Looking to learn how to read female hormone blood test results? Look no further than our complete guide to understanding hormone blood test results- we have the how, the why, and the what it means all in one place! 

Complete Guide: Understanding Female Hormone Blood Test Results

Testing hormone levels can get confusing, and many doctors will tell you there is no value in testing them.  Well, we disagree!  So we created this comprehensive guide on how to read female hormone blood test results.

Whether you’re curious about your hormone levels or investigating potential health concerns, this guide will provide you with the knowledge to interpret your test results and start a conversation wtih your healthcare provider about the results. We’ll cover the importance of hormonal balance in women’s health, the key hormones analyzed in blood tests, and provide an overview of the endocrine system (your hormone production system).

Key Takeaways:

• Lab tests can provide valuable insights into female hormone levels and overall health.
• Understanding the normal ranges for hormone levels is important to know how to read your female hormone blood test results.
• Hormonal balance plays a vital role in women’s health and well-being.
• Common hormones analyzed in blood tests include estrogen, progesterone, testosterone, cortisol, and thyroid hormones.
• Interpreting hormone blood test results will require some basic knowledge of terminology and units of measurement.

Introduction to Female Hormones and Their Functions

In this section, we’ll provide an introduction to female hormones and their vital functions in the body. Understanding the role of hormones is crucial for maintaining overall women’s health and well-being. Hormones act as messengers in the body, regulating various bodily functions and processes.

Female Hormones and Hormones that Factor into Female Hormone Balance:

• Estrogen (often tested as Estradiol but other forms like Estriol and Estrone make up Total Estrogen): plays a key role in the development of female secondary sexual characteristics, regulates the menstrual cycle, and promotes bone health.
• Progesterone: prepares the uterus for pregnancy and helps regulate the menstrual cycle.
• Testosterone: although predominantly known as a male hormone, testosterone is also present in women and contributes to muscle growth, energy levels, and libido.
• Cortisol is one of our key stress hormones.
• Thyroid Hormones: regulate metabolism, and energy production, and influence various bodily functions.

Hormonal balance is vital for optimal health. When the levels of these hormones are in harmony, we feel balanced in terms of mood, energy, sleep, sexual desire, and muscle tone. However, hormonal imbalances can lead to various health concerns and disrupt this delicate equilibrium.

The Importance of Hormonal Balance in Women’s Health

Hormonal balance is essential for women’s health. Imbalances can have a significant impact on mood, energy levels, menstrual cycles, and reproductive health. Hormonal imbalances can occur at any age and may lead to symptoms such as irregular periods, mood swings, weight gain, infertility, and more.  In particular, during perimenopause, we can have big swings in our hormones, and not just our female hormones.  This can create a myriad of imbalanced hormone symptoms.

Key Hormones Analyzed in Blood Tests

• Estrogen: typically checked as estradiol, is measured to evaluate ovarian function, monitor fertility, diagnose menopause or estrogen dominance in perimenopause, and assess hormone replacement therapy.
• Progesterone: evaluated to determine ovulation, assist in diagnosing menstrual irregularities (particularly those in all stages of perimenopause), and ensure proper hormonal balance.
• Testosterone: measured to assess androgen levels in women, associated with various symptoms such as hirsutism (excess hair growth on the face, arms, etc), acne, and irregular periods.
• Cortisol: this stress hormone is difficult to accurately measure in the blood (more about that later) but it is checked to look at how chronic stress may be impacting your metabolism, energy levels, and body composition.
• Thyroid Hormones: including TSH, T3, and T4, are evaluated to diagnose and monitor thyroid disorders.

Overview of the Endocrine System

The endocrine system is a complex network of glands and organs that produce and regulate hormones. It includes the hypothalamus, pituitary gland, thyroid gland, adrenal glands, ovaries, and others. These glands work together to maintain hormonal balance, ensuring homeostatis, or balance, in the body. The endocrine system plays a vital role in growth, metabolism, reproduction, and other essential processes in the body.

Preparing for Your Hormone Blood Test

Before undergoing a hormone blood test, it’s essential to adequately prepare for the test. By following the necessary preparation guidelines, you can help ensure that your hormone blood test results provide an accurate representation of your hormonal status.  But keep in mind that hormones are always fluctuating, so observing patterns over time can also be helpful.

