Menopause treatment monitoring (for women already prescribed)
This panel is for women whose doctor has already prescribed menopausal hormone therapy. It checks the levels and general health markers your prescribing doctor uses to monitor that treatment, explained in plain English.
What it measures
- Oestradiol: the main oestrogen. A level is most useful where your therapy delivers oestradiol itself through the skin and absorption is in doubt. With other forms of prescribed oestrogen the assay does not reflect the dose, so the level says little.
- FSH: the pituitary signal to the ovaries. Prescribed oestrogen lowers it, so once therapy has started it is reported for context only and cannot settle whether you have reached menopause.
- Testosterone: the main androgen, which women also make. Measured to establish where your level sits.
- SHBG: the carrier protein for testosterone and oestradiol. Some therapies change SHBG, which alters how much hormone is free and active.
- Liver function: a general marker of how the liver is working. Your prescribing doctor decides whether it is relevant for you and how often.
- Lipid profile: cholesterol and triglycerides, read as part of your overall cardiovascular risk rather than against a single cut-off.
- HbA1c: a three-month average of blood sugar, a metabolic baseline.
- Full blood count: red cells, white cells and platelets, including whether any bleeding has led to anaemia.
Who it's for
Women aged 18 and over who are already taking menopausal hormone therapy prescribed by their own doctor, and who want their levels and general health markers checked between appointments. If you have not been prescribed treatment, the perimenopause and menopause panel is the right starting point instead.
What you'll learn, and what you won't
You will see your current oestradiol, FSH, testosterone and SHBG alongside liver, lipid, blood sugar and blood count results, each explained in plain English. Your doctor can use the report to see whether therapy is being absorbed as expected and whether your general health markers are where they should be.
What you will not get is a verdict on your treatment. This panel does not tell you whether your dose is right, whether to change anything, or how long to continue. Those decisions belong to the doctor who prescribed for you. A blood test is one input to a doctor's assessment, not a diagnosis on its own. If anything needs prompt attention, a doctor contacts you directly.
Why these markers are monitored
| Marker | Why your doctor checks it on therapy | What it usually means |
|---|---|---|
| Oestradiol | Absorption varies from person to person, so a level shows whether therapy is reaching the bloodstream. | Read against the form you use and the time since your last dose. There is no single target number for everyone. |
| FSH | Of limited value once therapy has started, because prescribed oestrogen lowers it. Reported for context only. | Typically above about 30 IU/L after menopause when untreated. It cannot confirm the menopausal picture on therapy, which is a question settled before treatment begins. |
| Testosterone and SHBG | Establishes androgen status and how much testosterone is free and active. | SHBG can rise on some therapies, lowering free testosterone even when the total is unchanged. |
| Liver function | Included where your prescribing doctor wants it. Australian guidance does not set routine liver testing on menopausal hormone therapy. | Persistent changes are followed up by your doctor. |
| Lipid profile | Cardiovascular risk rises after menopause. Checked on the usual preventive-health schedule your doctor sets, not on a therapy schedule. | Cholesterol is read as part of overall cardiovascular risk (Australian CVD risk guideline 2023), not against a single cut-off, and your doctor sets your own target. |
| HbA1c | Metabolic baseline and long-term diabetes screening, on the interval your doctor sets from your risk. | 6.5 per cent (48 mmol/mol) or above is in the diabetes range and is repeated to confirm; 6.0 to 6.4 per cent is a flag for follow-up. |
| Full blood count | General health, and whether any bleeding has affected haemoglobin. | Haemoglobin below the lab's lower limit points to anaemia that needs a cause found. |
Ranges vary by laboratory; your report shows the range your lab uses. Typical ranges on this page are drawn from Pathology Tests Explained (RCPA) and the sources listed below.
How often should monitoring tests be done?
Your prescribing doctor decides. Australasian Menopause Society guidance does not require routine hormone levels for most women over 45 on standard therapy, because dosing is guided mainly by how you feel. Levels tend to be checked in specific situations: when absorption is uncertain, in early menopause or premature ovarian insufficiency, or after a change. The usual pattern is a clinical review about three months after starting or changing therapy and at least yearly after that, with blood levels only when there is a specific reason. Australian guidance does not set a routine blood monitoring schedule for this therapy: general markers such as lipids, blood sugar and liver function are checked on the usual preventive-health schedule, which for many women is every one to five years depending on risk, and liver tests only if there is a reason. Your prescribing doctor decides which of these markers are relevant and how often. Ask them what interval suits you, then order this panel to match.
