How Are Hormone Levels Tested
Often practitioners rely on blood tests alone to provide information about hormone levels. But Ive found that sometimes, a blood test wont give me the full story. Not only that, but the range considered normal in many blood tests is so wide it doesnt pick up on slight imbalances that can make a huge difference. Thats why so many women are told their levels are in the normal range, but still feel lousy.
Saliva tests have been shown to be more accurate for measuring cortisol, DHEA, and for some, estrogen, progesterone and testosterone levels. Saliva testing provides more specific information and measures the amount of hormone bioavailable at the cellular level, rather than simply how much is circulating in the bloodstream.
Your provider should discuss all the options with you so that together you can decide which form of testing makes the most sense. Its also important to note that to get the best information, hormone levels should be monitored over time. One moment in time doesnt provide enough information to understand your normal.
Some women ask about the testing kits that are being sold for home use now. I always think its best to have testing done through your health care practitioner, who can help you interpret results and guide you in treatment.
Commonly Asked Questions About Female Hormones
What is the lifelong role of estrogen in female health?
Most people think estrogen is primarily responsible for reproduction, but it also helps with bone, skin and cardiovascular health. In addition, it affects thyroid hormone production. During menopause, estrogen levels decline along with the production of progesterone and testosterone. Hormone replacement therapy , which means replacing lost hormones by re-introducing them into the body, is often suggested to offset the positive benefits of estrogen and can be helpful in reducing common symptoms of menopause. But some studies show that artificial doses of estrogen carry risks and have been linked to cancer, dementia, strokes and arthritis. Never assume that hormone replacement therapy is the right thing to do without consulting your healthcare provider.
What is Puberty? Hormones that control puberty
Puberty is the time in life when children begin to show changes through hormone secretions that indicate they are about to become adults physically. In girls, the most obvious sign of puberty is the onset of menstruation. It can happen anywhere between the ages of 9 17, with a median age of 12. The menses, or monthly cycle, is interrupted during pregnancy and typically ends when the ovaries stop secreting steroid hormones a stage known as menopause.
What are the hormonal milestones in a females life?
What Causes Hot Flashes?
Why do I feel so different during my monthly cycle?
Why dont men have monthly cycles?
Preparing For Hormone Testing At Cedars
We explain the tests you need and answer any questions you may have.
Heres what to expect:
- Stop certain medications: We let you know whether to stop taking drugs such as oral steroids or estrogen supplements before your test.
- Visit one of our labs: You go to a Cedars-Sinai lab and provide a blood, urine or saliva sample. If you need stimulation or suppression testing, we let you know in advance how long youll need to stay.
- Collect samples at home: If we need samples over a period of time, you may be able to perform testing at home. We give you special containers for collecting saliva or urine samples and detailed instructions on how to handle them.
- Receive more than one form of hormone testing: Blood testing is one way we evaluate hormone imbalances. We may recommend additional tests, including stimulation or suppression tests, to learn more about whats causing the imbalance.
- Undergo other forms of testing: For problems such as tumors or a possible cancer diagnosis, we use imaging to learn more about their size, location and nature.
Have Questions or Need a Second Opinion?
To make an appointment or refer a patient, call us or send a message to the Endocrinology care team.You can also have us at your convenience.
Treatment For Hormone Imbalance
There are various treatments for a hormonal imbalance, and they depend on what is causing the problem. Common treatments include medication, lifestyle changes, and supplements.
Having a balanced diet, exercise, losing weight, and changing sleeping patterns can help for mild hormone imbalances. Furthermore, vitamins and natural supplements can correct hormone imbalances. Herbs like ginseng and red clover are sometimes effective, as are selenium and vitamin D.
More serious cases of hormonal imbalance can require hormone therapy and medication. In addition to testosterone or estrogen supplements, patients can have thyroid-based hormone therapy, anti-androgen medication, or metformin.