Fasting requirements:

Some hormone blood tests may require fasting beforehand. It is important to check with your healthcare provider or the laboratory conducting the test for specific fasting instructions. Typically, fasting for 8-12 hours is recommended. This means avoiding food and drinks (except water) during the fasting period.  Fasting is essential when testing cortisol, and this stress hormone should be tested between 7 to 9 a.m.  It’s not necessary to fast for sex hormone testing like estradiol, progesterone, or testosterone.  Opinions vary on whether to fast for thyroid hormone testing so always check with your provider, and be consistent when checking your thyroid hormone (if you usually fast when you test it, then stick with that each time you test it).

Avoiding certain medications:

Inform your healthcare provider about any medications, supplements, or herbal remedies you are currently taking. Some medications can affect hormone levels in the blood and may interfere with the accuracy of the test results. Your healthcare provider may advise you to temporarily stop taking certain medications before the test.  I often have my patients not take any hormones (thyroid medicine, bioidentical hormones, or even cortisol supplements) the morning of their hormone test.

Optimal timing:

Hormone levels can fluctuate throughout the day, so the timing of your blood test can impact the results. Your healthcare provider will guide you on the optimal time to schedule your test based on the specific hormones being measured. This might include testing at a particular phase of your menstrual cycle or at a specific time of day.  See my notes above on cortisol timing.  For estradiol and progesterone, I have women do their blood tests between day 19-22 of their cycle, with the first day of bleeding being day 1.  If their cycles are irregular we usually choose a date that makes sense just to at least get a ratio.  Testosterone can be tested any time of the cycle.

By sticking with these preparation guidelines, you can optimize the accuracy and reliability of your hormone blood test results. Remember to consult with your healthcare provider for personalized instructions based on your specific circumstances and the goals of the test.

How to Read Female Hormone Blood Test Results

In order to accurately interpret your female hormone blood test results, it’s important to understand the terminology and units of measurement used in hormone testing. This knowledge will allow you to fully comprehend the information presented in your test results, get ratios, and compare them to the normals. Let’s dive into the key aspects you should be aware of when reading your test results.

Decoding the Terminology and Units of Measurement

The terminology and units of measurement used in hormone testing can often be confusing. To help you navigate through this, it is important to familiarize yourself with some common terms related to hormone levels.

Additionally, hormone levels are typically measured using specific units of measurement. These units can vary depending on the laboratory, so it’s crucial to be mindful of the units mentioned in your test results. Common units of measurement for hormone levels include nanograms per milliliter (ng/mL), micrograms per deciliter (mcg/dl), mIU/l,  and picograms per milliliter (pg/mL). By decoding the terminology and units of measurement, you’ll be better equipped to interpret your test results accurately.

Normal Ranges and What They Mean

When analyzing the hormone levels in your test results, you’ll first need to compare them with the normal ranges. Normal ranges represent the typical hormone levels for individuals of a certain age and gender.

Estrogen and Progesterone

For example, normal estrogen levels in women typically range from 15 to 350 pg/mL, while progesterone levels range from 0.1 to 25 ng/mL, depending on the phase of the menstrual cycle.

Testosterone

Testosterone levels in women generally range from 8 to 48 ng/mL. I prefer to check free and total testosterone in my patients, as this hormone like many others can be bound to proteins.  The free version of this hormone is what we actually feel and get the effects of.

Cortisol

Cortisol normals can vary greatly depending on the time of day that they are measured.  That’s why it’s best to stick with fasting cortisol morning levels, checked between 7 to 9 a.m.  Normal levels at this time of day for blood testing are between 9 and 15 mcg/dl.

I prefer to check cortisol via salivary or urinary testing as it is more accurate and can reflect an overall cortisol pattern (i/e stress hormone pattern) throughout the day.  For salivary or urinary I typically use the DUTCH test.  If your provider isn’t open to functional medicine testing you can order this through my Labshop (DUTCH complete Dried Urine Testing) and the results will show your overall stress hormone patterns.

The DUTCH test COMPLETE is my preferred test as it looks at cortisol pattern, cortisol metabolism, testosterone and the breakdown of testosterone, all the different types of estrogen and how they break down, and progesterone.  It also includes b vitamin markers, which when optimal support healthy hormone balance, neurotransmitter levels like dopamine and norepinephrine, and melatonin levels.  See my complete video on how to interpret your DUTCH test if you need help or want to learn more!

Thyroid Hormones

Thyroid hormone levels, such as TSH, T3 and T4, have their own respective normal ranges.  The thyroid hormone that is most commonly checked as a screening tool for thyroid disease is TSH, or thyroid stimulating hormone.    Additional helpful thyroid markers include T3 and T4, which I prefer to check the Free versions of (Free T3, Free T4).

