What You Can Learn from A Hormone Test

Tiffany Lester, MD
Medically Reviewed
September 5, 2019

Feeling out of sorts, but not sure why? Your hormones might be the answer.

Your hormones are involved in nearly every bodily function and can disrupt areas of your body you might not even be aware of. Parsley Health clinician Dr. Tiffany Lester shares what a hormonal imbalance may look like and what you can learn from a hormone test.

What is hormonal imbalance?

Many women and men are suffering needlessly from hormonal imbalance every single day. Whether it's painful periods that require medication and time off work, acne , or sleepless nights, none of these symptoms are normal. They all indicate some type of hormonal imbalance that can typically be corrected through diet, exercise, and supplementation. A hormonal imbalance test can help identify this.

When we talk about hormones, we’re not just talking about those that you learned about in middle school health class. Hormones are a huge category that includes cortisol , thyroid hormones , and melatonin , as well as sex hormones like estrogen, progesterone, and testosterone.

Each hormone plays a unique role while working together to keep your body functioning properly, so if something is off, you may have noticeable symptoms.

What does a hormonal imbalance look like?

I see many young women in their 20s and 30s who no longer want to be on synthetic hormones for birth control, and prefer more intuitive and natural forms of contraception.

One woman lost her period for over a year after stopping birth control after being on it for more than a decade. The only thing that would stimulate a period for her were high doses of progesterone. We used a hormonal imbalance test and additional lab work to identify what was really going on.

Over nine months, we addressed her high levels of cortisol at night, lowered inflammatory markers with changes to her diet, healed her digestive dysfunction, and added supplements to help stimulate natural production of estrogen and progesterone while replenishing certain micronutrients. Her period finally returned, and at 27 years young, she was no longer worried about her cycle.

When should I test my hormones?

Not everyone’s symptoms of hormonal imbalance will be the same. Symptoms of a hormone issue vary in their intensity and severity. You may experience one or all of the below.

  • Bloating
  • Swelling and tenderness in your breasts
  • Fibrocystic lumps in your breasts
  • Acne
  • Decreased sex drive
  • Irregular menstrual periods
  • Increased symptoms of premenstrual syndrome (PMS )
  • Mood swings
  • Headaches
  • Anxiety or depression
  • Night sweats or hot flashes
  • Weight gain
  • Increase in body fat, particularly breasts
  • Erectile dysfunction
  • Low sperm count
  • Decreased bone mass

If you have any of these symptoms, hormone testing could help you get a better picture of what’s going on in your body.

How does hormone testing work?

Hormones can be tested through blood, urine, and saliva. Which one is best for you depends on your symptoms or any diagnosed conditions.

In general, for fertility and to monitor the status of hormone replacement therapy, blood tests are sufficient. When evaluating hormone imbalances like PMS, PCOS , and chronic fatigue , choosing urine or saliva will give you additional insight into the root cause of the condition. It’s important to test your estrogen metabolites and the circadian rhythm of your cortisol to obtain a complete picture of your hormone levels and evaluate any potential hormone imbalance.

If you’re on birth control, your hormone levels on any test will be suppressed, because birth control pills contain synthetic estrogen and/or progesterone, which deplete your body’s natural production of these hormones. Once off the birth control pill, your body should naturally take over this process again; however, it can take up to 12 months to regain a regular menstrual cycle.

What can I learn from a hormone test?

Most hormone tests address the following:

  • Cortisol. If you often wake up tired in the mornings, feel wired at night, and/or feel like you need a nap in the afternoon, you may have what many functional medicine experts now refer to as adrenal fatigue or HPA dysfunction. Chronic stress over months to years cause an imbalance in our HPA axis, which can lead to elevated or suppressed levels of cortisol. Our cortisol acts on a circadian rhythm. It should typically peak at 6-9 am and gradually go down throughout the day so that melatonin can rise at night for a restful sleep. Testing shows us how your cortisol acts throughout the day and identifies any imbalance.
  • Sex hormones. Female sex hormones, which include estrogen and progesterone, as well as testosterone, vary during the course of a normal menstrual cycle. Testing on Day 3 or 21 can provide your doctor with valuable information connecting your symptoms to hormone imbalances. Estrogen also aids in enhancing the effects of neurotransmitters in the brain, supports bone and cardiovascular health, and reduces the incidence of acne in women. Progesterone prepares our endometrium for a potential pregnancy after ovulation. It is also high during pregnancy to maintain a viable fetus.

Common hormonal imbalances

High cortisol and low progesterone is a common pattern I see in young, stressed out professional women. Progesterone is like nature’s Xanax and keeps your mood calm and steady. Low levels of progesterone can increase anxiety and PMS symptoms, especially the week before your period starts.

Estrogen dominance is also very common as we now live in a world full of endocrine disruptors . These xenoestrogens are man-made chemicals that mimic estrogen in your body and can negatively impact your hormones. This, along with liver and gut dysfunction, can make it difficult to detoxify estrogen daily. This leads to estrogen dominance, which can cause heavy periods and breast tenderness.

Ready to take control of your hormonal health? Schedule a call  to learn more about Parsley’s root-cause approach, using insurance  with Parsley, and how we can personalize your health journey.

Tiffany Lester, MD

Dr. Tiffany Lester is a board-certified Integrative Medicine Physician who has practiced a holistic approach to health for over a decade. She is a graduate of the University of Cincinnati College of Medicine, where she completed her training in internal medicine. She also graduated from the Integrative Medicine Fellowship at the University of Arizona with Dr. Andrew Weil, and has extensive training in functional medicine through the Institute of Functional Medicine. Dr. Lester is also featured as a teacher for the Institute of Integrative Nutrition and regularly contributes to national wellness publications.

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