TL;DR:
- Hormone tests help diagnose hormonal disorders and must be performed in specific menstrual phases for accurate results.
- Recommended test timings:
- Follicular phase: Days 3–5 of the cycle
- Ovulation: Days 12–14
- Luteal phase: Day 21
- Symptoms requiring hormone testing: irregular cycles, acne, fatigue, hair changes, low libido, or fertility issues.
- Common hormones tested: FSH, LH, estrogen, progesterone, androgens (e.g., testosterone).
- Estrogen norms:
- Follicular: 0–587 pmol/L
- Ovulation: 124–1468 pmol/L
- Luteal: 101–110 pmol/L
- Progesterone norms:
- Follicular: <0.6–3.6 nmol/L
- Ovulation: 1.5–5.5 nmol/L
- Luteal: 3.0–68.0 nmol/L
- FSH and LH peak during ovulation; their abnormal levels may indicate ovarian or thyroid issues.
- Testosterone (norm: 0.69–2.77 nmol/L): excess causes masculinization; deficiency can cause metabolic problems.
- Results interpretation should involve a doctor due to cycle phase dependencies.
Hormone blood tests allow you to find out the level of particular hormones and check whether the amount of hormones is sufficient. Typically, this type of testing is carried out for any suspected hormone disorders. These tests are widely available and can be performed in any laboratory. However, a common problem is the proper interpretation of the results. To be sure that the hormone test made any sense, it must be performed at the correct phase of the cycle and the result must be read correctly.
In what phase of the cycle to perform hormonal testing?
The menstrual cycle consists of two phases: follicular and luteal. In the middle of the cycle between these two phases, ovulation occurs. The first phase begins with the onset of menstrual bleeding. This is when the pituitary gland increases the secretion of FSH which stimulates the ovaries to produce estrogen. Ovulation, on the other hand, occurs when estrogen levels are very high. Stimulating ovulation also requires a spike in FSH and LH levels. Once ovulation is complete, the luteotropic phase begins. LH increases the concentration of progesterone, which is produced in the ovaries. The concentration of FSH and LH drops abruptly, but estrogen still remains at a high, constant level. When fertilization does not occur, the amount of sex hormones decreases and menstruation occurs.
When should hormone tests be performed?
Sex hormone tests are recommended to be performed at each phase of the cycle, before hormone therapy. Initially, the follicular phase is determined (recommended between 3 – 5 days of the cycle). Sometimes doctors recommend repeating the tests during ovulation (12 – 14 days before the expected menstruation). Diagnosis in the luteal phase, on the other hand, is carried out on the 21st day of the cycle. Only such tests provide a complete picture of the hormonal changes that have occurred in a given menstrual cycle. Indications for hormonal testing also include many symptoms that women often underestimate. The most characteristic ones include acne lesions, irregular menstrual cycles, hyperpigmentation, decreased libido and excessive body hair. A hormonal imbalance also causes women to experience chronic fatigue, worse moods and trouble sleeping.
How to prepare for hormone testing?
Hormone tests are ordered to be carried out by a gynecologist. They should be performed on the appropriate day of the menstrual cycle, since the concentration of many hormones depends on the current phase of the cycle. Between the 3rd and 5th day of the cycle, it is recommended to perform tests showing the concentration of hormones during the follicular period. The next measurements are taken between the 12th and 14th days, and the last around the 21st day of the cycle. However, it is worth remembering that each woman's menstrual cycles may vary in length. So it is worth asking your gynecologist to indicate the dates of the next tests.
What do female hormone tests consist of?
Determination of hormone levels among women is the basis of diagnosis for any gynecological disorders. It is on these hormones that the entire menstrual cycle, the course of pregnancy, or the functioning of the body after menopause depends. Hormone testing usually refers to a package containing folliculotropic hormone, luteinizing hormone, estrogen, progesterone, and androgens. Indications for testing, however, are menstrual disorders, trouble getting pregnant, or the onset of menopause.
How to properly read the results of hormone tests?
When receiving test results from the laboratory, it is a good idea to write down in which phase of the cycle they were conducted. It is the part of the cycle that matters for proper interpretation. On the result, the names of the hormones are marked, and next to them are the concentration values in the blood. The printout also shows the norms for the hormone in each phase of the cycle, as well as the reference range for menopause. So if you know in which phase of the cycle the tests were performed, it is very easy to find the correct concentration range for each hormone. However, it should be remembered that the correct interpretation of the results requires consultation with a doctor. Therefore, you should not interpret the tests yourself, even with knowledge of the reference values and concentration levels.
