Hormonal Testing

By Dr Hazel Batten, Integrative GP at Remede Wellness Medicine

Why We Use Hormonal Testing?

Hormone testing is an integral part of my practice. It is incredibly useful for knowing what’s going on with your overall health. It can be used to detect the following conditions: polycystic ovarian syndrome, relative energy deficiency syndrome, hypothalamic amenorrhoea, perimenopause and menopause. It can also assist in diagnosing and monitoring conditions such as endometriosis, early pregnancy and pre-menstrual disorders and can be really good for tracking the effectiveness of menopause hormone treatment.

Specific Tests To Assess Hormones & When To Test?

Hormones can be checked from a blood, urine or salivary sample. These are all very accurate methods. The most accurate times to check hormones are during the follicular phase of the menstrual cycle (day two or three of menstrual bleeding) and in the luteal phase (seven days post ovulation). In post-menopausal patients, hormones can be checked at any time.

The tests I like to order in the follicular phase are: FSH/LH, oestrogen, progesterone, prolactin, testosterone, free testosterone, sHBG, DHEAs. This gives you an overall idea of how the brain and the ovaries are communicating. Each one of these tests can give you a valuable piece of information about what’s going on.

The luteal phase hormones in a standard 28 day cycle, would be done on day 21. On this test you can measure oestrogen and progesterone and look at the ratios.

With any menstrual disorders it is essential to check the thyroid hormones and nutrients such as iron and B12. I usually check fasting insulin, a full blood count and inflammation markers such as ESR and CRP. I check a fasting homocysteine, which can be a good marker for showing how the body is detoxifying the hormones in conditions such as endometriosis.

I do mostly serological testing. However, in certain individuals I may recommend a DUTCH complete hormone test. This is a dried urine test which is carried out over 24hours. The reason for this is that it can give a more detailed explanation of individual hormones and how the body is eliminating them. As well as measuring DHEA, testosterone, oestrogen and progesterone, it also measures cortisol and melatonin.

Remember that hormones can fluctuate and one month of hormones may be different from the next month. It can be important to check on more than one occasion and to ensure timing is correct before interpreting the overall picture.