My consultant generally disregards blood tests results and diagnoses primarily on a patient's symptoms, and previous history such as PMS or PND.
If you are suddenly riddled with anxiety and very low moods and random insomnia then something is very WRONG even if your blood tests come back as 'normal'.
Two female GPs disregarded my symptoms, never once mentioned peri menopause and just stuck me with ADs. Even when I explained about my history of PMS and PND and that every month I was still getting quite a lot of 'good' days and that I felt very good around ovulation.
Too many women suffer quietly just assuming that because they still have periods they can't be suffering from menopausal problems.
My poor Mum suffered terribly with sudden chronic anxiety and mood swings for over 4 years between the age of 39 and 43. She calls those 4 years 'my Hell years'. It was only when she had to have a full hysterectomy due to fibroids at 43, and was put on HRT that within weeks she was 'magically' cured of her anxiety and mood swings.
Yes, yes, YES! This!!
My GP and gastroenterologist have both tried to tell me it's anxiety, despite my protestations that I was on top of the world when it started, never happier, and that it coincided with my cycles going haywire. My gastro even argued that for some people, anxiety comes out of the blue.
It's ridiculous - I'm getting palpitations, night sweats, insomnia, fatigue, irregular cycles (although still periods every month), spots, aches and pains, blood sugar crashes etc...but only at certain times of the month. I can have runs of days where I feel completely normal - all symptoms gone.
I actually told my GP I feel like I'm undergoing a chemical change, but she still won't consider peri!