Fertility Hormone Testing Overview
- Fertility hormone testing usually involves analyzing a womans blood or urine samples to determine if hormonal issues may be preventing her from becoming pregnant.
- Hormonal imbalances are a leading cause of infertility in women.
- Hormone levels can also affect male fertility and hormone testing may be appropriate for men as well.
- Primary fertility hormone testing involves analysis of follicle-stimulating hormone , luteinizing hormone levels and progesterone.
When To Test Progesterone
Progesterone levels are highest 5-7 days following ovulation, which is within our luteal phase . This is why testing is recommended days 19-22 of a 28 day cycle.
Even though were commonly told that women ovulate like clockwork on day 14 of their cycle, unfortunately, this isnt always the case. Its a great idea to track your basal body temperature and evaluate your cervical mucus to get an idea of when and if you are ovulating. Or you can use over-the-counter LH strips which can help you dial in the day you ovulate.
Ive got a whole article devoted to this practice, but the general idea is pretty simple, but can take some time. When you ovulate, your body temperature rises and your vaginal discharge becomes the consistency of stretchy egg whites. If you keep an eye on these changes to your body, theres a pretty good chance you can approximate when youre ovulating.
For a lot of women, this will mean that testing for progesterone should happen on roughly day 19-22 of their cycle. Again, this recommendation could change if youre not ovulating day 14 of your cycle which is actually pretty common, or if your typical cycle is shorter or longer than 28 days. Track your cycle for a few months before and talk to your doctor so that they can tell you the best day to test progesterone.
If you feel confused, talk to the provider ordering your test.
When Is Hormone Testing Performed
According to Kelly Kasper, MD, an ob-gyn with Indiana University Health, there is a long list of symptoms that might prompt a doctor to suggest hormone testing for a patient, such as:
- Hair loss
Because there are so many health issues and symptoms that may call for hormone testing, it’s especially important to speak to your doctor or a medical professional about any and all of your concerns they are the most qualified people to decide if these steps are necessary.
Some specific hormone tests don’t necessarily require symptoms to be performed. For example, Lucky Sekhon, MD, a fertility specialist and board-certified ob-gyn, said that if you’re curious about your egg count â whether you’re currently trying to get pregnant or may in the future â a doctor might test for something called Anti-MÃ¼llerian hormone , which indicates how many eggs may be available for fertilization. In fact, Dr. Sekhon says it’s the number one fertility-related hormone that her patients want checked.
Other Hormones That Can Interfere With Ovulation:
- Androgens normally, small amounts of androgens are produced in women excess production may interfere with the development of the follicles, ovulation, and cervical mucus production.
- Prolactin stimulates milk production blood levels may be higher than normal in certain disorders or if you are taking certain medications
- Thyroid an under-active thyroid can result in high prolactin levels
How Early Can A Blood Test Detect That You’re Pregnant
Hormonal blood tests performed by a medical facility can detect pregnancy earlier than home pregnancy tests using urine. Blood tests can detect pregnancy between six and eight days after you ovulate. By contrast, home pregnancy tests should be taken after your period is late, which is between 12 and 16 days after ovulation. Waiting until this point can help you avoid false negatives or positives.
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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.
What Hormones Are Doctors Looking For
Dr. Sekhon explained that your doctor may take a targeted approach in hormonal testing, meaning they will test for one specific hormone that’s commonly associated with your symptoms rather than testing everything.
She added that your doctor should also fill you in on exactly what is being tested and why. “I think a huge movement in medicine right now is more transparency because people go to the doctor and sometimes get this whopping copay and they’re like, ‘I don’t even know what was tested!'”
If you have an irregular period, your doctor may call for a hormonal panel that tests for multiple hormones that play a part in the menstrual cycle and fertility, such as estrogen, progesterone, FSH, LH, and prolactin.
Dr. Kasper added that the hormones testosterone, thyroid, cortisol, and DHEAS are also commonly checked during hormone testing.
Regardless of what hormones are being tested, Dr. Sekhon believes that any doctor that is sending off a hormone test should be able to then read that test for you and explain what it means for your body. “If they can’t interpret what the test results mean, then they should really be sending you to a specialist who can,” she said.
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When Is The Best Time To Test Hormone Levels
If youre struggling with a hormone imbalance, testing your sex hormones can help you understand where the issue is rooted. Evaluating estrogen, progesterone and testosterone can be helpful in understanding which hormones are driving your symptoms.
Hormone levels arent static throughout the monthand this is why so many women get within range blood test results.
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How To Test Cortisol Levels
Cortisol levels are measured with lab tests. These may be blood tests, which measure levels of the hormone in the bloodstream, or saliva tests, which measure cortisol levels in a saliva sample. Cortisol testing is typically done early in the morning, when levels are normally highest. Often, to produce the most accurate results, testing is repeated in the afternoon of the same day. Cortisol testing is often done in conjunction with ACTH level tests, since this pituitary gland hormone works to regulate cortisone levels. ACTH tests measure levels of the hormone in the bloodstream.
Getting tested can be done through your health care provider, who can order your tests for you, take your blood or saliva samples or send you to a lab to have them done. Then, your provider will let you know your results once they are delivered to his or her office.
You can also order these lab tests yourself online or over the phone from independent testing services, like Health Testing Centers. Ordering your own tests is generally less expensive, since you skip the cost of an office visit, and more efficient, since the results are delivered directly to you.
However, it is important to note that if your tests show that your cortisol and/or ACTH levels are abnormal too high or too low following up on those results with a visit to your healthcare provider is essential. Abnormal levels of these important hormones require further examination and testing.
A Full Thyroid Investigation
Why you might need it: The thyroid regulates metabolism, including body temperature, heart rate, growth, energy production, the musculoskeletal system and brain health: basically every cell in the body needs thyroid hormones to function. If youre struggling to lose weight or have a low mood, its worth exploring the thyroid hormones.
