For most women over 45, menopause is diagnosed from symptoms and the pattern of periods, not from a blood test; Canadian guidance says FSH testing adds little at that age because levels swing from month to month. Blood tests matter under 45, when periods stop unexpectedly, after a hysterectomy, or to rule out other causes such as thyroid disease or pregnancy. When ordered by your provider, these tests are covered by OHIP and can be drawn at any Bio-Test centre in Ottawa without an appointment.
Why a blood test usually isn't needed after 45
During perimenopause the ovaries produce hormones unevenly, so follicle-stimulating hormone (FSH) and estradiol can look menopausal one week and normal the next. A single result can mislead. The Menopause Society of Canada and the Society of Obstetricians and Gynaecologists advise diagnosing on symptoms and menstrual history in women over 45, and treating symptoms on that basis.
When testing is useful
- Under 45 with irregular or absent periods, to assess for premature or early ovarian insufficiency.
- After a hysterectomy or endometrial ablation, when periods can no longer be used as a guide.
- On hormonal contraception that masks the menstrual pattern, with the timing of the test planned by your provider.
- To exclude other causes: TSH for thyroid disease, prolactin, and a pregnancy test when relevant.
- Before or during hormone therapy in specific situations chosen by your provider.
Which tests are ordered
FSH, often repeated four to six weeks apart, and estradiol are the core hormone tests. Anti-Müllerian hormone (AMH) is sometimes discussed for ovarian reserve but is not a menopause test and is often uninsured. TSH is frequently added because thyroid symptoms overlap with menopausal ones. Our hormone tests and OHIP guide explains timing and coverage in more detail, and the TSH guide covers thyroid testing.
Timing and preparation
If you still have periods, your provider may ask for the draw on a specific cycle day, usually day 2 to 5. No fasting is needed. Tell the desk if you take hormonal contraception or hormone therapy so it is noted on the report.
Is menopause testing covered by OHIP?
FSH, estradiol, TSH and prolactin ordered by a physician or nurse practitioner for a clinical reason are insured. Tests requested for wellness screening without an indication, and some specialised panels, are patient-pay; the desk confirms before collection. See what OHIP covers.
Getting tested in Ottawa
Walk in to any of Bio-Test's 11 centres with your requisition and Ontario health card. Results go to your provider within 24 to 48 hours and to your patient portal. Your provider, not the laboratory, interprets hormone results in the context of your symptoms.