Normal Lab Values for Thyroid Hormones

• TSH: conventionally normal ranges are 0.4-4 mIU/L, however, optimal ranges from a more functional perspective are 0.4-3.0 mIU/L.
• Free T4: normal ranges are between 0.82-1.8 ng/dl, with optimal levels being between 1.0-1.8 ng/dl
• Free T3: normal ranges are between 2.0-4.4 ng/dl, with optimal levels being between 2.4-4.4 ng/dl

Keep in mind that normal ranges can vary slightly between different laboratories and healthcare providers. Therefore, it is important to refer to the specific normal ranges provided on your test results for accurate interpretation.

Interpreting Estrogen and Progesterone Levels

Estrogen and progesterone are two crucial hormones for female reproductive health. Understanding their levels in your test results can provide insights into your menstrual cycle, fertility, and overall hormonal balance.

Estrogen levels throughout the Menstrual Cycle

Estrogen levels fluctuate throughout the menstrual cycle, peaking just before ovulation. Low estrogen levels may indicate issues such as late stage perimenopause, menopause or a hormonal imbalance. Conversely, high estrogen levels may point to conditions like polycystic ovary syndrome (PCOS), estrogen dominance in perimenopause, or adrenal gland disorders.

• Follicular Phase Estradiol Normal Levels (usually the first two weeks of the cycle): 20-350 pg/ml
• Ovulation Phase Estradiol Normal Levels (mid cycle peak): 150-550 pg/ml
• Luteal Phase Estradiol Normal Levels (usually the last two weeks of the cycle): 30-250 pg/ml
• Post-menopausal Estradiol Levels (when you have gone 1 year without a period): < 20 pg/ml

This is one lab that can VARY GREATLY between different lab companies, so always read the normals on your report.

Progesterone levels throughout the Menstrual Cycle

Progesterone levels, on the other hand, play a significant role in maintaining pregnancy and regulating the menstrual cycle. Low progesterone levels can indicate issues with ovulation or potential fertility concerns. High progesterone levels may suggest pregnancy or certain conditions such as adrenal gland disorders.

• Follicular Phase Progesterone Normal Levels (usually the first two weeks of the cycle): 0.1-0.7 ng/ml
• Ovulation Phase Progesterone Normal Levels (mid-cycle peak): 4.4-28.0 ng/ml
• Luteal Phase Progesterone Normal Levels (usually the last two weeks of the cycle): 0.2-25 ng/ml
• Post-menopausal Progesterone Levels (when you have gone 1 year without a period): 0.0-0.7 ng/ml

Notice that the the measurement units here are different with estradiol and progesterone.  This is important when determining if you have estrogen dominance.  Here’s a great calculator to help you determine if you have estrogen dominance, the most common hormone imbalance found in early to mid perimenopause.   While this calculator is used for IVF and fertility optimization it can help determine the ratio.  If the ratio is lower than 100, you know you MAY have estrogen dominance.

I find the DUTCH test easier to read and establish estrogen dominance more reliably, but the expense often limits some women from being able to do this test, in which case the above technique can be an alternative.

Understanding Testosterone and Other Androgens in Women

Although often associated with men, testosterone also plays a role in women’s health. It contributes to maintaining bone density, muscle mass, libido, and overall well-being. Abnormal testosterone levels in women can have various implications.

Low testosterone levels in women may lead to decreased libido, fatigue, and low mood. In contrast, high testosterone levels can impact menstrual cycles, fertility, mood, and even cause symptoms like unwanted facial hair growth or acne.

Other androgens, such as dehydroepiandrosterone (DHEA), androstenedione, and dihydrotestosterone (DHT), are also important for women’s health. Deviations from the normal ranges of these androgens can have various effects on the body and may indicate underlying health concerns like tumors, genetic conditions, and more.

The DUTCH test is very helpful in looking at these individual androgens, but you can check the basic levels of them through bloodwork.

Thyroid Hormones and Their Impact on Women’s Health

The thyroid gland produces hormones that play a crucial role in regulating metabolism and energy levels. In women, thyroid issues are more common and can have a significant impact on overall health.

Thyroid hormone levels, such as T3 (triiodothyronine) and T4 (thyroxine), can be assessed through blood tests. Low thyroid hormone levels may indicate an underactive thyroid (hypothyroidism), while high levels may suggest an overactive thyroid (hyperthyroidism).  TSH has the opposite pattern with thyroid activity.  A higher than normal TSH indicates hypothyroidism, while a low TSH indicates hyperthyroidism.

