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Hormone tests for women

Reviewed by Dr. Sarika Arora, MD

Your hormones are designed to stay in tight and harmonious balance with each other. So, that’s why when that balance is off, you notice it. Symptoms of hormonal imbalance include hot flashes, weight gain, brain fog, hair loss, mood swings, and anxiousness. If you’ve been experiencing these types of health issues, you may want to know if  hormone testing or a women’s hormonal panel can help you pinpoint the problem.

Here’s where it gets complicated.

In isolation, the “raw” results from hormone panels and other tests aren’t as helpful as you might wish. This is not like taking a binary yes/no Covid test! But in the hands of a skilled doctor who will take the time to “connect the dots”, the tests can be meaningful. To help you understand your options, here is a general overview of basic hormone tests and how the information they provide can benefit your health and hormonal balance.

hormonetests

What is a female hormone test?

A female hormone test is a blood test that measures levels of a woman’s sex hormones, including estrogen and progesterone. (The complete list is below.) A female hormone test can provide insight into hormonal imbalance by detecting the presence of elevated or declining hormone levels, such as those commonly experienced during menopause or pregnancy. Female hormone tests may also be used in the diagnosis of hormone-related disorders, such as PCOS and uterine fibroids. 

Why is female hormone testing important?

The body typically does an excellent job of letting you know a problem has developed in one or more hormonal systems by producing telltale symptoms. For this reason, most women are able to identity their hormonal imbalance through symptom recognition alone and won’t require formal testing or even at home hormone testing. If you are a woman in your 40s and experiencing hot flashes, for example, it’s a reliable sign that you are experiencing an imbalance related to estrogen and progesterone. If you care for your hormones and bring them back to balance, the hot flashes will fade.

Some women prefer hormone testing, especially if they suspect they have PCOS or breast cancer or are recovering from hysterectomy, experiencing fibroids, or if their periods have stopped or become erratic at an early age for no obvious reason, or other postmenopausal issues may have developed. By measuring levels of hormones in a woman’s blood or via saliva hormone testing, healthcare providers can determine if there are any imbalances and, if so, which hormones are involved. This information can then be used to develop an appropriate treatment plan or provide further information for a specific diagnosis. Hormone testing costs may or may not be covered by insurance. 

For some women, especially those experiencing a mix of severe symptoms, it may make sense to test for other causes of symptoms that can mimic a perimenopausal imbalance, such as low thyroid.

When is hormone testing helpful for women?

To help you understand if you could benefit from hormone testing, see where you fall in these three generalized groups. 

Women with fertility issues. For women in this category, hormone panels are key, both as a diagnostic and a therapeutic tool. So many fertility problems can be traced to irregularities in the menstrual cycle, and your practitioner needs to understand what’s wrong in order to give you the right support.

Women with ordinary symptoms of hormonal imbalance. Women often ask us: is there a test to tell whether I’m in menopause? The short answer is no. You’re menopausal when you haven’t had a period for a year. Hormone tests are not required for this largest group of women. The symptom patterns are very individual, but the first line therapy is mostly the same: build a nutritional foundation, take the right basic supplements to restore balance, and make meaningful lifestyle changes.

Women with severe symptoms of hormonal imbalance. For women with debilitating or intractable symptoms, a hormone panel is essential. Talk to your doctor about your need for hormone testing. When dealing with PCOS, fibroids, diagnosed alopecia (hair loss), and other more severe hormone issues, your practitioner simply can’t treat you without knowing where your hormones are.

How often should women get their hormones tested?

If your initial hormone panel revealed an imbalance and you’ve taken steps to correct it through nutrition, exercise and other lifestyle interventions, having your symptoms diminish is a great sign that balance has been restored. If you are feeling good, chances are your hormones are also in a good place and no further testing is necessary. 

In other situations, women may need follow up testing. For example, regular hormone testing may be recommended for women recovering from hysterectomy or breast cancer, especially if HRT or hormone-blocking drug (i.e., Tamoxifen) was prescribed.

When is the best time to test for hormone imbalance?

Women’s sex hormones are in a constant state of flux over the course of her cycle. In general, testing is recommended in the ‘first half’ of the cycle (the follicular phase) when normal and abnormal hormone levels are more clearly separated. Progesterone may be deliberately measured on day 21 in the middle of the ‘second half’ (luteal phase) to see if ovulation has occurred.

If you are taking birth control pills or HRT or a hormone-blocking drug, results will reflect this and may not accurately reflect the state of your natural hormones. Your doctor recommend going off birth control pills for more than a month or more to get the most accurate results of your hormonal function. Use your symptoms as your guide.

What tests make up a female hormone panel?

When it comes to key tests in a hormone panel, what they measure and what the results mean, levels and ranges will vary from lab to lab. This chart gives you a very general idea of what high or low levels of a particular hormone may indicate.

Hormone tests

Estrogen

What is measured There are three main types of estrogen measured in our blood: estrone (E1), estradiol (E2), estriol (E3). Estrogen levels naturally fluctuate daily, hourly, and even on a minute-to-minute basis.

Interpreting results Estrone typically increases after menopause, while estriol usually only rises with pregnancy. Estradiol (the most commonly measured estrogen) varies throughout the menstrual cycle and drops to a low, steady level after menopause. High estrogen may be connected to fibroids, weight gain, diabetes, or high blood pressure. Low estrogen levels typically occur naturally after menopause, but may also happen with certain genetic disorders, extreme exercise, and anorexia.

Progesterone

What is measured Progesterone levels in the blood increase after ovulation to prepare the uterus for pregnancy.

Interpreting results Low progesterone is common during perimenopause and menopause. It may also indicate a problem with fertility in younger women. High progesterone may be caused by pregnancy, an adrenal imbalance, and some forms of cancer.

Testosterone

What is measured Testosterone is naturally produced in women by the ovaries and adrenal glands. It’s released in a pulse-like fashion, and levels vary from hour to hour, minute to minute.

Interpreting results High levels of testosterone could indicate problems with infertility and/or polycystic ovarian syndrome (PCOS). Testosterone levels gradually decline after menopause. But a drastic decrease in testosterone may happen in conjunction with high stress and high cortisol.

DHEA (dehydroepiandrosterone)

What is measured DHEA is a natural steroid and a precursor to your sex hormones.

Interpreting results Low DHEA typically happens when you are under great amounts of stress. Low DHEA can throw off your sex hormone balance and cause depression, fatigue and other symptoms.

FSH (follicle stimulating hormone)

What is measured LH spikes during ovulation to help release the egg from the ovary.

Interpreting results If FSH is high, it could indicate a problem with the ovaries. Or it may indicate that a woman is in perimenopause or menopause. If FSH is low, it indicates there may be an issue with the pituitary or hypothalamus.

LH (Luteinizing hormone)

What is measured LH spikes during ovulation to help release the egg from the ovary.

Interpreting results Similar to FSH, if LH is high, it may indicate an issue with the ovaries. If it is low, it may indicate an issue with the pituitary or hypothalamus.

Let your symptoms by your guide

For more serious cases and symptoms, hormone testing can be very helpful. But for most women who experience the normal, if unpleasant, fluctuations of hormones during perimenopause and menopause, hormone testing not generally needed — nor will they offer many answers. The best way to measure your hormones during perimenopause and menopause is to evaluate your symptoms. Ready to know more? Take our quick hormonal profile to see how your symptoms rate.

Last Updated: April 10, 2023
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