August 23, 2024
When your energy levels, mood or sexual desire feel off, your first impulse might be to get your hormone levels checked. After all, hormones tend to have a hand in every bodily function, from regulating blood pressure and blood sugar to controlling sexual function and reproduction. But it’s not always clear whether hormone testing is warranted and how much good it will do.
“You shouldn’t ignore symptoms related to hormonal imbalance, but we don’t do hormone testing without good reason,” says Dr. Shamita Misra, a family medicine doctor at MU Health Care.
Whether or not your doctor recommends hormone testing may depend on your age, menstrual cycle pattern and if you are on birth control. Dr. Misra shares what you need to know if you’re considering hormone testing:
1. Your Menstrual Cycle Is the Main — But Not the Only — Symptom of Hormonal Imbalance
It’s probably not the first time you’ve heard it, but your menstrual cycle is often a window into your health.
“Women tend to feel well as long as they have a normal menstrual cycle,” Dr. Misra says. “And it’s typically the most critical indicator of hormonal imbalance in reproductive age women.”
Several kinds of hormonal imbalance affect the menstrual cycle. Dr. Misra says some concerning menstrual pattern abnormalities or issues include:
- Excessive menstrual bleeding, marked by needing to use more than 16 standard-size tampons or pads during one period
- Irregular or infrequent menstrual cycles, going more than 35 days in between cycles or having eight or fewer cycles in a year
That doesn’t mean your menstrual cycle is the only sign of hormone issues. Hormonal imbalance may also cause other symptoms, such as:
- Acne
- Excessive sweating or hot flashes
- Fatigue
- Memory problems
- Thinning hair
- Weight gain
If hormones are involved, you’ll probably have these symptoms along with menstrual issues. “If you’re having some of these symptoms, but your menstrual cycle is regular, we still need to address those symptoms,” Dr. Misra says. “But we can address those symptoms without hormone testing.”
2. You Shouldn’t Ignore Signs of Hormonal Imbalance
If you’re having symptoms that could indicate a hormonal condition — especially if your menstrual cycle is off — it’s essential to see your doctor.
“Many women concerned about their hormones are experiencing menstrual irregularities, having problems conceiving or it’s later in life, and they aren’t sure what’s going on,” Dr. Misra says.
But your symptoms could also be a sign of a severe issue, such as:
- Early or premature menopause, if you have these symptoms before age 40
- Eating disorder, since hormones regulate the body’s metabolism
- Endometriosis, which indicates abnormal levels of estrogen or progesterone
- Fertility issues because hormonal imbalance can affect ovulation
- Polycystic ovarian syndrome (PCOS), a hormonal imbalance problem that can affect health and fertility
“A lot of conditions go hand-in-hand with menstrual irregularities, from thyroid disease to brain tumors,” Dr. Misra says. “If you’re having ongoing issues with your menstrual cycle, it’s always a reason to talk to your doctor about testing your hormones.”
3. Hormone Testing Is Limited While Taking Hormonal Birth Control or Breastfeeding
If you’re breastfeeding or on hormonal birth control, it’s common to not have a period. So, if you have troubling symptoms during that time, it’s hard to use your menstrual cycle as a gauge.
“We often rely on other symptoms, not your period, to guide hormonal testing for people who are breastfeeding or on birth control,” Dr. Misra says. “We won’t test sex hormones until you’re finished breastfeeding or have been off hormonal birth control for at least three months. But we can test the levels of other hormones, including thyroid levels, which may contribute to your symptoms.”
4. There’s No Real Need to Check Estrogen Levels Once You Are 45 and Reach Perimenopause
If you have menstrual irregularities and other symptoms of hormonal imbalance, your doctor may test for baseline hormones, including:
- Follicle-stimulating hormone (FSH), which helps control your menstrual cycle
- Luteinizing hormone (LH), which helps control ovulation and your menstrual cycle
- Prolactin, responsible for lactation (milk production) and breast tissue development
- Thyroid hormones (TSH), which regulate your weight, energy, skin, hair and other functions
But if you’re 45 or older, have normal baseline hormone levels and your symptoms are typical of perimenopause and menopause, there’s rarely a need to test estrogen.
“Between ages 40 to 45, we can assume your symptoms signify perimenopause and that your estrogen is low, as long as other causes have been excluded. In most cases, we can manage symptoms without further hormone testing,” Dr. Misra says. “Before age 40, there’s more need for estrogen testing. Your ovaries could be going through a change early or losing their function, and estrogen testing can guide our treatment.”
5. Men Shouldn’t Take Testosterone Supplements Without Hormone Testing
Men may be worried about testosterone levels if they experience:
- Decreasing muscle mass
- Lower libido
But evidence shows that, in most cases, there isn’t a need for hormone testing for men unless they’re having trouble conceiving or the libido issues are severe and affecting quality of life.
“If you’ve successfully conceived a child, that’s an indicator that your testosterone level is normal,” Dr. Misra says. “A lot of men take testosterone supplements when they don’t need them, and it can be harmful.”
But if you are concerned, she recommends seeing a doctor instead of self-diagnosing or self-medicating. When in doubt, let your doctor check it out.
6. At-Home Hormone Testing Is Not Always Reliable
It’s tempting to test your hormones from the safety of your own home. Submit a blood and saliva sample, and you’ll clearly understand your health, right?
Maybe. Dr. Misra explains that at-home testing kits are not FDA-approved and only provide a snapshot of what’s really happening. The results you receive may be confusing, and the process often leads to self-diagnosis that doesn’t take the full picture into account.
“It’s better to have a frank conversation with your doctor about what’s going on,” Dr. Misra says. “We practice evidence-based and proven medicine. Most of the time, hormone testing is not needed.” Your doctor will consider your health history, current symptoms and lifestyle to decide whether hormone testing is necessary or useful.
7. Healthy Lifestyle Choices May Help Restore Normal Cycles and Hormonal Balance
There’s a lengthy list of things that can affect hormone levels. But certain modifiable lifestyle factors, such as exercise, diet and stress level, can significantly affect hormonal balance.
“I cannot stress enough how critical it is to maintain a healthy body weight and build good exercise and dietary habits into your daily routine,” Dr. Misra says. “If there isn’t an underlying health condition, regular exercise with a goal for a healthy weight can often restore normal menstrual cycles.”
Next Steps and Useful Resources
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