Q: I have been told I need a hysterectomy, and that HRT will be offered to me afterward. My doctor suggested hormone testing before the surgery as a way to learn what my normal hormone levels are, but my insurance policy won’t cover that. I don’t want to spend the money on testing if I don’t have to. Do I really need it?

A: If you can afford baseline hormone testing, with either saliva or blood samples, and your practitioner is willing and able to put that information to good use, then it can be very useful. A baseline level is beneficial as a pre-hysterectomy reference, because it helps the practitioner to provide a dose of bHRT that most closely mimics your natural levels. It’s especially useful when compounded bHRT is used, for more precise ratios in your prescription.

But while testing hormones can be a wonderful tool, it is not mandatory for using low doses of FDA-approved products. This is important to understand, for those who are financially tapped-out or for women working with a doctor who doesn’t believe in testing. Practitioners who don’t have access to pre-hysterectomy hormone levels must still prescribe hormone doses based on the age, symptoms, exam findings, period status, body weight, and response to hormones their women patients used previously. As imprecise as these indicators are, most providers can still determine a dose that is close to the target. A skilled practitioner should be able to “read” the individual, not rely just on test numbers.

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