The FSH test: when it helps, when it doesn't, and what it costs here

Follicle-stimulating hormone (FSH) is the signal your brain sends to your ovaries to ripen an egg each cycle. As the ovaries slow down in your 40s, the brain "shouts louder" and FSH rises. After menopause it stays high.

The catch: in perimenopause, your ovaries still have good months and bad months. FSH can be high one week and normal the next. That is why a single test can mislead.

Many Filipinas are told to "get a hormone panel" to find out if they are in menopause. For most women over 45, this is not needed. International guidance (NICE NG23) says to diagnose perimenopause in women over 45 from symptoms and period changes, and menopause after 12 months without a period, without blood tests. It also advises against using AMH, inhibin, estradiol or ultrasound counts to diagnose menopause over 45 (NICE NG23 and QS143).

What matters more:

• Your age
• How your periods have changed (shorter, longer, skipped, heavier)
• Your symptoms: hot flashes, night sweats, 3 am waking, brain fog, mood, joint pain

A symptom diary kept for 4 to 8 weeks often tells your doctor more than one blood test.

• Under 40 with missed or changing periods: to check for premature ovarian insufficiency (POI). Older criteria asked for two raised FSH results (above 25 IU/L) taken 4 to 6 weeks apart. The 2024 international POI guideline says one raised result, after at least 4 months of missed or irregular periods, can be enough, with a repeat test or an AMH test if the picture is unclear (RACGP 2023; HealthDay on the 2024 guideline).
• 40 to 45 with symptoms: to look for early menopause.
• After a hysterectomy where the ovaries were kept, if symptoms are unclear.
• When symptoms could be something else and your doctor wants a fuller picture, often with thyroid tests (see perimenopause or thyroid?).

Hormonal birth control changes FSH results. If you use the pill or a hormonal IUD, tell your doctor before testing.

Test	Price
FSH	₱855 per test (Exact Check)
FSH	₱1,000 per test (Hi-Precision via Hati Health)
LH	₱900 per test (Exact Check)
Estradiol	₱1,325 per test (Exact Check)
TSH (thyroid)	₱490 per test (Exact Check)

Prices checked October 2026. Exact Check prices are from its July 2025 price list. A doctor's request is usually needed. You can book lab tests through Hati Health.

• High FSH under 40 or 45: your doctor will usually repeat it and talk about early menopause or POI, bone health and treatment.
• Normal FSH in your mid-40s with symptoms: this does not mean you are not in perimenopause. Treat the symptoms, not the number.
• High FSH after 12 months without a period: fits menopause, which your periods already told you.

You do not need FSH results to start HRT if you are over 45 with symptoms. See HRT for menopause.