Why You Should Get Your Hormones Tested
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.1
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.2
This article looks at the tests done for each hormone, when the tests are needed, what's considered normal and abnormal, and what the results could mean.
What's Being Tested?
Hormone blood tests can look at several key hormones:3
Testosterone/DHEA
Thyroid hormones
Luteinizing hormone
In most cases, healthcare providers use hormone test results combined with other factors—such as symptoms, medical history, and other test results—to reach a diagnosis.
Estrogen
Estrogen isn't a single hormone. You have many types of estrogens. Only three of them are commonly tested:4
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.
Lessons in Gut Health: Why Balancing Bacteria Matters
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).
When to Take a Pregnancy Test
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:5
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.
Estrogen levels are measured in picograms (one-millionth of a gram) per milliliter (pg/mL).
E2 Test Timing | Range (pg/ml) |
Follicular phase | 19.5-144.2 |
Periovulatory phase | 64.9-356.7 |
Luteal phase | 55.8-214.2 |
Postmenopausal | 32.2 or lower |
Source: University of North Carolina Medical Center
What the Results Mean
Low estrogen levels may be a sign of:
Decreased pituitary function (hypopituitarism)
Low body fat7
Low Estrogen: Symptoms, Causes, and Treatments
High estrogen levels may occur with conditions such as:8
Obesity
Light or heavy menstrual bleeding
Worsened premenstrual syndrome
Fatigue
Loss of sex drive
Certain medications are also known to increase estrogen levels. These include steroid hormones, phenothiazines, tetracycline antibiotics, and ampicillin.
When Should You Get a Hormone Blood Test?
You may need one if you're having symptoms of a hormonal imbalance. These are often done during the first half of your menstrual cycle, when levels are more distinct.9 However, progesterone tests to check ovulation are typically done on day 21 of your cycle.
Progesterone
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:10
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:11
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Progesterone test.
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.
Progesterone levels are measured in nanograms per milliliter (ng/mL) or nanomoles per liter (nmol/L).
Progesterone Test Timing | Range (ng/mL) | Range (nmol/L) |
Follicular phase | 1 or lower | 3.18 or lower |
Mid-cycle | 5-20 | 15.9-63.6 |
1st trimester | 11.2-90 | 35.62-286.2 |
2nd trimester | 25.6-89.4 | 81.41-284.29 |
3rd trimester | 48-above 300 | 152.64-above 954 |
Postmenopausal | 1 or lower | 3.18 or lower |
Source: University of North Carolina Medical Center
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.12 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.
How Early Can a Blood Test Detect Pregnancy?
Blood tests can detect pregnancy between six and eight days after ovulation.13 By contrast, to be accurate, home pregnancy (urine) tests should be taken after your period is late. That's between 12 and 16 days after ovulation.14
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. Healthcare providers 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.
How Does Artificial Insemination Work?
When FSH Levels May Be Tested
In adult females, the FSH test may be used in diagnosing:15
Abnormal menstrual bleeding
Infertility
The start of perimenopause or menopause
Ovarian function issues and PCOS
FSH Test Results
This hormone also changes over the course of your menstrual cycle and lifetime.
FSH is measured in milli-international units per milliliter (mIU/mL).
FSH Test Timing | Range (mIU/mL) |
Follicular phase | 3.5-12.5 |
Ovulatory phase | 4.7-21.5 |
Luteal phase | 1.7-7.7 |
Postmenopausal | 25.8-134.8 |
Source: Laboratory Corporation of America.
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.16
The Hypothalamus and Your Menstrual Cycle
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:1819
Irregular or missed periods
Possible ovarian conditions, including PCOS and ovarian cancer
Weight gain
Development of male traits (excess hair growth, male pattern baldness, deepening voice)
Infertility
Decreased sex drive
Testosterone/DHEA Test Results
Testosterone doesn't fluctuate like female hormones, so the timing of tests isn't important. Testosterone is measured in nanograms per deciliter (ng/dL) or nmol/L.
Testosterone Range (ng/dL) | Testosterone Range (nmol/L) |
15-70 | 0.5-2.4 |
Source: Icahn School of Medicine at Mount Sinai
Normal DHEA levels depend on your age. It's measured in micrograms per deciliter (mg/dL) or micromoles per liter (mmol/L).
