Do I need blood tests before starting HRT?
Reviewed by Kindr Health Clinical Team · Last reviewed July 3, 2026
Answer published
For women in their 40s and 50s with classic perimenopause or menopause symptoms, the 2022 NAMS position statement supports symptom-based prescribing without routine hormone labs — FSH and estradiol fluctuate too much in perimenopause to be diagnostic. Labs are appropriate before starting if you are under 40 (rule out POI), have atypical symptoms, are on thyroid medication, or before starting testosterone (baseline total/free testosterone, SHBG). Many kindr providers also check ferritin, vitamin D, and TSH when symptoms overlap. None of this is required to begin care.
People also ask
- How do I get HRT prescribed online? →
Complete a clinical intake, meet with a licensed menopause provider via telehealth, and have prescriptions sent to your pharmacy — usually within 5–7 days.
- What are the most common symptoms of perimenopause? →
Irregular periods, hot flashes, night sweats, sleep disruption, mood changes, brain fog, joint pain, and vaginal dryness are most commonly reported.