Test and standards for estrogen
Every hormone test must include the determination of estrogen concentrations. This hormone is responsible during the menstrual cycle for stimulating the proliferation of the endometrium, while preparing it for embryo implantation. It also helps lower harmful cholesterol levels, regulates calcium metabolism and prevents osteoporosis. Estrogen is therefore the primary female sex hormone. Its level varies depending on the day of the cycle. Norms for estrogen are respectively:
- During the follicular phase: from 0 to 587 pmol/L,
- During ovulation: from 124 to 1468 pmol/l,
- During the luteal phase: from 101 to 110 pmol/l.
Too low a concentration of estrogen levels can indicate polycystic ovarian syndrome, or problems with gonadal or pituitary insufficiency. Too high a concentration of the hormone, on the other hand, is a signal that may indicate hormone-producing tumors, hypothyroidism or liver disease. During menopause, estrogen concentrations decline and the norm is believed to be between 0 and 110 pmol/l.
Testing and standards for progesterone
Hormone testing in women also includes the determination of progesterone. This is a hormone that is produced during the luteal phase and early stages of pregnancy. It helps release ovulation and stimulates estrogen. It also prevents excessive proliferation of the endometrium. Depending on the phase of the cycle, progesterone levels should be:
- During the follicular phase < 0.6 – 3.6 nmol/l,
- During ovulation 1.5 – 5.5 nmol/l,
- During the luteal phase 3.0 – 68.0 nmol/l.
During menopause, the norm for progesterone is <0.6 – 3.2 nmol/l. Based on the results of the progesterone concentration in the blood, it is also possible to assess whether the pregnancy is going well or is at risk.
Test and norms for folliculotropic hormone
FSH hormone is responsible for stimulating the maturation of Graaf follicles and for the production of estrogen. It plays a very important role in regulating the menstrual cycle. FSH norms depending on the cycle are respectively:
- In the luteal phase: 1.2 – 9.0 mlU/ml,
- During ovulation: 5.8 – 21.0 mlU/ml,
- During the follicular phase: 2.8 – 11.3 mlU/ml.
Too high levels of folliculotropic hormone can indicate ovarian failure and negatively affect a woman's fertility. Too low a level of FSH, on the other hand, is the result of hypothalamic or pituitary insufficiency. During menopause, the norm for this hormone is between 21.7 and 153 mlU/ml.
Testing and norms for luteinizing hormone
LH hormone allows the ovarian follicle to burst and lead to ovulation. It is also responsible for stimulating the production of the corpus luteum and its secretion of estrogen and progesterone. The norms for LH during the menstrual cycle are respectively:
- During the luteal phase: 0 – 14.7 mlU/ml,
- During ovulation: 17 – 77 mlU/ml,
- During the follicular phase: 1.1 – 11.6 mlU/ml.
During menopause, values from 11.3 to 39.8 mlU/ml are the norm. If, on the other hand, the results indicate too high a level of LH in the follicular phase, it is advisable to perform an additional test of thyroid hormones. Such a situation may indicate hypothyroidism.
Test and standards for testosterone
Testosterone and androstendione have much higher concentrations in women than in men, but they play an important role in the proper functioning of the hormonal balance. Deficiency and excess of these hormones can have negative health effects. Testosterone norms range from 0.69 to 2.77 nmol/L, and androstendione norms range from 2.7 to 5.8 nmol/L. Masculinization among women can indicate an excess of testosterone. Symptoms include an increase in muscle mass, excessive hairiness and a lowering of voice tone. Testosterone deficiency can contribute to metabolic disorders or diabetes.
Conclusion
Hormone blood tests are crucial for diagnosing imbalances affecting your health and cycle. Testing at the right phase ensures accurate results and proper interpretation. Each hormone—estrogen, progesterone, FSH, LH, and testosterone—has specific roles that guide diagnosis for issues like infertility, cycle irregularities, or menopause. Prepare according to your doctor’s timeline, and never self-interpret results. Testing provides key insight into hormone levels, helping address issues early and improve overall well-being. Always consult a doctor to translate results into action. Hormonal testing isn’t just diagnostic; it’s a tool for proactive health care. Take it seriously.
