The Hormone Testing You Need (That Your Doctor Probably Isn’t Doing)

Meet Laura.

She’s 46. She’s gaining weight despite eating clean. She’s waking up at 3 a.m. soaked in sweat. Her energy is gone. Her moods are all over the place. And she’s starting to feel like a shell of the person she used to be.

She goes to her doctor. They run some basic labs—CBC, cholesterol, maybe thyroid. Then they say what so many of us have heard:

“Everything looks fine. You’re probably just stressed.

Maybe try yoga?”

Laura leaves the office discouraged.
She wonders:

• Am I doing something wrong?

• Is it what I’m eating?

• Am I not trying hard enough?

Sound familiar?

Let me be clear: You’re not imagining things. You’re not broken. You’re just not getting the full picture—because the standard hormone tests most doctors run are incomplete.

Why We Test (Not Guess)

If you’re in your 40s or beyond and noticing changes in your weight, sleep, mood, or energy—comprehensive hormone testing can provide real, actionable answers.

There are three main ways we can measure hormones:

• Blood (serum)

• Saliva

• Dried urine

Let’s walk through each—what they’re good for, what they miss, and how to know which one is right for you.

1. Blood (Serum) Testing

(What your doctor is probably ordering)

Most conventional providers will test FSH and LH—hormones produced by your pituitary gland, not your ovaries. These are useful for diagnosing menopause (once it’s already happened), but they won’t give you a nuanced view of where you are on the spectrum of hormonal change.

Here’s the problem:
Modern medicine is built to diagnose disease, not detect the subtle declines in hormone adequacy that cause your symptoms.

This is why many women are told “you’re not menopausal yet” even though they feel completely off. (And no, “menopausal” is not the only time hormones matter!)

❗ What your doctor might say:
“Hormones fluctuate too much to test accurately.”

✅ Here’s the truth: That’s partially correct—hormones do fluctuate. But there are ways to test that account for this.

Best practices for testing:

• No menstrual cycle? Test estradiol, estrone, and progesterone anytime (no need to fast).

• Still cycling?
  Test:

  • Estrogen on day 12 of your cycle

  • Estrogen + progesterone on day 21
    (These are their natural peak days—great for spotting deficiencies.)

2. Saliva Testing

(Easy and insightful for free hormone levels)

Saliva testing is simple to do at home and gives us insight into free (bioavailable) hormones—which blood tests often miss. It’s especially helpful for assessing cortisol patterns and how your stress response is functioning throughout the day.

However, saliva tests aren’t perfect. The hormone concentrations are lower, which can sometimes affect accuracy. Still, it’s a great tool, especially if convenience is key.

3. Dried Urine Testing (DUTCH Test)

(My go-to for deep insight)

Dried urine testing (like the DUTCH Complete) offers the most comprehensive look at your hormone landscape. It tracks:

• Hormone levels

• Hormone metabolites (how your body is breaking hormones down)

• Daily fluctuations (using samples collected over time)

It also gives you insight into estrogen detox pathways—key for women at risk for estrogen dominance, fibroids, or certain cancers.

But What If Testing Isn’t Accessible?

That’s okay. While testing is helpful, it’s not the only way to understand what’s going on. Your symptoms tell a powerful story.

Here’s how I group the most common hormone-related symptoms:

Classic Menopause Symptoms

These are the ones you’ve probably heard of (or are living through):

• Mood changes: Irritability, anxiety, or depression driven by drops in estrogen and progesterone

• Weight gain: Especially around the belly, often linked to estrogen decline and cortisol imbalance

• Bloating + gut issues: Slower digestion, constipation, and inflammation tied to poor cortisol metabolism

• Hot flashes + night sweats: A direct result of disrupted temperature regulation as estrogen drops

• Sleep disturbances: Triggered by night sweats, cortisol spikes, or low progesterone

The “Unvoiced” Symptoms (That Are Hormone-Driven Too)

These symptoms often get brushed off—but they’re just as real:

• Stress intolerance: “I can’t handle anything anymore.” This often stems from progesterone loss and cortisol imbalance.

• Brain fog: Forgetting words, losing focus, walking into a room and forgetting why? Estrogen decline affects cognition.

• Emotional overwhelm: It's not just “empty nest syndrome.” When hormone regulation, sleep, and inflammation all shift, the emotional load can feel unbearable.

So What Can You Do?

Here’s where we start—simple, powerful steps that restore balance:

• Follow an anti-inflammatory diet. Lots of veggies, antioxidant-rich foods, minimal sugar + alcohol.

• Eat more protein. At least 100g/day, with a protein-rich breakfast. Choose high-quality, organic sources when possible.

• Sleep 8 hours. Go to bed at the same time. Cut blue light in the evening. Your brain and hormones need rest.

• Move daily. Walking, yoga, strength training—whatever feels good. Aim for 8–10k steps.

• Get tested. Knowledge is power. If accessible, comprehensive testing is one of the best investments in your health.

• Consider bioidentical hormone therapy. When done right, it can be life-changing.

You’re Not Crazy. You’re Not Alone. You’re Not Broken.

If your labs came back “normal” but you feel anything but—trust your gut. The standard of care just isn’t built for the nuance of perimenopause and midlife hormone shifts.

But there is a better way.
You can feel like yourself again—clearer, stronger, calmer. It starts with understanding what’s really going on inside your body.