Table of Contents
Introduction
Suppose you’re a woman between 30 and 65, especially approaching perimenopause or menopause. In that case, you might wonder whether your fluctuating mood, fatigue, weight gain, or irregular periods are more than stress or aging.
Hormones regulate nearly every function in a woman’s body—from metabolism and menstrual cycles to mood, bone health, and sleep. The symptoms can be confusing and overwhelming when they fall out of balance.
Hormone imbalance testing can be an essential step toward understanding what’s going on beneath the surface.
This guide breaks down everything you need to know about hormone testing, whether you’re considering at-home hormone tests, a blood test for hormones, or want to understand the best time to test hormones and what the results mean for your health.
Why Test Your Hormones?
Symptoms of Hormone Imbalance
Hormones affect everything from your metabolism and mood to your sleep and bone health. When these levels fluctuate or fall out of range, especially around perimenopause or menopause, the symptoms can be hard to ignore. You may want to consider hormone testing if you’re experiencing:
- Irregular or missed periods
- Hot flashes or night sweats
- Low libido
- Weight gain, especially around the abdomen
- Hair thinning or hair loss
- Mood swings, anxiety, or depression
- Chronic fatigue or poor sleep
- Vaginal dryness
- Difficulty concentrating (“brain fog”)
These are just a few signs that your hormone levels might be out of balance. Shifts in estrogen, progesterone, testosterone, thyroid hormones, cortisol, and others can cause it.
Who Should Get Tested?
Hormone testing is appropriate if:
- You are in your 30s to 60s and experiencing new or worsening symptoms
- You suspect early perimenopause or premature ovarian insufficiency.
- You’re managing PCOS, thyroid disease, or adrenal issues.
- You’ve tried lifestyle changes with little improvement.
- You’re considering natural hormone support or alternatives to hormone replacement therapy.
If you’re unsure whether hormone testing is right for you, speak with a healthcare provider familiar with women’s hormonal health. It’s essential to test before starting any supplement or hormonal treatment.
Types of Hormone Tests
Choosing the right type of test depends on which hormones you’re checking, your symptoms, and the accuracy you’re seeking. Below is a breakdown of the most common hormone testing options for women.
1. Blood Tests (Most Accurate)
Blood hormone tests are the gold standard, especially in a clinical lab. They measure active hormone levels at a specific point in time and are used to test:
- Estrogen (estradiol, estrone)
- Progesterone
- Testosterone
- FSH and LH (important in menopause)
- TSH, free T3, and free T4 (thyroid function)
- DHEA and cortisol (adrenal function)
- Prolactin
- DHEA
You should do blood testing when accuracy is paramount, especially when evaluating thyroid function or determining if you are in menopause. However, it typically requires a visit to a lab or clinic.
Pros:
✔️ Widely available
✔️ High accuracy
✔️ Often covered by insurance
Cons:
❌ Only captures hormone levels at one point in time
❌ May not reflect daily fluctuations (especially for cortisol)
If you’re wondering where to get hormone testing, your primary care provider, gynecologist, or endocrinologist can order these labs.
2. Saliva Tests (Cortisol/DHEA)
Saliva hormone tests are commonly used to measure free (bioavailable) hormone levels, especially for:
- Cortisol (across different times of the day)
- DHEA
- Progesterone
- Estradiol
You are likely to do this in at-home hormone tests for adrenal fatigue, stress, or to track diurnal cortisol patterns.
Pros:
✔️ Non-invasive
✔️ Easy to collect at home
✔️ Reflects free, unbound hormone levels
✔️ Better for tracking daily cortisol rhythm
Cons:
❌ Less standardized than blood tests
❌ Not ideal for all hormones
❌ Affected by eating, brushing teeth, and other daily habits
Saliva testing is beneficial if your symptoms are related to chronic stress or suspected adrenal dysfunction.
3. Urine Tests (Comprehensive Metabolites)
Urine hormone testing, especially dried urine testing (e.g., DUTCH test), measures:
- Hormone metabolites over 24 hours
- Estrogen breakdown pathways
- Cortisol and melatonin patterns
- Nutrient markers related to hormone health
- Progesterone and its metabolites
- Androgens (testosterone, DHEA)
This type of test can help assess how your body processes and eliminates hormones, which is essential for those with a history of estrogen dominance, breast cancer risk, or detoxification concerns.
Pros:
✔️ Offers a comprehensive picture
✔️ Useful for tracking how your body processes hormones
✔️ Easily collected at home
Cons:
❌ Expensive
❌ Requires proper timing and collection technique
❌ Interpretation can be complex
Urine test is one of the more advanced forms of hormone imbalance testing, ideal for women looking for in-depth hormone and detoxification profiles.
