The Role of Hormone Tests for Women
Women and people assigned female at birth can have hormone testing for many different reasons. Hormone testing may be used for diagnosis, monitoring, and screening:
- Diagnosis: Hormone testing is often used to identify the cause of a person’s symptoms. Testing may be helpful in diagnosing conditions like delayed development, infertility, menopause, polycystic ovary syndrome (PCOS), and certain types of tumors.
- Monitoring: After someone has been diagnosed with a medical condition, ongoing testing may be used to track any changes in their health, including whether treatments are effective. A hormone test for women may be used to monitor people who are having treatments for infertility or cancer. Testing can also help monitor hormone levels in transgender women who are having gender-affirming hormone treatment.
- Screening: Occasionally, hormone testing may be used for screening, which is looking for health issues before there are any signs or symptoms. For example, testing for certain hormones may be performed during pregnancy to screen for potential fetal health problems. In addition, women and people assigned female at birth who are of childbearing age may have hormone tests to see if they are pregnant prior to surgery or admission to a hospital. Pregnancy tests may also be done before incarceration.
Who should get testing?
Hormone testing in women and people assigned female at birth is most often ordered when a patient has symptoms that suggest a possible hormonal imbalance.
Because hormones affect so many bodily systems, hormonal imbalances can result in a wide range of symptoms. Doctors may suggest hormone testing in patients with one or more of the following symptoms:
- Signs of menopause like vaginal dryness, hot flashes, and/or trouble sleeping in people under the age of 40
- Difficulty becoming or staying pregnant
- Signs of pregnancy such as a missed period, tender breasts, nausea, and frequent urination
- Abnormal vaginal bleeding including menstrual periods that are longer than usual or bleeding between periods
- Absent or irregular menstrual periods
- Acne
- Abnormal hair growth
Hormone testing is also used to detect thyroid conditions, which are more common in women and people assigned female at birth. Symptoms of thyroid conditions that may lead to hormone testing include:
- Constipation or diarrhea
- Feeling cold
- Mood changes
- Unexplained weight gain
- Feeling very tired
- Slow or irregular heart rate
- Irritability
- Trouble sleeping
- Changes to skin or hair
Hormone testing may also be suggested if you have previously had health conditions related to hormonal imbalances. People receiving medical care to change hormone levels may have ongoing hormone tests to monitor their response to treatment.
It is important to talk with a doctor if you have any signs of a hormone imbalance or other concerns about your hormone levels. A doctor can help determine whether hormone testing is appropriate and which hormone panel tests to perform.
Getting test results
Your health care provider may call to share your hormone test results with you, or you may be able to access them through an online portal. You may wish to make an appointment with your health care provider to discuss your hormone test results, which are usually available within a few business days.
In many situations, your health care provider will consider the findings from hormone tests along with other test results. It is often the pattern of test results, rather than a single result, that enables your health care provider to determine the cause of your symptoms. For this reason, your doctor may also wait until all test results are available before reviewing them with you.
Types of Hormone Tests for Women
Women and people assigned female at birth may have many different kinds of hormone tests. The following sections describe some of the most common tests related to female sex hormones or to conditions that generally affect women and people assigned female at birth.
Menopause tests
Menopause refers to the time when a person with a uterus stops menstruating. Menopause typically begins with perimenopause, the time leading up to the last menstrual period. During perimenopause, hormone levels change rapidly, causing irregular periods along with symptoms like hot flashes and mood swings.
The transition to menopause typically lasts for two to eight years. A person is considered post-menopausal one year after their last menstrual period.
Menopause can often be identified based on a person’s health history and symptoms. However, hormone testing may be used to determine or confirm menopause in certain people, including:
- People with premature menopause, which means the permanent end of menstruation before age 40
- People with menstrual disorders, such as polycystic ovary syndrome (PCOS)
- People using oral contraception
- Women and anyone born with a uterus who has had treatments such as surgery to remove the uterus or to alter the uterine lining
The following hormone tests may be used to identify menopause:
Luteinizing Hormone (LH) | Blood | A hormone made by the pituitary gland that triggers the ovaries to make estrogen and signals them to release eggs |
Estrogens | Blood | Hormones made mainly in the ovaries that have multiple functions in the body |
Follicle-Stimulating Hormone (FSH) | Blood | A hormone made by the pituitary gland that helps control menstruation and triggers the release of eggs from the ovaries |
Anti-Müllerian Hormone | Blood | A hormone made in the ovaries that plays a role in the development of a fetus |
Fertility tests
Hormone tests may be performed if a couple has problems getting or staying pregnant, usually after six months to a year of trying. Testing may take place sooner if there are known health issues that may affect fertility.
More details, including about the hormone tests that may be used in evaluating fertility in women and people with a uterus, are available in our article on fertility testing.
Pregnancy tests
Checking to see if someone is pregnant is done by testing for a hormone called human chorionic gonadotropin (hCG). This hormone is produced by the placenta, a temporary organ that nourishes the fetus during pregnancy.
Either blood or urine may be tested for hCG. Typically, blood tests are more accurate and can detect pregnancy as early as six days after ovulation.
More information is available in our article on the pregnancy test (hCG).