How To Test Your Hormones At Home
My gold standard is a blood draw for serum testing, but its hard to get a blood draw during a pandemic! There are convenient, reliable alternatives for many biomarkers. In the video, I talk about the blood spot test from ZRT Labs. I also love the dried urine test for hormone metabolism and to follow certain hormones in my patients on bioidentical hormone therapy. Occasionally I will run saliva tests but only for limited indications.
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Common Hormone Testing For Women
Before you begin your search and compare your options, lets take a look at 12 lab tests designed to help identify hormonal imbalances in women.
This acronym stands for Dehydroepiandrosterone-sulfate. This is a weak male hormone that adrenal glands produce in both men and women.
What It Measures
A DHEA-S test measures the level of this hormone in your blood. It is appropriate for women who appear to have too many male hormones.
Clinical Test Reference Range
Normal levels of DHEA-S will vary depending on each individuals sex and age. The average normal ranges for females measured in mcg/dL, as reported by Quest, are listed below.
- < 1 Month: 15-261
There is a particular group of steroids responsible for regulating your menstrual cycle and functioning as your main female sex hormones. This group includes the most predominant form of estrogen, called Estradiol, also referenced as Estradiol-17 Beta or E2.
What It Measures
An Estradiol test measures the level of Estradiol in your blood.
As its produced mainly in your ovaries, doctors can analyze this hormonal activity to see if your organs are functioning as they should.
Clinical Test Reference Range
Normal levels of Estradiol in women will vary depending on the menstrual cycle and age. The following Estradiol levels are considered normal for women, as reported by Quest.
- Follicular Phase: 19-144 pg/mL
Normal levels for postmenopausal women should be lower than 10 pg/mL.
What an Imbalance Means
Why Should You See A Hormone Specialist
Hormone specialists are physicians who have expertise in diagnosing, treating, and preventing conditions and illnesses related to hormones. Hormones are natural chemicals produced by the endocrine glands and serve as messengers in the body. Injected directly into our bloodstream, they send signals to the different parts of the body to regulate bodily processes and functions.
Hormonal imbalances can affect our growth and development, mood, metabolism, reproduction, sexual function and drive, heart rate, sleep cycle, and body temperature. Hormones are critical for our wellbeing and when an imbalance happens, it can wreak havoc on our bodies.
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Period Problems And Period
A common complaint of women who visit Madison Womens Health is irregular periods or unexpected changes to their periods. A period is considered irregular when it occurs more often than before or less often than before, or if the amount and duration of bleeding has changed significantly for repeated months. Is your period suddenly much heavier than it has been? Or are you not having a period at all?
Keep track of your cycles, when you begin to bleed, and for how long. A popular app among our patients for tracking cycles is Period Tracker Period Calendar , although there are many options. Let your doctor know how many days there are between your periods and what your typical flow is like. Discuss what is different and why you are concerned. Let them know if youre under more stress than before, if youve changed your diet or exercise recently, or if you have a family history of irregular periods.
These changes could have a structural cause having to do with your cervix or uterus or a hormonal cause. Your doctor will likely want to perform a physical exam and may also check specific hormones on a specific day of your menstrual cycle.
When To Test Cortisol
We cant always get a full picture of whats going on with your hormones without looking at the adrenals, which produce the stress hormone cortisol.
Cortisol is involved in your stress response, hair loss, blood sugar regulation and more. In time of stress, the body will shift into preferentially making cortisol over progesterone. Read more about the importance of cortisol here.
Cortisol blood tests are best performed in the morning, along with Adrenocorticotropic hormone , because this is when levels are highest. ACTH is produced in the pituitary gland and helps your adrenals to function. For a more comprehensive picture of adrenal function, a 4-point salivary or urinary cortisol is best. Cortisol can be tested at any time of the month.
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Stimulation And Suppression Hormone Testing
We use tests called stimulation and suppression tests to evaluate a hormone imbalance. We give you hormones and other substances that either start or stop your production of certain hormones. We then evaluate how your body responds.
