Female Hormones Test

Hormones are found in saliva, urine, and blood. While all of these specimen samples can be used to test female hormone levels, blood testing is the most sensitive and accurate method.

It’s important to note that not all female hormone tests are treated equally. Some blood test panels are tailored specifically for fertility and evaluating the reproductive abilities of women, while others are focused on Menopause, puberty, and other specific conditions. The best way to test female hormones is a blood test that covers specific markers of interest, such as Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), Oestradiol, Prolactin, Testosterone and Sex-hormone Binding Globulin (SHBG), which all play a role in a woman’s reproductive health.

Because blood is the most accurate way to determine female hormone levels, most testing is done by way of a finger-prick test or blood draw. The benefit of a finger-prick method is that testing can be carried out at home and mailed to an accredited laboratory. Typically, a blood draw is conducted in a clinical setting, such as a physician’s office, and later sent to a lab for testing. While both methods are accurate and effective, many women find it easier and more affordable to use at-home finger-prick tests to determine their hormone levels. Keep in mind that the timing of when a blood sample is taken matters considerably to achieve accurate test results.

When it comes to testing hormones in women, the timing of the test is very important. For females that are having periods, it’s generally best to test hormone levels on day 3 of their menstrual cycle, assuming a typical 28-day cycle. (Day one begins at the start of the menstrual period.)

For women who experience longer cycles (e.g. 40-day cycles), it’s also advised to conduct the test on day 3.This is because it’s generally recommended to assess certain health and hormonal markers during a woman’s early follicular phase, which is characterised by low progesterone and low levels of LH and FSH. This means that any tendency towards menopause or low ovarian reserve will be picked up.

In situations in which a woman is not menstruating, a female hormone blood test can be done at any time.

Follicle-stimulating hormone, or FSH, is a hormone released by the pituitary gland and acts on the ovaries to stimulate the growth of ovarian follicles which contain a female’s eggs. FSH also activates the granulosa cells that surround ovarian follicles to trigger the production of oestrogen, an essential hormone for regulating the menstrual cycle in women.

FSH is one of the two primary types of gonadotropic hormones, or gonadotropins, which are key female hormones released from the pituitary gland in the brain and into the bloodstream, and then go on to act on the ovaries. In addition to FSH, the other type of gonadotropin is luteinizing hormone (LH).

Cells in the hypothalamus can sense when gonadotropin levels fall toward the end of a woman’s menstrual cycle, which stimulates the pituitary gland to produce and release more FSH and LH into the bloodstream. The increase in FSH stimulates the growth of the follicle in the ovary, which in turn, produces greater amounts of oestradiol.

Although FSH levels will vary widely depending on a woman’s age, stage of life, and menstrual period, FSH levels typically need to be at an optimum level depending on the stage of the cycle for a woman to conceive. When FSH levels are either too low or too high, it can be much more difficult to get pregnant because FSH has such a profound effect on a woman’s menstrual cycle and whether or not she ovulates.

One way to confirm menopause in women is to test for elevated FSH levels. When FSH blood levels are consistently high, and a menstrual period has not occurred for a year, it can indicate menopause has been reached. While FSH levels can be a helpful marker in confirming menopause, elevated levels alone and can sometimes be misleading, especially if certain hormone therapies, like birth control pills, are being used.

Perimenopause, or the transition period before menopause, can last for several years in some women. Generally, FSH levels are higher than normal but during this stage, FSH levels are also known to fluctuate. Because of this variation of FSH, testing for FSH alone can be misleading in determining perimenopause. Instead, a more comprehensive assessment of markers, including LH and oestrogen are needed for a menopause test.

At the start of a woman’s menstrual period, oestrogen levels are low. The pituitary gland then produces more FSH and LH, which stimulate the growth of ovarian follicles, each containing one egg. Over time, a single dominant follicle will begin to grow faster than others. As the dominant follicle grows, blood levels of oestrogen increase significantly. This rise in oestrogen will start to inhibit the production of FSH, thereby causing the other smaller follicles to die off. This process and relationship between oestrogen and FSH ensure that only one egg is developed during each cycle.

