any post. We do have a post asking for that specifically, so if you can seek that out and put it there, um, we can be on the lookout for it.

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