Age | DHEA Range (mg/dL) | DHEA Range (mmol/L) |
18-19 | 145-395 | 3.92-10.66 |
20-29 | 65-380 | 1.75-10.26 |
30-39 | 45-270 | 1.22-7.29 |
40-49 | 32-240 | 0.86-6.48 |
50-59 | 26-200 | 0.7-5.4 |
60-69 | 13-130 | 0.35-3.51 |
69-older | 17-90 | 0.46-2.43 |
Source: Icahn School of Medicine at Mount Sinai
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 testosterone. A drop in testosterone can also indicate perimenopause.20
Testosterone in Menopause
Testosterone naturally drops during menopause, causing myriad symptoms including:21
Diminished sex drive, sexual pleasure, and orgasmic response
Low energy
Depression
High DHEA levels on blood tests may be a sign of conditions such as congenital adrenal hyperplasia or cancer of the adrenal gland.
Thyroid Hormones
Thyroid function is determined by the levels of a group of hormones. These hormones are produced by the pituitary and thyroid glands. The three main ones are:
Thyroid-stimulating hormone (TSH): A pituitary hormone that tells the thyroid gland to produce more hormone
Thyroxine (T4): An inactive thyroid hormone that can be converted to an active state
Triiodothyronine (T3): The active thyroid hormone, most of which comes from converted thyroxine
Thyroid peroxidase antibodies (TPOAb): An enzyme that helps your body produce thyroid hormones. Thyroid peroxidase antibodies interfere with the action of this enzyme. High levels of TPOAb can be a sign of Hashimoto's thyroiditis.22
Thyroid function tests are often included in a female hormone panel because thyroid diseases are more common in women than men. It may also be included to examine whether the thyroid is affecting fertility and pregnancy.
When Thyroid Levels May Be Tested
You may need a thyroid hormone test if you have symptoms of either an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism).
Hypothyroidism symptoms include:23
Fatigue
Unintended weight gain
Puffy face
Intolerance of cold
Pain in the joints and muscles
Constipation
Dry skin
Dry, thinning hair
Decreased sweating
Heavy or irregular menstrual periods
Fertility problems
Depression
Slow heart rate
Goiter (enlarged thyroid gland causing a lump in the front of your throat)
Hyperthyroidism symptoms include:24
Anxiety
Fatigue
Frequently feeling cold or hot
Irregular or light menstrual period
Hair loss
Unintended weight loss or gain
Tremors
Rapid heart rate
Goiter
Hyperactivity
Thyroid Test Results
Healthcare providers may use TSH alone or a combination of TSH, T4, and T3 tests to diagnose thyroid disorders.
TSH is measured in milli-international units per liter (mIU/L). There's a range for non-pregnant females as well as trimester-specific ranges in pregnancy.
TSH Test Timing | Range (mIU/L) |
Non-pregnant | 0.5-5 |
First trimester | 0.1-2.5 |
Second trimester | 0.2-3 |
Third trimester | 0.3-3.5 |
Sources: UCLA Health, study by Galoiu S.
T4 is measured in micrograms per deciliter (µg/dL). T3 is measured in nanograms per deciliter (ng/dL).
Thyroid Hormone | Range |
T4 (Thyroxine) | 5-12 µg/dL |
T3 (Triiodothyronine) | 80-220 ng/dL |
Sources: UCLA Health
What the Results Mean
Interpreting TSH results can be confusing. That's because high TSH means low thyroid activity and low TSH means high thyroid activity.
Your provider may look at TSH alone or all three hormones together in order to reach a diagnosis.
TSH | T4+T3 | Diagnosis |
High | Low | Hypothyroidism |
High | Normal | Borderline hypothyroidism |
Low | High | Hyperthyroidism |
Low | Normal | Early or mild hyperthyroidism |
Low | Low | Pituitary disease |
Source: UCLA Health
If results start out with low TSH and high thyroid hormones and then reverse with further testing, it indicates thyroiditis, which is inflammation of the thyroid gland.
Autoimmune Thyroid Disease
Antibody (TPOAb) testing may be done to see if you have an autoimmune thyroid condition such as Hashimoto's or Graves' disease. TPOAb is measured in international units per microliter. A normal range is less than 9 IU/mL.
Luteinizing Hormone
Your pituitary gland makes luteinizing hormone (LH), which helps control your menstrual cycle. This hormone is responsible for triggering ovulation, or the release of an egg.