Imbalances in thyroid hormones can affect menstrual cycles, fertility, weight, energy levels, and mood. Proper interpretation of thyroid hormone levels in your blood test results can help identify potential thyroid disorders and guide appropriate treatment.  If you are gaining weight and feel sluggish this may be hypothyroidism (among MANY other symptoms that can occur).  Conversely, if you are feeling revved up with anxiety, heart palpitations, and trouble sleeping this could mean hyperthyroidism.

By understanding how to read and interpret your female hormone blood test results, you can gain valuable insights into your hormonal status and overall health. If you have any concerns about your test results, consult with your provider.  These tests must be individually interpreted and your health history and health concerns should be factored in before any diagnosis or treatment plan is made.

Common Hormonal Imbalances and Associated Health Concerns

In this section, we will delve into some common hormonal imbalances and their associated health issues. By understanding these imbalances and how they manifest in hormone blood test results, you can gain insights into potential health concerns.

Polycystic Ovary Syndrome (PCOS) and Hormones

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects many women. It is characterized by an imbalance of reproductive hormones, such as estrogen and progesterone. PCOS can cause irregular periods, ovarian cysts, weight gain, and fertility issues.

Lab results in PCOS:

Typical hormone blood test results in PCOS can be elevated testosterone, elevated DHEA, and possibly estrogen dominance.   Other lab results that can be high in PCOS are blood sugar, fasting insulin levels, and sometimes liver enzymes and cholesterol.

Menopause, Perimenopause and Hormone Fluctuations

Perimenopause

Perimenopause is the 2-10 years leading up to menopause.  This phase in a woman’s life can be accompanied by irregular periods, heavy periods, mood swings, problems sleeping, skin changes, hot flashes, night sweats, and more!

Lab Test Results in Perimenopause

The first phase is usually characterized by declining progesterone and intermittent estrogen dominance.  Subsequently, in the second phase, the estrogen starts to decline leading to hot flashes, sleep problems, and more low estrogen symptoms. 

Menopause

Menopause is a natural process that marks the end of a woman’s reproductive years. During this transition, there is a significant fluctuation in hormone levels, especially estrogen and progesterone. These hormonal changes can lead to symptoms such as hot flashes, mood swings, and bone density loss. Hormone blood tests can help monitor hormone levels during menopause and guide appropriate interventions for symptom management.

Lab Test Results in Menopause

Menopause is defined as the day when a woman has gone 1 year without a period.  In contrast, after menopause is “post-menopause” but the terms are often used interchangeably.   Estradiol is usually < 20 pg/ml and progesterone is typically 0.0-0.7 ng/ml after menopause.  Testosterone may stay the same or decline.  To confirm menopause providers often add FSH and LH testing.  These are hormones made by the pituitary gland that signal the ovaries to make estradiol and progesterone respectively.   When FSH is greater than 21 mIU/ml and LH is greater than 10.9 mIU/ml that typically indicates menopause.

Thyroid Disorders in Women

The thyroid plays an important role in regulating various bodily functions, including metabolism and energy production. Thyroid disorders, such as hypothyroidism and hyperthyroidism, are more prevalent in women.  Having an underactive thyroid (hypothyroidism) is much more common than an overactive thyroid.  These conditions can cause a range of symptoms, including fatigue, weight changes, and mood disturbances.

Adrenal Health and Stress Hormones

The adrenal glands play a vital role in managing stress and producing hormones, such as cortisol. Chronic stress can lead to an imbalance in stress hormones, impacting sleep, estradiol and progesterone levels, blood sugar balance, and more.  Understanding the status of stress hormones can provide insights into the effects of chronic stress and guide stress management strategies.

Conclusion

Understanding how to read female hormone blood test results is incredibly helpful as you navigate phases in your life like perimenopause and menopause.   Additionally, understanding the connection between thyroid and adrenal health and your female hormone health is important when trying to get the bottom of hormone imbalance.  By following this comprehensive guide, you now have the knowledge to interpret your test results accurately and be proactive about your hormone health!

Moreover, you may consider exploring functional medicine approaches, which focus on addressing the root causes of hormonal imbalances rather than merely alleviating symptoms. Functional medicine practitioners take a holistic view of your health, considering factors such as nutrition, lifestyle, and stress management, and addressing root causes of hormone imbalance.