Thyroid tests
The thyroid is a small gland that makes hormones that are important for the body’s metabolism. Thyroid diseases can affect anyone but are more common in women and people assigned female at birth, especially after pregnancy or menopause.
The following table shows hormone tests that may be used to detect or rule out thyroid disease:
Test Name | Sample Type | What it Measures |
Thyroid-Stimulating Hormone (TSH) | Blood | A hormone made in the pituitary gland that stimulates the thyroid gland and reflects thyroid function |
Free Triiodothyronine (T3) or Total T3 | Blood | The most active form of thyroid hormone, which is known as free or total T3 based on whether or not it is bound to protein in the blood |
Free Thyroxine (T4) or Total T4 | Blood | A type of thyroid hormone referred to as free or total T4 based on whether or not it is bound to protein in the blood |
Some people may have a thyroid panel test, which measures TSH, T3, and T4 using the same blood sample. More information about tests to evaluate the thyroid can be found in our guide to thyroid function testing.
Polycystic ovary syndrome tests
Polycystic ovary syndrome (PCOS) is a condition caused by a hormonal imbalance. In PCOS, women or people assigned female at birth tend to have high levels of male sex hormones known as androgens.
Symptoms of PCOS include irregular menstrual periods, infertility, acne, abnormal hair growth, and ovarian cysts. A health care provider may suggest the following hormone tests to help diagnose PCOS:
Test Name | Sample Type | What It Measures |
Estrogens | Blood | Hormones made mainly in the ovaries that have many functions, including in regulating the menstrual cycle |
Follicle-Stimulating Hormone (FSH) | Blood | A hormone that helps control reproduction, development of eggs, and sexual development |
Luteinizing Hormone (LH) | Blood | A hormone that helps regulate the menstrual cycle |
Testosterone | Blood | A hormone produced by people of all sexes but found in higher levels in men and people assigned male at birth |
Human Chorionic Gonadotropin (hCG) | Blood or urine | A hormone produced during pregnancy as well as by some tumors |
Prolactin | Blood | A hormone made by the pituitary gland that triggers breast development and milk production |
Thyroid-Stimulating Hormone (TSH) | Blood | A hormone made in the pituitary gland that activates the thyroid and reflects thyroid function |
17-Hydroxyprogesterone | Blood | A hormone made in the adrenal glands that can be related to abnormal development of sex organs |
Puberty testing
Puberty is the time when girls and people assigned female at birth start producing more female sex hormones. These hormones cause the body to go through changes including breast development, the growth of pubic hair, and the start of menstrual periods.
When these physical changes begin before age eight, it is considered to be early puberty, also known as precocious puberty. If these changes have not begun by the age of 13, puberty is considered delayed.
The tests in the following table may be prescribed to check hormone levels in people with either early or delayed puberty.
Test Name | Sample Type | What It Measures |
Estrogens | Blood | Hormones involved in regulating the menstrual cycle, development of the breasts and uterus, and many other functions in the body |
Follicle-Stimulating Hormone (FSH) | Blood | A hormone that helps control reproduction, egg production, and sexual development |
Luteinizing Hormone (LH) | Blood | A hormone that stimulates the menstrual cycle |
Prolactin | Blood | A hormone made by the pituitary gland that is involved in breast development |
Insulin-Like Growth Factor 1 (IGF-1) | Blood | A hormone mainly made in the liver that helps promote normal growth of bones and tissues |
Free T4 | Blood | A hormone made by the thyroid gland |
Thyroid-Stimulating Hormone (TSH) | Blood | A hormone made in the pituitary gland that activates the thyroid gland |
Other hormone tests
Other hormone tests are prescribed based on a person’s condition, including their symptoms and health history. Examples of other hormones that may be measured include:
Test Name | Sample Type | What It Measures |
---|---|---|
Progesterone | Blood | A hormone made in the ovaries in the second half of the menstrual cycle that prepares the body for pregnancy |
Testosterone | Blood | A hormone produced by people of all sexes but found in higher levels in men and people assigned male at birth |
Androstenedione | Blood | An adrenal hormone that can be associated with menstrual abnormalities, infertility, and excess body and facial hair |
DHEAS | Blood | A male sex hormone that may be elevated in disorders involving the adrenal glands or ovaries |
Prolactin | Blood | A hormone made by the pituitary gland related to breast development and milk production |
Getting Hormone Testing
Hormone testing for women and people assigned female at birth may be ordered by a primary care physician, obstetrician/gynecologist (OB-GYN), or another doctor like an endocrinologist or fertility specialist.
Tests that require blood or urine samples may take place at a doctor’s office, clinic, laboratory, or hospital. When testing requires 24-hour urine collection, the sample is typically collected at home and brought to a laboratory.
At-home testing
Commercial kits are available that offer at-home hormone testing and hormone tests available online for women and people assigned female at birth. These at-home tests include:
- At-home thyroid testing
- At-home fertility testing
- At-home polycystic ovarian syndrome (PCOS) testing
- At-home pregnancy testing
More information about at-home options is available in our article about at-home hormone testing.
It is important to work with a health care provider to diagnose or monitor any health condition including infertility, thyroid disease, PCOS, or pregnancy. At-home tests and online hormone tests should not be used as a substitute for working with a health care provider.
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