When you have too much luteinizing hormone, you may have difficulty getting pregnant. Too much LH can also cause problems with menstruation such as irregular periods.
When Luteinizing Hormone May Be Tested
Your healthcare provider may want to check your LH levels for a few possible reasons:25
To look for the cause of infertility
To help you find the time during your menstrual cycle when you are most likely to get pregnant
If you have irregular periods
To confirm the start of perimenopause, the transition period before menopause
Luteinizing Hormone Test Results
LH is measured in international units per milliliter (IU/mL). Normal LH levels vary during the menstrual cycle. They are also different for someone who has reached menopause.
LH Test Timing | Range (IU/mL) |
Follicular phase | 1.68 to 15 IU/mL |
Midcycle peak | 21.9 to 56.6 IU/mL |
Luteal phase | 0.61 to 16.3 IU/mL |
Postmenopausal | 14.2 to 52.3 IU/mL |
Source: University of Rochester Medical Center
What the Results Mean
High LH levels could mean a few different things:25
The onset of perimenopause (in older people)
Polycystic ovary syndrome (PCOS), a condition that causes cysts to form on the ovaries
Turner syndrome, a genetic condition that affects sexual development
Low LH levels can be related to:25
An eating disorder or malnutrition
A problem with the pituitary gland
Other Hormones
Your healthcare provider may also want to check the levels of other types of hormones. Some of these include:
Cortisol: Cortisol is an important hormone that impacts things like your metabolism, blood pressure, and stress response.
Melatonin: This hormone helps regulate the sleep-wake cycle. Your healthcare provider may want to check your melatonin levels if you are having trouble sleeping.
Serotonin: Serotonin is a hormone that helps transmit impulses through your nervous system. High levels of this can mean you have a certain type of serotonin-secreting tumor.
Growth hormone: Your child's pediatrician may check their growth hormone levels if they are growing too slowly or too quickly. Adults can also have too much growth hormone.27
Leptin: Leptin is a hormone that helps your body maintain weight. People with low leptin may have trouble controlling how much they eat.
Ghrelin: Ghrelin is produced by your stomach. It helps you know when you are hungry or full. If you have obesity, you may have low ghrelin levels.
Insulin: Insulin helps your body use blood glucose. A blood insulin test can help diagnose insulin resistance or find the cause of hypoglycemia. It may also be done to help your healthcare provider develop a treatment plan for type 2 diabetes.
Testing Options
Depending on your symptoms and/or the hormone that needs to be tested, you may have a few options for where to have the test done.
Your Healthcare Provider's Office
Most people have their hormone levels tested after a visit to a healthcare provider. Your healthcare provider may want to check your hormone levels because of a symptom you are experiencing or some other concern.
Many hormones can be tested with a simple blood test. These tests are usually done in your provider's office or in a separate testing facility. During the test, a sample of blood is collected into a vial using a small needle.
Some hormones are checked with a urine or saliva test. These can also be done at a testing facility or in your healthcare provider's office.
At Home
At-home testing kits are also available. Some home tests check female reproductive hormones as well as cortisol and thyroid hormones. These tests involve collecting a small amount of saliva and mailing it to a laboratory for testing.
At-home tests are more convenient than testing at a healthcare provider's office and can be a good option for people who prefer to avoid needles. However, these tests are not always reliable. This is because hormone levels can fluctuate and because at-home tests are more prone to error.
If you get one of these tests, it is also important to discuss the results with your healthcare provider rather than trying to interpret them yourself.
*If you are interested in at home test, click on the link below to learn more.
Summary
Hormone tests are often done as part of regular blood work, but your healthcare provider may order them if you're having menstrual issues, changes in sex characteristics, fatigue, loss of sex drive, or problems getting pregnant.
Providers may specifically check estrogen, progesterone, FSH, testosterone/DHEA, and thyroid hormone levels. Abnormal readings can indicate that you have a condition such as PCOS, ovarian cysts, thyroid disease, or, possibly, cancer.
Tests are one step in the process of diagnosing a condition. If the results are concerning, your provider may order additional tests.
Book your one-on-one consultation to balance your hormones @305-396-1571
Khattar D, Sodhi C, Parmod J, Dutta A. Correlating estrogen levels and cognitive functions in regularly menstruating females of reproductive age group and post menopausal women of North India. J Family Reprod Health. 2015;9(2):83-88.