It is possible to lower FSH levels with oestrogen medication and birth control pills. Lifestyle changes like reducing stress, losing weight, diet, exercise, herbal supplements, and acupuncture have also supposedly been reported to help lower FSH levels.It’s critical to note that reducing high FSH levels will not directly influence a woman’s ovarian reserve or her chances of getting pregnant. In other words, the primary issue is egg quality, and simply lowering FSH levels will not work in improving egg quality and fertility.

Next to FSH, Luteinizing Hormone (LH) is the other primary gonadotropin hormone that stimulates ovulation in females. As a vital biochemical in regulating one’s reproductive system, elevated LH levels in women are what trigger hormone production needed for pregnancy. It’s common to have LH levels checked as part of fertility or menstrual-related blood test.

LH is an important chemical that effectively controls the menstrual cycle in women. It’s secreted from the pituitary gland into the bloodstream and signals to the sex organs to produce key hormones (progesterone or testosterone) which support reproductive health in both men and women. For females, LH levels rise dramatically just before ovulation to trigger the release of an egg from the ovary. This makes LH a key player in stimulating the female reproductive system and supporting a healthy pregnancy.

Testing your LH levels is the best way to determine whether your numbers fall into a healthy range. Normal LH levels in women depend on a few key factors, such as your age and the stage of the menstrual cycle you’re in. Because LH levels peaks at the middle phase of your cycle, the timing of your hormone test matters. For younger women who have yet to experience menopause, normal LH levels will stay low at day 3 of the cycle. After menopause, normal LH levels will be consistently higher

Low LH levels may indicate that your pituitary gland is not producing adequate hormones required to stimulate necessary changes to support reproductive health. This is a condition referred to as hypopituitarism. Other conditions that contribute to lower than normal LH levels are Kallmann syndrome (a rare condition) and Functional Hypothalamic Amenorrhea1 (a condition in women characterised by irregular or missed periods due to excessive exercise).

Sex hormone-binding globulin (SHBG) is an essential protein that’s primarily synthesized in the liver but also produced in smaller quantities by the placenta, uterus, breast, ovaries, and brain. SHBG serves a vital role in binding to sex hormones (testosterone and oestradiol) and transporting these hormones around the body. Abnormal levels of SHBG are associated with a number of different diseases, with high levels being found in conditions like hyperthyroidism, hypogonadism, and androgen insensitivity

The primary function of SHBG is to control the amount of testosterone and oestradiol available in the body. The production of SHBG ultimately influences the balance between these two hormones, which shapes overall reproductive health in both men and women. Only hormones that are unbound (non-binding to SHBG) can be used by the body. When SHBG binds to testosterone and oestradiol, these hormones become inactive. In short, the higher the SHBG concentration, the fewer sex hormones are available to the body, while lower SHBG levels generally mean more sex hormones are available.

In addition to fertility problems surrounding conception and menstrual cycles, the symptoms of high SHBG in women can also include:

• Decreased sex drive
• Vaginal dryness
• Memory loss
• Low mood and fatigue
• Reduced wellbeing

Having an SHBG blood test done, or a female hormone test that includes SHBG is critical when these symptoms start showing up.

Androgens, both in states of depletion and excess, have been implicated in reproductive health disorders among women⁸. Free Androgen Index or FAI is a ratio that can be used to determine abnormal androgen levels. The FAI ratio is calculated by dividing the total testosterone level by the SHBG level and then multiplying that number by 100 for an index measurement.

Roughly half of the testosterone found in the bloodstream is tightly bound to SHBG and the other half is weakly bound to albumin. Only a small percentage is considered unbound or free testosterone (generally less than 0.7% in females). Because only free testosterone is capable of binding to tissue receptors to exert its effects, unbound testosterone is known as the best marker of a woman’s androgen status.

FAI provides insight into a female’s free testosterone level. FAI is a guidance metric that’s factored alongside other markers like FSH and LH, to name a few.