I showed signs of early menopause (REALLY early) and I had blood work. None of the hormones that would indicate menopause were found or elevated. So next time in office after my exam my doctor recommended a uterine biopsy. The take these like..snippers and go up through the cervix and snip a small piece of the lining and send it out. Yes it hurt and I had cramping. Apparently sometimes your bloodwork can be normal but this test shows the hormones(?). Anyway I am not in menopause but still have those symptoms so my doctor is operating under the assumption that its perimenopause. Hormones are very important, especially for women.