5 surprising hormone tests for period concerns

I struggled with my cycle for years. I had irregularity, acne, and ovarian cysts. I know how frustrating it can be to navigate hormonal concerns in the standard medical system. Unless something is really, really wrong, symptoms are either overlooked or you’re offered the cure-all: birth control (which, of course, is doing nothing to solve the problem, rather a band-aid solution). 

The issue lies in 1. a misunderstanding or lack of knowledge about the nuances of hormones and their interplay with one another (not only sex hormones) and 2. limited testing options and wide reference ranges. I’ve had many patients come in having done blood work. They're told ‘It’s normal!’ and sent on their way without direction on how to proceed. We can do better than this. 

There are a number of different hormonal concerns relating to the menstrual cycle that you can have and we start with getting an in-depth understanding of symptoms. This can guide us to what testing will be helpful in getting down to the specific hormonal patterns applicable to you. 

We can see heavy periods, painful periods, irregular or absent cycles, acne, hair loss, unwanted hair growth, weight fluctuations, mood swings etc. as symptoms of hormonal dysfunction. But what does that mean hormones are doing? 

If you’ve seen your GP or even an endocrinologist, you’ve likely had blood tests. They test for hormones like oestrogen, testosterone, progesterone, and LH/FSH. Maybe if they’re really good, they’ve had you do those tests on specific days of your cycle. But, if you have had these tests and your provider told you they are normal, but your symptoms are not, then the tests likely were not evaluated in the best reference range. Or, you may need more tests.

Five tests to learn more about your hormones

Here are five hormone tests I use in practice to help uncover each person’s unique hormonal underpinnings:

(Note: I don’t use all of these with each person, I will recommend only what is necessary based on symptoms and history)

1. The DUTCH (Dried Urine Test for Comprehensive Hormones)

This is a urine test. It looks at a panel of androgens (male-dominant hormones), progesterone, and estrogen. But, most importantly, it shows us how the body processes these hormones. How is your liver functioning and processing these hormones? This helps us treat more specifically. This also gives us valuable information about your adrenal function (cortisol). Stress can play a significant role in sex hormone imbalance, so it’s important to assess this.

2. Genetic testing for hormones

This tests for specific genes. It shows your predisposition to hormone synthesis and processing. This includes sex hormones, your stress response, and insulin. The combo of DUTCH and genetic testing is amazing. We can see your predisposition and risk. We can also see your real-time levels, which lifestyle has influenced. Very cool.

3. Insulin and glucose

Testing insulin shows your insulin sensitivity or resistance. It does so years before it shows up in your blood sugar. This is important. It's especially true for those with absent or irregular cycles. They may or may not have PCOS (polycystic ovarian syndrome).

4. Thyroid panel

Typically when you get thyroid testing done with your GP, it is TSH and maybe T4. To fully assess thyroid function, we want to look at the full spectrum of thyroid hormones. The thyroid can play a role in period heaviness and regularity as well as metabolism. This is important for people with PCOS. They have a higher rate of thyroid dysfunction.

5. Gut testing

This is important. Much hormone metabolism (phase III detox) happens in the gut. Bad gut microbes, digestion, or inflammation can harm hormone balance. If there is a long history of gut problems, finding out what they are is key. It can help keep hormones stable in the long term.

As I mentioned, I don't often run all these tests for patients I work with. I base decisions on symptoms and goals. Then, we will decide together on the best affordable option. I want to be clear: blood tests for hormone concerns are still very helpful. Most research has used blood tests as the main investigation. However, hormone blood tests have a limitation. This occurs when more comprehensive testing is helpful. 

I’m passionate about helping people navigate their hormone health, gut health and nervous system/stress response to achieve long-lasting results where they feel more balanced and like themselves again (or better!). If this sounds like you, or you’d like to know more, I offer 15-minute discovery calls as an opportunity to ask questions and see if we would be a good fit to work together, because I do believe health is collaborative. You are also free to email me with your concerns and I can let you know how I might be able to help.