Saran S, Gupta BS, Philip R, et al. Effect of hypothyroidism on female reproductive hormones. Indian J Endocrinol Metab. 2016;20(1):108-113. doi:10.4103/2230-8210.172245
Ajayi O, Charles-Davies M, Anetor J, Ademola A. Pituitary, gonadal, thyroid hormones and endocrine disruptors in pre and postmenopausal nigerian women with ER-, PR- and HER-2-positive and negative breast cancers. Med Sci (Basel). 2018;6(2):37. doi:10.3390/medsci6020037
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Estrogen levels test.
Victoria State Government, Victoria, Australia: Better Health Channel. Menstrual cycle.
Schorr M, Miller KK. The endocrine manifestations of anorexia nervosa: mechanisms and management. Nat Rev Endocrinol. 2017;13(3):174-186. doi:10.1038/nrendo.2016.175
Ko SH, Kim HS. Menopause-associated lipid metabolic disorders and foods beneficial for postmenopausal women. Nutrients. 2020;12(1):202. doi:10.3390/nu12010202
Endocrine Society. What is estrogen?
Society for Endocrinology: You and Your Hormones. Laboratory tests: Introduction to laboratory tests.
Mesen TB, Young SL. Progesterone and the luteal phase: a requisite to reproduction. Obstet Gynecol Clin North Am. 2015;42(1):135-151. doi:10.1016/j.ogc.2014.10.003
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Progesterone test.
Haas DM, Hathaway TJ, Ramsey PS. Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology. Cochrane Database Syst Rev. 2018;10(10):CD003511. Published 2018 Oct 8. doi:10.1002/14651858.CD003511.pub4
U.S. Department of Health & Human Services. Knowing if you are pregnant.
U.S. Food and Drug Administration. Pregnancy.
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Follicle-stimulating hormone (FSH) levels test.
Mikhael S, Punjala-Patel A, Gavrilova-Jordan L. Hypothalamic-pituitary-ovarian axis disorders impacting female fertility. Biomedicines. 2019;7(1):5. doi:10.3390/biomedicines7010005
Davis S, Wahlin-Jacobsen S. Testosterone in women—the clinical significance. Lancet Diabetes Endocrinol. 2015 Sept;3(2):980-92. doi:10.1016/S2213-8587(15)00284-3
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Testosterone levels test.
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. DHEA sulfate test.
Vegunta S, Kling JM, Kapoor E. Androgen therapy in women [published correction appears in J Womens Health (Larchmt). 2020 Nov;29(11):1487]. J Womens Health (Larchmt). 2020;29(1):57-64. doi:10.1089/jwh.2018.7494
Achilli C, Pundir J, Ramanathan P, Sabatini L, Hamoda H, Panay N. Efficacy and safety of transdermal testosterone in postmenopausal women with hypoactive sexual desire disorder: a systematic review and meta-analysis. Fertil Steril. 2017;107(2):475-482.e15. doi:10.1016/j.fertnstert.2016.10.028
National Library of Medicine. Thyroid antibodies.
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Hypothyroidism.
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. TSH (thyroid-stimulating hormone) test.
National Library of Medicine. Luteinizing hormone (LH) levels test.
National Library of Medicine. Cortisol test.
National Library of Medicine. Growth hormone tests.
National Library of Medicine. Insulin in blood.
North American Menopause Society. What is hormone testing?
Additional Reading
Galoiu S. First trimester of pregnancy reference ranges for serum TSH and thyroid tumor reclassified as benign. Acta Endocrinol (Buchar). 2016;12(2):242-243. doi:10.4183/aeb.2016.242
Icahn School of Medicine at Mount Sinai. DHEA-sulfate test.
Icahn School of Medicine at Mount Sinai. Testosterone.
Laboratory Corporation of America Holdings: LabCorp. Follicle-stimulating hormone (FSH).
University of California Los Angeles: UCLA Health. What are normal thyroid hormone levels?
University of North Carolina Medical Center, UNC Health Care. Serum progesterone.
University of North Carolina Medical Center, UNC Health Care. Estrogen, serum (estradiol).
Recent Posts
See AllHe hath made everything beautiful in His time." Ecc 3:11 These nutrients are essential for maintaining healthy skin, and applying blackstrap molasses to the skin may help improve its appearance and te
