If you are considering HRT, one of the first questions you will probably ask is whether you need blood tests beforehand. The answer depends on what the tests are for. Blood tests to diagnose  menopause or perimenopause are rarely needed. Blood tests to exclude other causes of your symptoms  are a different matter entirely. NICE guideline NG23 says most women aged 45 and over can be diagnosed with perimenopause or menopause on symptoms alone, without any laboratory tests at al