Hormone Testing

A hormone test for women can reveal important information about your health. These tests can detect fertility problems, where you are in your menstrual cycle, or whether you’re starting perimenopause.

Hormone blood tests can also play a role in diagnosing medical conditions such as thyroid disease or diabetes. In some instances, they can show how well a medication is working.

What’s Being Tested?

Hormone blood tests can look at several key hormones:

  • Estrogen
  • Progesterone
  • Follicle-stimulating hormone (FSH)
  • Testosterone/DHEA
  • Thyroid hormones
  • Luteinizing hormone


Estrogen isn’t a single hormone. You have many types of estrogens. Only three of them are commonly tested:

  • Estrone (E1): The main post-menopausal hormone
  • Estradiol (E2): The main female hormone before menopause and outside of pregnancy
  • Estriol (E3): A form that increases during pregnancy

E2 is the most often tested form. It’s the major hormone responsible for sexual function and also plays a major role in:

  • Healthy bones
  • Female characteristics
  • Other aspects of health

Estradiol is primarily produced by the ovaries and levels vary throughout the menstrual cycle. They’re highest at ovulation and lowest at menstruation.

E2 levels slowly decrease as you age. The largest drop occurs at menopause when the ovaries “switch off.”

Everyone has some estradiol in their bodies, regardless of their biological sex.

When Estrogen May Be Tested

You may need an estrogen test if you have symptoms of an estrogen-related condition or:4

  • You’re having trouble getting pregnant.
  • Your periods are irregular.
  • Puberty appears to be delayed, regardless of biological sex.
  • You’re having menopause symptoms.
  • You have vaginal bleeding after menopause.
  • You’re biologically male but displaying female characteristics (such as developing breasts).

Estrogen Test Results

What’s considered normal for estradiol levels depends on your menstrual cycle and phase of life. Testing for fertility looks at three phases of the menstrual cycle:

Follicular phase: This lasts from the first day of your period until ovulation, usually about 14 days. It’s named for the follicle housing the egg before it’s released during ovulation.

Periovulatory phase: This is an approximately three-day period around the time of ovulation.

Luteal phase: This lasts from ovulation until the start of menstruation. After ovulation, the follicle releases estrogen and progesterone to prepare your uterus for a fertilized egg to implant.

What the Results Mean

Low estrogen levels may be a sign of:

  • Polycystic ovary syndrome (PCOS)
  • Decreased pituitary function (hypopituitarism)
  • Anorexia nervosa
  • Low body fat

High estrogen levels may occur with conditions such as:

  • Obesity
  • Light or heavy menstrual bleeding
  • Worsened premenstrual syndrome
  • Fatigue
  • Loss of sex drive


Progesterone is essential for regulating menstruation and fetal development. During the luteal phase, it helps prepare the uterus to receive a fertilized egg. What happens next depends on whether the egg is fertilized:

If the egg is not fertilized, progesterone levels plummet, and a new menstrual cycle begins.

If the egg is fertilized, progesterone levels remain high. This stimulates the growth of blood vessels that supply the lining of the uterus (endometrium) and makes glands in the endometrium that release nutrients to nourish the developing embryo.

When Progesterone Levels May Be Tested

You may need a progesterone test to determine:

  • Whether you’re ovulating normally
  • Why you’re having trouble getting pregnant
  • Your risk of miscarriage or other pregnancy complications
  • If you have a pregnancy outside of the uterus (ectopic pregnancy)

Progesterone Test Results

As with estrogen, what’s considered normal for progesterone depends on the timing of the test. Midway through the menstrual cycle, progesterone levels start climbing. Between six and 10 days later, if there’s no fertilized egg, levels drop off.

If the egg is fertilized, levels rise through the earliest stage of pregnancy.

What the Results Mean

If progesterone levels are low during pregnancy, it could be a sign that you’re at risk of miscarriage or premature labor. You may be given a synthetic form of progesterone to prevent early labor.

High progesterone levels usually do not signal any health problems unless they continue for a long time. In those instances, high levels may indicate an increased risk of breast cancer.

Follicle Stimulating Hormone

Follicle-stimulating hormone (FSH) is produced by the pituitary, a pea-sized gland in the brain. FSH stimulates the growth of an egg in the ovary to get it ready for fertilization.

FSH can be checked with either blood or urine tests. We may look at a single sample or, to look for fluctuations, several samples taken over a 24-hour period.

The pituitary gland produces more FSH when estrogen and other hormone levels begin to drop before menopause, when the ovaries are losing their reproductive potential.

When FSH Levels May Be Tested

In adult females, the FSH test may be used in diagnosing:                                                                                                                                                                                                                                                                                                                      Follicle-stimulating hormone (FSH) levels test.

  • Abnormal menstrual bleeding
  • Infertility
  • The start of perimenopause or menopause
  • Ovarian function issues and PCOS
  • Pituitary gland tumors
  • Ovarian cysts

What the Results Mean

Abnormal FSH levels are often caused by a disease of the pituitary gland or the hypothalamus (a part of the brain). The hypothalamus has several functions, including:

  • Balance
  • Temperature regulation
  • Hunger and satiation
  • These glands can be affected by PCOS, cancer treatment, a congenital defect (a condition you’re born with), or other diseases and disorders.

Testosterone and DHEA

While testosterone is usually regarded as the “male sex hormone,” it’s also part of the female hormonal makeup. In females, testosterone is produced in the ovaries and adrenal glands. Most of it is then converted to estradiol with the help of an enzyme called aromatase.17

Dehydroepiandrosterone (DHEA) is also classified as an androgen, but it is normally present in females as well.

When Testosterone/DHEA Levels May Be Tested

You may need a testosterone or DHEA test because of:

  • Irregular or missed periods
  • Possible ovarian conditions, including PCOS and ovarian cancer
  • Weight gain
  • Acne
  • Development of male traits (excess hair growth, male pattern baldness, deepening voice)
  • Infertility
  • Decreased sex drive

What the Results Mean

High testosterone could mean steroid abuse, PCOS, cancers of the adrenal glands or ovaries, and congenital adrenal hyperplasia.

Low libido is associated with low levels of testoterone. A drop in testosterone can also indicate perimenopause

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