What You Can Learn from A Hormone Test

Tiffany Lester, MD
September 5, 2019

Feeling out of sorts, but not sure why? Your hormones might be the answer. They’re involved in nearly every bodily function and can disrupt areas of your body you might not even be aware of. Parsley Health LA Dr. Tiffany Lester shares what a hormonal imbalance may look like and what you can learn from a hormone test.

Many women and men are suffering needlessly from hormonal imbalance every single day. Whether its painful periods that require medication and time off work for severe cramps or mood swings, acne , and sleepless nights, none of these symptoms are normal. They all indicate some type of hormone 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 , and melatonin, as well as sex hormones (estrogen, progesterone, and testosterone). Each hormone plays a unique role and they work together to keep your body functioning properly, so if something is off, you may have noticeable symptoms.

What a hormonal imbalance may look like

I see many young women in their 20s and 30s who no longer want to be on synthetic hormones and prefer more intuitive and natural forms of contraception. One woman in particular 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 were high doses of progesterone. We used a hormonal imbalance test and additional lab work to identify what was really going on.

Over 9 months, we addressed her high levels of cortisol at night, lowered inflammatory markers with changes to her diet, healed her digestive dysfunction, and added in 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 if she would ever be able to have a healthy cycle and have children in her future.

When you should consider getting a hormonal imbalance test

Not everyone’s symptoms will be the same though, and yes, men can have hormonal imbalances, too! 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 that you’ve been unable to resolve, hormone testing could help you get a better picture of what’s going on in your body.

How hormone testing works

Hormones can be tested several different ways— 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 provide 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 hormones 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 going off the birth control pill, your body should naturally take over this process again, however that can take up to 12 months to regain a regular menstrual cycle.

What can you learn from a hormone test?

There are a few key things that most hormone tests address.


If you often wake up tired in the mornings, wired at night and/or feel like you need a nap in the afternoon, you may be suffering from what many functional medicine experts now refer to as adrenal fatigue. The official medical term for this condition is 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

Our sex hormones include estrogen and progesterone that 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.

The purpose of estrogen goes beyond solely helping to support fertility and a healthy menstrual cycle. It 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 if our liver and gut are not functioning optimally can make it difficult to detoxify estrogen daily. This leads to estrogen dominance which can cause heavy periods and breast tenderness.

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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