Common types of stimulation and suppression testing include:
- Growth hormone response to glucagon: We inject a hormone, glucagon, into muscle tissue and measure growth hormone levels over four hours. This test helps us confirm or rule out adult growth hormone deficiency.
- Cortisol response to cosyntropin: We give you cosyntropin, which acts like ACTH . ACTH is a hormone produced in the pituitary gland that stimulates the adrenal glands to produce cortisol. We measure cortisol levels every 30 minutes for one hour. This test helps us confirm adrenal insufficiency.
- Glucose tolerance test: We give you a sweet drink, which should lower levels of growth hormone. We measure levels of growth hormone in the blood every two hours. This test helps us confirm acromegaly.
- Cortisol response to dexamethasone: You take a pill at night that should block cortisol production. The next day we take a blood sample to measure cortisol levels. This test helps us confirm or rule out Cushing’s syndrome.
- Metyrapone suppression test: You take a pill at night that should block cortisol production. The next day we take a blood sample to measure cortisol and ACTH levels. This test helps us confirm or rule out adrenal insufficiency.
How Does The Male Reproductive System Work
While there are hundreds of hormones that control the bodys chemistry, testosterone is a versatile and critical part of the balance that specifically controls male characteristics and sex drive. When the levels dip, the result can cause a male to experience low sex drive and depression, among other complaints. Low T as it is commonly referred to in the media, can cause a number of symptoms, including:
- Fatigue or generalized weakness
- Memory problems or lack of concentration
- Changes in mood or irritability
- Erectile dysfunction
Some diseases, like diabetes, can cause similar symptoms, so it can be hard to diagnose. To further complicate matters, testosterone decline in men is a slow process and, some healthy men can produce sperm well into their 80s.
In addition, there are variables that affect hormonal decline and speed up the process. These include weight gain, drug use, tobacco or alcohol abuse, mental illness or severe depression, as well as stress and chronic illness. One may need to keep in mind that medical experts still disagree about the link between declining hormone levels in men and their need for HRT.
What Are The Symptoms Of A Hormone Imbalance In Women
These can vary greatly, explains Dr. Eccles, but include the following: hot flushes, vaginal dryness, irregular bleeding, fibrocystic changes in the breasts, weight gain, fluid retention, dry skin and hair, hair loss, anxiety, irritability, mood swings, sleeplessness, headaches, breast tenderness, foggy thinking, joint pain, loss of libido and difficulty reaching orgasm.
Acne, depression, fatigue, hirsutism , increased thirst, migraines, infertility, irregular periods, loss of periods , night sweats, pain during sex, poor memory and a puffy face can also be indicative of a hormone imbalan
Hormones affect us through their daily subtle shifts, more strongly through the monthly cycle, and then through the massive hormonal swings during pregnancy, perimenopause and the menopause, says Dr Marion Gluck, womens health specialist and author of Its Not My Head, Its My Hormones . While not everyone will struggle with these changes, many women suffer physically and emotional. Heres the low-down on your hormones, and what happens when you have a hormone imbalance.
What Should The Patient Expect When They Visit The Hospital For A Test
Bring a fully filled-in request form . It is important to make sure that the patients name, date of birth, and date and time of collection are written on the container if urine or faeces has been collected.
Most samples can be taken in the family doctors surgery. However, some hormones last such a short time in the sample that the test must be taken in hospital. Most blood tests in hospital are taken in a phlebotomy unit without having to make an appointment, although some, such as a glucose tolerance test, may require an appointment.
Dynamic tests are more detailed and usually involve resting in bed while blood samples are taken over a period of time. An overnight stay is not usually needed and patients should come with details of their medicines and prepare as instructed, for example, without having eaten breakfast.
Any queries about the details of individual tests should be discussed with the patients doctor.
