How Can I Get My Hormones Checked For Imbalance?

Are you wondering if you have a hormone imbalance or how you can get your hormone levels checked for imbalance? In this video, we look at this question and specifically look at what hormones you should check, when you should check them, and what some of the levels suggests.  We will looking at estrogen, progesterone, some androgens and imbalances scenarios.  As we make our way through these different scenarios you will begin to understand how some of the enzymes involved with production and breakdown of androgens and estrogen can influence your hormone balance.Specifically we will look at how to get evaluated or checked for hormone imbalance.  There are several ways to check your level of hormones for balance.  There are urine tests, blood tests and even salivary tests.   Be careful though.  Just because your lab results look normal doesn't necessarily mean your hormones are all good and balanced.  Sometimes the lab stated reference range is not what you want to look at.  Part of the focus of this article will be looking at what values to check, when to check and what some of those values could mean. 

When we say hormone imbalance generally we are referring to female hormone imbalance.  It is the relative levels of the estrogen and progesterone that create the balance or imbalance.  That doesn't mean that estrogen and progesterone need to be in a one-to-one ratio.  We will discuss more details on this further along.  Before we get into those details, it's important to mention, there are other ways that hormones can be imbalanced  as well.  There are cortisol issues both high and low. DHEA-s can also be high and low and of course, thyroid levels can be low or high too. So there are many other hormones and ways to look at balance.  The specifics of this article will be more so on female hormone imbalance (estrogen and progesterone). When to Test For Hormone Imbalance

So when do we want to test your estrogen and progesterone to best understand what the relative balance or imbalance is? Most of the time when there's hormone imbalance going on, the women is premenopausal or perimenopausal.  This would be from age 17-18 all the way up to say 50 or even 55.  If you are still menstruating you are susceptible to the relative balance of estrogen and progesterone.  Imbalance is more common closer to menopause though.  When we check your estrogen and progesterone typically, we want to do this at the peak of the progesterone.  We do that because low progesterone is often times part of the problem and causing the imbalance and other times it is high estrogen.  To verify this you want to check the levels at a specific time of the month when the progesterone is peaking.  For any female that is menstruating, we want to tested for estrogen and progesterone on cycle day 21 or close to it.  If you have a shorter cycle that peak of progesterone may come a little bit earlier.  If that is the case, you may want to do it on cycle day 19 or something close to day 21. The hormone levels that we check are estradiol and progesterone.  The specific test that we use for estradiol is done through mass spectrometry and liquid chromatography.  There are also standard estradiol tests that are fairly accurate.  If there is suspicion of hormone imbalance though, it is a good idea to check the ultrasensitive estradiol because sometimes they are incongruent.  The incongruence occurs because something that is similar to estradiol is interfering with the standard estradiol test (the non-mass spectrometry).  Estradiol is the most biologically active hormone at the estrogen receptors.  That is why we want to test this hormone.  Using the more accurate test you can get a better understanding of where you are at. So use ultrasensitive estradiol or mass spectrometry/liquid chromatography estradiol test. 

We also test for progesterone and both the estradiol test and the progesterone that we typically do are blood tests.  There are other tests which we will get into a little bit later but estradiol ultra sensitive estradiol and progesterone are really good tests.  The peak of the progesterone around cycle day 21 is known as the luteal phase.  The stated reference range at the lab for the luteal phase is pretty broad.  For progesterone it might be 2.0 all the way up to 23.  In the beginning in the beginning of the luteal phase around day 14, the progesterone is stating to increase but still quite low.  It will be highest around day 21.  At this time we are looking for the progesterone to be at the higher end of the reference range too.  That's why we check your levels at this time to see how high it gets.  The peak may vary a little bit by a few days from one person to the next.  

For estradiol the peak of estradiol is closer to ovulation around day 10 and a bit earlier than the progesterone.  When you are checking on day 21 the estradiol is already coming down.  That's why your reference ranges are going to look a little different.