What will it tell you? An imbalance of either high or low levels of TSH are linked to hyperthyroidism . If you get your thyroid tested by your GP, they usually just test some of the thyroid hormones .
But its also worth looking at FT3 levels when FT4 is normal and hyperthyroid is suspected. FT3 levels are usually raised and are the first to show change. Low levels of T3 are linked to depression.
Make the most of your moods and hormones, we have vitamins, tools and tips to help you support you better,
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Where Should I Get A Hormone Balance Test
Hormone balance tests can be performed in a variety of settings. Many people first get their hormones tested by their primary care doctor or gynecologist. Others prefer to go straight to a lab facility. While both of these methods can garner accurate results, we recommend getting your hormones tested by a hormone health specialist. These practitioners will have the training and experience necessary to determine which tests are right for you and are experts at both interpreting your results and providing treatment.
Common Symptoms Of A Hormonal Imbalance
Hormonal imbalances can cause many different symptoms. Some common issues to look out for include:
- A bulge in the neck
- Puffy face
Many symptoms of a hormonal imbalance can be misleading. For example, both weight gain and weight loss can be symptomatic of a hormonal imbalance. So, it’s really difficult to just rely on symptoms to understand which specific hormone is the root of the problem. This is when getting tested becomes handy.
If you’re having trouble falling asleep, you may have low progesterone levels that are usually in charge of helping you fall asleep. On the other hand, high progesterone levels could be problematic as well, as these will make you feel sleepy even if you’re getting enough rest.
Low melatonin gives your body a signal that it’s time to rest. Low estrogen can give you night sweats that can be unbearable for many.
If you’re struggling with any symptom of a possible hormone imbalance, you need to get tested. Your hormone levels will depict the root cause of the symptoms you are experiencing and, you will be able to target them properly.
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Preparing For Hormone Testing At Cedars
We explain the tests you need and answer any questions you may have.
Here’s 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 you’ll 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 what’s 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.
Can You Test While On Bioidentical Hormones
For my patients on oral bioidentical progesterone, I use blood and dried urine. Serum tells me levels that are clinically relevant and supported by research. Dried urine tells me about the metabolism of progesterone and cortisol. I do not use saliva testing for my patients on bioidentical hormones as I believe the data suggests it leads to underdosing.
Testing Your Hormones With Urine Testing
Urine testing is like saliva testing, except it usually tests more hormones.
It may also be slightly more accurate especially if collected over a 24 hour period, and is more stable if its a dried urine test .
But, its also more expensive. And you also need to do it through a natural practitioner who offers it.
An example of this is the DUTCH test. This is a great test. If you can afford it and can find someone who does it and knows how to interpret it for acne patterns, then Id recommend this.
For the most part though, a basic saliva test that tests the hormones I listed will do a great job. I find myself recommending this the most.
Natural Ways To Support Healthy Hormones
While you should always speak to your doctor if you have hormonal imbalance, he might not have to give you any kind of medication to restore the balance. This is particularly true if the imbalance is caused by something like diet or stress. In general, people who have the following criteria are at higher risks of developing hormonal imbalances:
- Being overweight or obese
- Consuming an excessive amount of alcohol
- Being exposed to pesticides and toxins
- Experiencing high stress levels
- Not sleeping enough
Many of these risk factors are easily controlled when you’re mindful of your diet, exercise routine, and daily habits. If you quit smoking, moderate your drinking, or avoid exposure to pesticides, you can help reduce your risk factor for hormonal imbalances and naturally keep them moderated.
Changing the way you eat can go a long way towards improving your hormonal balance. For example, when you exchange carbohydrates for healthy fats, like coconut oil and avocado, you can lower your bodys inflammation and help maintain your hormone at the right levels. Consuming enough proteins will help control the ghrelin hormone that makes you feel hungry. This gives you the feeling of fullness and then, you will stop eating at the appropriate time and maintain a healthy weight.
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Testing For A Hormonal Imbalance
Although a hormone imbalance may bring some obvious symptoms, thatâs not always the case. For example, it can be challenging for someone to decipher whether the depression theyâre experiencing is related to a life event or if itâs instead because of hormone levels that are affecting their mental health. Thatâs why consulting with a healthcare provider is a good idea any time you arenât sure whatâs going on with your health.
Hormone testing may also be worth considering if youâre curious to learn whether you have a hormonal imbalance. Everlywell makes testing your hormones easy with at-home test kits that come with everything you need for collecting your sample and sending it to a lab . Plus, you can view your results on our secure, online platform in an easy-to-understand format. This can be a simpleâbut powerfulâway to see if hormones are balanced in your body and learn your personal levels.
As an example, consider a Womenâs Health Test to check for a hormonal imbalance in women.
What Are Hormone Blood Tests Used For
These symptoms that might require hormonal blood work are generally indicative of various conditions, such as polycystic ovarian syndrome , thyroid disease, diabetes, obesity, and more.
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Can You Test Day 3 Hormones If Youre On Birth Control And Get A Period
Some people who use a continuous form of contraception, like the minipill or hormonal IUD, get regular periods. In these causes, day 3 hormones will be included in your test.
Not all periods are created equal in fact, for some birth control methods, the periods you experience arent actually periods. If you are using the regular pill , the vaginal ring, or the birth control patch, the bleeding you experience during the placebo days/week is actually withdrawal bleeding your bodys response to the sudden drop in hormones. And because this withdrawal bleeding is caused by the changes in hormones of your birth control, its not a reflection of your bodys hormones during a natural period. If youre looking to test your day 3 hormones, we recommend waiting three months after going off these birth control methods for your levels to return to non-birth control levels.