I'll admit, I was kind of surprised. Aren't hormone tests just for women dealing with infertility? While that's traditionally been the case, I soon learned that hormones are responsible for a lot more than just the mechanics of baby-making. And a growing number of docs are taking a closer look at their patients' levels in an effort to find explanations for perplexing health concerns.
This can be partially chalked up to the rise of functional medicine—a discipline that aims to correct the root cause of symptoms, rather than just medicating them, and is historically more open to incorporating holistic methods. "Functional medicine doctors very often do test hormones in younger women," says Kerri Masutto, MD, a physician in Parsley Health's San Francisco office. "We know that there may be imbalances that are showing up in ways most [doctors] don't know to look for. We have special training in knowing what labs to order, how to interpret them, and how to treat things that we do find."
It's not just PMS and menstrual pain that are leading doctors to order hormone tests for their millennial clients, although those are definitely two big factors in the decision. "Hormones contribute to our energy levels, our pain tolerance, how much we're affected by stress, how well we sleep," says Dr. Masutto. "They even contribute to whether you're feeling down or totally joyful. The short answer is that hormones affect so much of what makes you feel like you." And if your hormone balance is off due to diet, environmental stressors, or lifestyle habits, everything from your mood to your vitality can feel off kilter, too.
Sound familiar? Read on to find out what hormone testing actually means—and what it can teach you about your health.
Hormone testing 101
Hormones are straight-up complex, and every doctor will have their own testing protocol that will vary based on a patient's specific set of symptoms.
That said, if you're experiencing frequent or missing periods, mood swings, low libido, heavy or painful periods, or changes in weight or hair growth, many doctors would choose to run a reproductive hormone panel. "In these cases, I test estradiol, total estrogen, progesterone, DHEA (an adrenal hormone), and testosterone (both free and total testosterone)," says Laurie Steelsmith, ND, a women's health expert and naturopathic doctor. These hormones can be checked via blood, urine, and saliva—your doctor can advise you on which one is right for you.
Your doctor may also test your thyroid hormones and your levels of the "stress hormone," cortisol, depending on your symptoms. "All of these—and many more—work together to make up a woman's hormone system," says Dr. Masutto. "And any one of these hormones being out of balance can make you feel pretty miserable."
While there are tons of at-home hormone testing kits on the market today, Dr. Masutto doesn't recommend taking that route unless you're being guided by a medical pro. "Find a doctor that can advise, interpret, and recommend a course of action to take based on the results," she says. "If you can get all the testing recommended cheaper from an accurate at-home kit, then great! But please, don't try to go it alone."
Another important thing to note before you get tested: When it comes to checking your reproductive hormones, timing matters. "In women under 40, it's best to test hormone levels on around day 21 of their cycle, if they typically have 28-day cycles," says Dr. Steelsmith, who notes that day one is the first day of your last menstrual period. "If a woman has longer cycles—for instance, 40-day cycles—then it’s best to test hormones about 7-10 days prior to their period due date. This is because it’s best to assess a woman's progesterone level during her mid-luteal phase." And what if you're not menstruating regularly? In that case, says Dr. Steelsmith, testing can be done at any time.
What can you learn from hormone testing?
In some cases, hormone testing can unveil a major imbalance indicative of, say, a thyroid condition or polycystic ovary syndrome (PCOS). But even a slight hormonal shift away from the optimal range can have an impact on your well-being. "There are a lot of conditions that fall on the imbalance spectrum," says Dr. Masutto. "Your cycle can be thrown off a little, or you could have PMS or premenstrual dysphoric disorder (PMDD). [Hormone imbalance] can even put you into premature ovarian failure, which is something that can be really life-altering."
Once your doctor knows exactly which hormones are causing your distress, they're able to offer a more targeted treatment. In the western medical tradition, drugs are often the answer—birth control pills, thyroid meds, or antidepressants, to name a few. And while there are certainly many cases in which pharmaceuticals are necessary, some doctors prefer to treat more moderate hormone imbalances through food and lifestyle modifications.
"From a holistic medical perspective, I would recommend that a woman with hormone imbalances use botanical medicines, acupuncture, nutritional supplements, and lifestyle and dietary therapy," says Dr. Steelsmith. Dr. Masutto says Parsley Health takes a similar approach, adding that she's not averse to prescribing medication in some cases. "Utilizing prescription or compounded hormone replacement can help alleviate symptoms and help you get your life back so you can work on the lifestyle changes that are needed," she says.
And what if your doctor doesn't suggest hormone testing when you bring up your symptoms? In this case, Drs. Steelsmith and Masutto say you have the right to ask about it—after all, it's up to you to be your own health advocate. "It's always okay to ask your doctor to investigate things further, and then you need to be open to hearing their answer and plan," says Dr. Masutto. "If it doesn't resonate with you, then you may need to find a different doctor, or even a completely different type of doctor. It's your body and you have a right to feel good in it." And, of course, to know why you're not feeling good in the first place.
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