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Updated July 2026 · Informational only

Perimenopause workup

Labs to request when symptoms (irregular cycles, hot flashes, brain fog) start but doctor says "labs are normal" or "wait until you're older."

What labs to request

  • TSH + free T4 (rule out thyroid mimic — must run first)
  • FSH on cycle day 2–5 (adjunctive — single value unreliable)
  • Estradiol on cycle day 2–5 (paired with FSH for staging)
  • CBC + ferritin (heavy bleeding → iron loss)
  • Vitamin D + B12 (common deficiencies affecting energy/mood)

DTC lab comparison

Compare home + clinic lab panels side-by-side

Each lab covers different markers. Quest is venous (most accurate). Everlywell is broadest panel. Mira is continuous tracking, not single-point. Pick based on what you actually need to learn — not on price alone.

ProviderPanelCash priceDraw methodCLIA / CAPResultsHSA/FSABest for
Quest DirectOwned labComprehensive Female Hormone Panel$199Venous (Quest / CAP location)CLIACAP3–5 daysMost accurate panel — venous draw at 2,000+ Quest locations. Best for PCOS workup or accurate testosterone.
EverlywellWomen's Health Test$249Fingerstick (home)CLIA5–8 daysComprehensive hormone + thyroid panel from home. Good if you want broad coverage a same-day collection.
LetsGetCheckedOwned labFemale Hormone Test$139Fingerstick (home)CLIACAP2–5 daysFocused fertility / cycle hormone panel. Owned-lab CLIA+CAP dual cert. Best for cycle-pattern investigation.

CLIA = Clinical Laboratory Improvement Amendments (federal lab standards). CAP = College of American Pathologists (additional voluntary accreditation, stricter). Owned-lab = provider runs their own lab vs outsourcing to partner labs.

Next steps