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Men And Estrogen: What You Need To Know
Estrogen is known primarily as a female hormone that helps regulate menstrual cycles, yet the hormone plays a bigger role in mens health than most people realize. Men produce small amounts of estrogen as part of their normal functioning male reproductive system, along with the male hormone testosterone. As they age, less testosterone is produced.
Yet questions are beginning to emerge as to what specific part estrogen plays in male development, especially as a man ages. Once largely ignored, estrogen levels in men are now under the microscope as researchers are trying to determine this hormone’s role in men and how it affects the body’s different hormone levels.
A decrease in estrogen, for example, may be a factor in fat accumulation in men as well as women. One endocrinologist at Harvard Medical School reported in a 2013 study that some of the symptoms of testosterone deficiency in males, including a decline in libido, were at least partially caused by lower estrogen production.
More Information About Hormone Testing
Hormone levels change as you agesome change throughout the day. We use hormone testing to detect and evaluate hormone imbalances that may be making you sick. We often conduct hormone testing using a blood sample, but some tests require urine or saliva samples.
We frequently test levels of:
- Estrogen and testosterone
- Adrenal gland hormones, such as cortisol
- Growth hormone, prolactin and other pituitary gland hormones
- Thyroid hormones, such as thyroxine
How Can Hormone Replacement Therapy Balance My Hormones
Medications often correct a hormone imbalance, as can hormone replacement therapy . HRT is designed to ease menopause symptoms by replacing the hormones your body no longer produces. Dunwoody OB/GYN, LLC, offers regular and bioidentical HRT.
Bioidentical HRT closely mimics the hormones naturally produced by the human body. They can provide relief from uncomfortable menopause symptoms, like hot flashes or low libido. But HRT may not be safe for all women. Your provider can help you determine if HRT is right for you.
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Treatment Of Womens Hormonal Imbalance
In most cases, female hormones balance can be improved or corrected with treatment. Often, changes in diet and lifestyle are sufficient to improve female hormonal imbalance and offer some protection against its potential health complications. Among the common changes recommended are:
- Weight control
- 30 minutes of exercise daily, including resistance and aerobic exercise.
- Dietary changes that include replacing processed, fatty and sugary foods with lean proteins, low-fat dairy and a wide range of fresh fruits and vegetables.
- Limit alcohol consumption
- Eliminate tobacco consumption
Female hormonal imbalance that cannot be resolved with lifestyle changes is most commonly treated with hormone replacement therapy. Conventional HRT uses hormone drugs to normalize levels of estrogens or progesterone in the system, while bioidentical hormone replacement therapy enhances hormone levels as needed with plant-derived supplements. HRT has been associated with health risks with long-term use, so women considering this treatment should discuss risks and benefits carefully with their doctors.
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Natural Levels Of Male Hormones Throughout Life
The main sex hormones found in both sexes are testosterone and estradiol. While women have more estradiol than testosterone, the opposite is true for men testosterone is the dominant hormone in males.
Considering testosterone and estradiol are essential for reproduction, it shouldnt come as a surprise that the peak age range for testosterone in males is ages 20-50. After 50, you see a steady decline in testosterone levels.
So for males, there are 3 main life stages for testosterone: puberty , fertile and active years , and andropause .
What Causes An Imbalance In Hormones
Hormone imbalance can be the result of various issues. There may be an underlying medical condition that is causing a shift in the level of hormones. Also, you may be taking medicines that are causing a change in your hormonal balance. At times, even minor stress can cause hormonal imbalance.
In women, polycystic ovary syndrome or PCOS is a leading cause for hormonal imbalance. The changes in hormone levels due to PCOS come with a whole different set of symptoms, which include irregular periods, darkening of skin, excessive hair on face and chin and weight gain.
Men also go through hormone imbalance. Changes in the hormone levels for men are usually caused by low levels of testosterone. Since testosterone plays a vital part in mens health, low testosterone levels can result in complications. Common symptoms of low testosterone include breast tissue development, erectile dysfunction, loss of bone mass, reduction in body hair and infertility.
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