THE WHY, HOW & WHEN TO TESTING YOUR HORMONES

Have you been feeling tired, unmotivated, experiencing weight gain and feeling disconnected from yourself?

Maybe you’ve had bloating and digestive issues, irregular periods or horrible PMS.

You may have even been to your doctor for tests and been told that everything is normal and are now second guessing yourself, thinking that maybe you are just depressed, anxious, or worried about nothing. 

If any of that sounds like you, then you’re in the right place!

I’ve been there.  You DO NOT have to just accept these feelings as your new normal.  I work with women who have experienced these same symptoms and functional testing allows us to get down to the root cause and fix these imbalances. 

Hormone testing is critical when getting to the root cause of hormonal imbalance symptoms.  

These symptoms may include:

Fatigue/exhaustion

Mood swings/irritability 

Weight gain, inability to lose weight

Low libido

Irregular periods 

Breast tenderness

Menstrual migraines

Bloating/digestive issues 

PMS

Hair loss 

Acne

Evaluating your sex and adrenal hormones can be helpful in identifying which hormones are driving your particular symptoms. Getting to the root cause of your symptoms eliminates guess work and allows implementation of a personalized protocol to optimize your lifestyle focusing on things like nutrition, sleep, stress, and movement.

Before we get into testing let’s first look at what is going on throughout your menstrual cycle:

Remember that your hormones are not static, they fluctuate cyclically throughout the month.

The entire menstrual cycle can be broken down into 4 phases.  

MENSTRUAL PHASE

Typically lasts 3-7 days in most women. 

Day 1 - Starts on the first day of your period. The first day is counted on the day that you see bright red blood. Some women may spot for a day or two before their true period begins, this is usually normal, but if spotting continues for many days or is painful check in with your provider. The menstrual phase begins with bleeding, initiated when estrogen and progesterone levels drop. 

FOLLICULAR PHASE

Encompasses the time after menses and before ovulation. 

Days 6-13 – During this time the follicle is developing, and estrogen levels are rising. Estrogen peaks around day 12-14 triggering a surge of luteinizing hormone (LH) which causes ovulation. Your testosterone is also reaching its peak during this phase, about 5 days before ovulation. This serves to boost your libido at your most fertile peak during your cycle. 

OVULATORY PHASE

When LH surges the ovary releases an egg, this is the hallmark of ovulation. The remnants of this process is called the Corpus Luteum and is the driver of progesterone production through the second half of your cycle. 

Day 14 – this is when women are often told they ovulate, but this will not be the case for everyone. I recommend you listen to your body’s cues and track your cycle to determine when YOU ovulate. 

LEUTEAL PHASE

After ovulation, estrogen levels start declining and progesterone levels continue to rise. Progesterone reaches its peak around day 21 of a “typical” 28 day period, or about 1 week after ovulation. This is the time frame that we are shooting for when testing hormones. 

Days 15-28* (not every woman will have a 28 day cycle) If the egg does not meet sperm, then hormone levels drop initiating your next period, and the cycle continues. 

Note:  These four phases are happening throughout the month in menstruating women who are NOT on birth control pills. Remember while you are on hormonal contraceptives you are not experiencing the same physiological hormonal fluctuations you have off the pill.  The goal of hormonal birth control is to prevent pregnancy. This occurs by preventing ovulation (and thereby conception) by interfering in the communication between the brain and the ovary. 

I’ve had my labs done and my doctor told me “everything was normal”

Have you already had your labs tested with your medical provider and been told that “everything is normal”? 

It might be because you weren’t getting the RIGHT lab tests or maybe you were being tested at the WRONG time of the month.

We also need to consider what “normal” really means! The “normal range” or the lab reference ranges are created based on the population being tested. When the majority of people being tested are not in ideal or optimal health we may not want to go off of conventional lab reference ranges. You don’t want to be average in a sick population, you want to build optimal health. 

 Hormones are not static throughout the month, for this reason many hormone reference ranges on medical labs are wide to account for this fluctuation. This leads many women to hear that their labs are “within normal range”. Many health care providers are also not skilled in interpreting the values provided by these tests and won’t order them for this reason. 

What test is best?

I use the DUTCH Complete Hormone test. This test checks your main adrenal and sex hormones including: estrogen (all the three main types), progesterone, testosterone, cortisol, DHEA & melatonin. What makes the DUTCH test unique is that because it is a dried urine test it can assess diurnal variations in your hormones throughout the day, as well as your hormone metabolites. This is important because it gives us insight into HOW your body is using and metabolizing hormones. If you don’t metabolize estrogen well, your risks of estrogen-related cancers such as breast, ovarian and uterine cancer can increase. 

In addition to hormones the DUTCH Complete Hormone test looks at nutrient co-factors vital to optimal function of your body. This includes:

Markers for B6 & B12

Markers for oxidative stress in your body – important in assessing DNA damage and cellular health 

Neurotransmitters – Serotonin, Dopamine (important for mood) & Epinephrine and Norepinephrine (adrenaline)

Marker for Glutathione - a potent anti-oxidant and important in the body’s detoxification pathways 

The DUTCH Complete test differs from other salivary and blood hormone tests in that it can check cortisol variability throughout the day, as well as hormone metabolites. 

Salivary tests won’t assess hormone metabolism which gives us insight into your liver function, detoxification potential or estrogen dominant cancer risk. Blood tests won’t check either hormone metabolism or cortisol variation throughout the day. 

For these reasons the DUTCH Complete Hormone test is THE most comprehensive and cutting edge functional medicine hormone test. 

The best time to test your hormones:

 If you are a menstruating female, the best time to check your hormones is about 1 week after ovulation. In most women this is around day 19-21, based on a typical 28 day cycle. However, tracking your own cycle is important to ensure that we are checking your hormones appropriately for your body. 

We check hormones at this time because it is when your progesterone and estrogen levels are both relatively elevated in the luteal phase of your cycle. 

If you have irregular cycles, are not ovulating, or no longer have a period timing may be different. I will work with you directly to troubleshoot any of these variables. 

If you are post-menopausal you can test your hormones on any day of the month. 

Tracking ovulation & Tracking your cycle

There are a few ways to help track ovulation. Ovulation occurs when LH and Estrogen surge. This correlates with some predictable signals from your body such as increased basal body temperature and changes in your cervical mucous. 

If you check your cervical mucous you will notice that the texture and consistency changes as you near ovulation. The mucous becomes thinner and more abundant to help facilitate the sperm to meet the egg. Cervical mucous associated with ovulation is an egg-white consistency, clear and stretchy.

Similarly, if you track your basal body temperature first thing every morning you may see a slight increase following ovulation. This temperature increase is caused by the drop in estrogen and rise in progesterone which increases body temperature. 

Another way to track ovulation is to purchase an ovulation monitor over the counter. These monitors track the levels of LH in your urine and detect a surge corresponding with ovulation. 

You don’t need to know exactly when you ovulate as long as your cycle is generally the same length every month. However, knowing when and if you ovulate is an important factor in understanding your body’s hormonal fluctuations and overall hormonal health.

Want to learn more about how the DUTCH Complete Hormone test can help you? 

Fill out an application to book your FREE 20 minute consultation.