​I hear it everyday: “My hormones are all out of whack, I just know it!” I would venture to guess that about 80% of women think that their hormones are out of balance. So how do you know if you are truly experiencing an imbalance?

1. If you think you are out of balance, you are probably right. Hormones and the ways they affect your body are complicated and it doesn’t take much to get things “out of whack”, especially in today’s world of high-stress, fast food, and chemical overload.


2. There are certain symptoms that are tell-tale signs like, irregular menstrual cycles, weight gain, mood swings, migraines, hot flashes and night sweats...just to name a few.


There are some hormone abnormalities that we can detect based only on your symptoms (and can sometimes recommend helpful OTC medications or supplements).


3. By far, the best way to find out if you have a hormonal abnormality is to take a hormone test. Which is our main topic today- because there are lots of different ways to get tested and people always ask me which way is best. Let’s talk about blood testing first.


This is the MOST commonly used testing method, mainly because of the cost and convenience. But don’t be fooled; just because it is the most common method doesn’t mean it is the best. Some hormones in blood are protein bound, which makes them inactive and a blood test measures both the free and the bound hormone.


Unfortunately, the amount of bound hormone can vary widely from one person to the next. So we need to look for a test that only measures the free/active hormone. For this reason, blood levels do not get my highest recommendation (although, there are some cases where blood levels are useful). My favorite testing method is the urine test. I use this test to evaluate almost all of my patients before they begin hormone replacement therapy. The first benefit is that it only measures “free” hormone levels, so you get a more clear picture of the hormone that is available for your body to use.


Also, this test gives us some insight into hormone metabolism, methylation, breast cancer risk and so much more! It is a little more tedious than the blood test because you complete it at home by collecting 4-5 urine samples at specific time points during the day. Most of my patients agree that the data we get from this test is well worth the additional effort on your part. Finally, this test really helps me to tailor a treatment to your body’s needs because I have so much more information to work with.


The last method I want to tell you about is saliva testing. This is the test we like to use after you have started HRT. Saliva testing is the best way to measure your free hormone levels once you start using medications because it most accurately measures how much of the medications are actually reaching your tissues, which is where all the action happens. If you are interested in having your hormones tested, email me at and I can help you get started today!


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