When to do this test
- Fasting: not required unless your doctor asks. If they want fasting lipids, fast for 8 to 12 hours and book a morning collection.
- Your treatment: take it as normal unless your doctor has advised otherwise. Note the time of your last dose on the day of collection; it helps the doctor interpret oestradiol.
- Timing: if your doctor has asked for a level after a change, allow the interval they suggested before collecting.
How it works
- Order online. Either upload the request your own doctor has signed ($189), or a KnowLuna women's health doctor reviews your details, requests the panel and explains the results in a 20-minute video consult ($269).
- Collect at an accredited (NATA) centre near you, or choose a home kit or a nurse visit (options below). One standard blood draw.
- Results are usually ready within a few business days, explained in your account. Download the report to share with your prescribing doctor.
Choose how you collect
Every option is the same accredited test and the same report. Pick what suits you at checkout; the fee, if any, is added to either pathway price.
A quick draw at an accredited pathology collection centre near you. Usually under ten minutes. Included.
Lancet kit posted to you with an Express return satchel. If the lab cannot test your sample we send a replacement kit at no charge.
A near-painless device draws a small sample from the upper arm, with far fewer failed samples than a finger-prick. Express return satchel included.
A registered nurse comes to your home or workplace for a standard blood draw. Metro areas of capital cities; other locations on request.
Common questions
Do I need blood tests while on menopausal hormone therapy?
Not always. For most women over 45 on standard therapy, Australasian Menopause Society guidance says dosing is guided by symptoms rather than routine hormone levels. Blood tests are useful in particular situations: uncertain absorption, early menopause, or when your doctor wants a general health baseline. Your prescribing doctor decides what is needed and when.
What does an oestradiol level mean when I am on therapy?
It shows how much oestradiol is circulating at the moment of collection. That is useful mainly where your therapy delivers oestradiol through the skin and absorption is in doubt; with other prescribed forms of oestrogen the level says little about the dose. There is no universal target, the reading is interpreted against the form you use and the time since your last dose, and a level alone never decides a dose.
Can KnowLuna prescribe or change my treatment?
No. KnowLuna does not prescribe, supply or adjust menopause medicines. This panel monitors levels and general health markers, a doctor explains what they show, and you share the report with the doctor who prescribes for you. Any change to your treatment is their decision, made with you.
How often should monitoring tests be done?
Your prescribing doctor decides the interval. Hormone levels are checked when there is a specific reason, and Australian guidance does not set a routine blood schedule for this therapy: general markers such as lipids and blood sugar follow the usual preventive-health intervals your doctor sets from your risk, and liver tests only if there is a reason. Ask your doctor what they want checked and when, then order the panel to match.
Why does the panel include lipids, HbA1c and a blood count?
Because heart and metabolic risk change after menopause, and these markers give your doctor the wider picture beyond hormone levels. They are general preventive-health markers rather than a required part of monitoring this therapy, so your prescribing doctor decides which of them are relevant for you and how often.
Sources and further reading
- Australasian Menopause Society: Combined menopausal hormone therapy (information sheet)
- Australasian Menopause Society: Diagnosing menopause (information sheet)
- Jean Hailes for Women's Health: treatments for menopause
- Pathology Tests Explained (RCPA): lipid profile
- Pathology Tests Explained (RCPA): HbA1c
- Healthdirect: menopausal hormone therapy
General information only, not medical advice. A test result is one input to a doctor's assessment, not a diagnosis on its own, and every abnormal result is followed up by a KnowLuna doctor. If your symptoms are severe or sudden, see a doctor promptly. Read our medical disclaimer.
Related
- Perimenopause and menopause tests: the stage hub.
- Women's testosterone therapy check: monitoring for women already prescribed testosterone.
- Postmenopause health check: bone, heart and metabolic baseline for the decades after.
- Perimenopause and menopause tests: what a blood test can confirm
Then talk to your doctor.