What happens during a perimenopause consultation? Is it mostly conversation, or is lab work involved? The majority of the time is spent listening and educating. Lab work can be an important part of the evaluation, but it is only one component of the conversation. During perimenopause, hormone levels can fluctuate considerably. If I check your estradiol and FSH today, those results could look completely different three days later, especially if you’re still cycling. Lab work can also help establish a baseline and identify an undiagnosed medical condition that may be contributing to your symptoms. But the answer should not simply be, “Your labs are normal; you don’t need treatment.” My focus is on treating the patient and her symptoms, not just the lab results. Many women have been told everything is fine because their labs are normal, even though they don’t feel fine. That’s why listening to what you’re experiencing is such an important part of the evaluation. — Transcript edited for clarity and reviewed by Alan McCool, MD, FACS and Menopause Society Certified Practitioner. Reviewed: October 15, 2026.