Is SHBG useful for menopause?

SHBG (sex hormone-binding globulin) is a carrier protein for sex hormones like estrogen and testosterone. During menopause, estrogen declines and SHBG often decreases as well – but not uniformly. Low SHBG can increase free, bioavailable testosterone, potentially contributing to weight gain or insulin resistance. However, the clinical utility of SHBG measurement in menopause is debated: values vary widely, standardized reference ranges are lacking, and evidence for independent predictive value beyond estradiol and testosterone is moderate. In practice, SHBG is sometimes included in hormone panels to calculate the free androgen index. For symptom management or guiding hormone replacement therapy, current evidence does not support SHBG as a standalone biomarker. A comprehensive assessment of hormones, lifestyle, and symptoms remains essential.