HORMONE TESTING

Let’s Talk About Hormone Testing (and Why Most Doctors Don’t Do It):

If you are in perimenopause or menopause do you actually need your hormones tested? Not necessarily. These days, however, some of us—like Dr. Sara Gottfried, head of Integrative Medicine at Jefferson—are practicing what’s called precision medicine. In other words, we may actually test your hormones instead of guessing.

So why don’t more doctors offer this?
Honestly? it’s due to archaic ways of thinking about women’s health. They'll say, "Your hormones can vary day to day." While that's true to a point, that's really not helpful and is frankly doing a disservice to women.  In perimenopause, your progesterone is on a pretty steady decline and estrogen goes up and down but is GENERALLY declining. If I catch a low estrogen level then, guess what? That can explain a lot, and you may benefit from estrogen therapy. If I catch you at a high point but you're in perimenopause? I can look at other markers and symptoms.  

 Let me ask you something else: have you ever gone to a fertility doctor? If not, you're lucky. But if you have....What do they do to assess your fertility? They test your hormones. At. Any. Age.

We can figure a lot out just by looking at what your hormones are doing at various times of your cycle (or post-menopause) by knowing where you are in your cycle, and by knowing appropriate reference ranges. (Please note, those of us practicing functional medicine look at what’s called the functional range—what’s actually ideal for your body.)

And again, you may not want testing done. That is why we engage in shared decision making, and decide together what is best for you.

Depending on what you’re dealing with, I’ll guide you on the best method for you. Here’s a quick breakdown of how I approach it:

This is a solid option for most people and is often covered at least in part by insurance. It gives us a good overview of:

• Whether you’re in perimenopause or menopause
• diagnosing PCOS
• Your testosterone and DHEA levels
• Thyroid function
• Key nutrient levels like B12, iron, and vitamin D

This is especially helpful if I want a closer look at your adrenals and cortisol, which is important in many women with hormonal symptoms.
Cortisol is a sneaky hormone that can throw everything off—energy, weight, sleep, mood. Since it naturally rises and falls throughout the day, we use saliva collected at different times to see your actual rhythm. The saliva testing I recommend ranges in cost from $100 to about $160 and is covered by HSA/FSA.

This is the most comprehensive hormone test out there. It tells me not just your hormone levels, but how your body is processing and clearing them—especially important when it comes to estrogen metabolism.
It also looks at:

• Cortisol and adrenal health (including breakdown products)
• Androgens like testosterone and DHT
• Mitochondrial markers
• Detox pathways

I tend to recommend the DUTCH Complete when someone is dealing with more complex hormone symptoms, fertility issues, or PCOS. It’s about $300, but gives us a very deep understanding of what’s going on (it's also covered by HSA/FSA).

I hope this helped clear up some of the confusion around hormone testing. I love this stuff—and I love educating women about what’s actually going on in their bodies.

If you’re interested in testing or would like me to do a short talk or class about this, let me know.

You can email me at: pam@pamelagordonmd.com