4. At-Home Testing Kits (Pros/Cons)
At-home hormone tests have become increasingly popular, especially for those who want convenience, privacy, or need multiple samples taken over time.
Standard kits test for:
- Estradiol, progesterone, testosterone
- Cortisol (multiple samples for rhythm tracking)
- Thyroid markers
- Luteinizing hormone and follicle-stimulating hormone
Pros:
✔️ Convenient and private
✔️ May include multiple time-point sampling
✔️ Increasingly reliable
Cons:
❌ May not be as accurate as clinical labs
❌ Often not covered by insurance
❌ Risk of improper sample collection
If you’re considering this route, look for the best hormone testing kits with Clinical Laboratory Improvement Amendments (CLIA) certified labs and reviews from licensed professionals.
How to Prepare for Testing
Timing (Menstrual Cycle, Time of Day)
The best time to test hormones depends on the specific hormone and whether you’re still menstruating.
- Timing is less critical for postmenopausal women, but morning tests are still recommended.
- For Estradiol and progesterone, the best time to test is day 21 of a 28-day cycle (mid-luteal phase)
- For follicle-stimulating hormone and luteinizing hormone, the best time to test is day 3 othe f cycle (early follicular phase)
- For cortisol, the best time to test is morning (8 AM) for a single test, multiple times for rhythm tracking.
- For thyroid, you can test at any time of day, preferably during fasting.
- For dehydroepiandrosterone (DHEA) and testosterone, the best time to test is morning, between 7 and 10 AM.
For postmenopausal women, timing is less critical, but morning tests are still recommended.
Foods/Medications to Avoid
To improve accuracy, consider avoiding the following foods and medications:
- Caffeine and alcohol for 24 hours prior
- Supplements that contain biotin, which can interfere with lab results
- Hormone-containing creams or patches on testing days
- Intense exercise, especially for cortisol test
Always follow the specific instructions provided by your provider or test kit.
Interpreting Results
Normal vs. Abnormal Ranges
Lab reports usually list your values alongside reference ranges. But what’s considered “normal” can vary based on age and menopausal status, time of day or menstrual cycle phase, and testing method (blood, saliva, urine). For example:
Estradiol:
- Premenopausal: 30–400 pg/mL (varies by phase)
- Postmenopausal: <30 pg/mL
Progesterone:
- Luteal phase: 5–20 ng/mL
- Postmenopausal: <1 ng/mL
TSH (thyroid): 0.4–4.0 mIU/L (optimal often considered 0.5–2.5)
Repeating testing or follow-up with a healthcare provider is often recommended if your results are borderline or abnormal.
Also, your healthcare provider should interpret results in the context of your symptoms, not just the numbers. For instance, a normal estrogen level may still be too low for optimal health in a symptomatic woman.
When to Retest
Retesting might be necessary if:
- You start or stop hormone therapy or supplements
- Symptoms worsen or new ones develop.
- You’re tracking a specific hormone intervention over time
- The initial test was inconclusive or borderline
- Every 6–12 months during perimenopause
In many cases, retesting every 3–6 months is ideal for monitoring changes.
Frequently Asked Questions
A hormone blood test offers the highest accuracy and reliability for most women, especially at a certified lab. However, saliva or urine tests may provide more insight into cortisol patterns or hormone metabolism.
Yes, at-home hormone tests are available and increasingly reliable. They often use saliva or dried blood spots and allow you to test key hormones like Estradiol, progesterone, and cortisol from the comfort of your home.
The cost of hormone testing can range from $50 to over $400, depending on the type of test and number of hormones tested. At-home kits typically cost $99–$250. Comprehensive tests like DUTCH can cost $300+. Insurance may cover blood tests ordered by a provider.
Final Thoughts for You
If you’ve been feeling off—whether it’s brain fog, low energy, or unexplainable weight changes—hormone testing could be the key to getting answers. Understanding your hormone levels provides insight into your overall health and gives you a foundation for action.
Whether you’re considering at-home hormone tests or going through your doctor for a blood test for hormones, what matters most is choosing the right test that aligns with your symptoms, goals, and access to follow-up care.
Don’t ignore what your body is trying to tell you. Speak with your healthcare provider, explore your options, and remember—when you understand your hormones, you can take better control of your health and well-being.
- Precision analytical (Dutch test) – test kits, providers & patients.
Bruce DF, PhD, Collier L. Normal testosterone and estrogen levels in women. WebMD.
Yu Z, Jiao Y, Zhao Y, Gu W. Level of estrogen in females—the different impacts at different life stages. Journal of Personalized Medicine. 2022;12(12):1995.
CDC. Clinical laboratory improvement amendments. Clinical Laboratory Improvement Amendments (CLIA).
