In order to find out what is going on in your body, it is a good idea to get your hormone levels checked. Through the years working with many women and attending many conferences, I am perplexed as to why it is not encouraged for women to have their hormone levels checked. I have found this resistance in both the conventional and naturopathic medical communities. While it is true that your hormones fluctuate on a daily basis, women that truly have issues with their hormones will reveal this in blood work, which will provide a baseline to help to determine the best treatment approach. I think this is often the most valuable for women that are in perimenopause. Sometimes low progesterone will be revealed, but just as often, high estrogen levels will be seen. Although in both cases symptoms can be very similar, the treatment approach would be different. If you are not able to have your hormone levels checked in blood, saliva is another option that you can use, and is commonly available through a naturopath or pharmacist that specializes in hormone health.
The blood tests to get checked include a number of hormones: LH, FSH, progesterone, estradiol, free testosterone, DHEA and estrone. I will also often check thyroid function in addition to the sex hormones, as thyroid issues can also arise once a woman enters perimenopause/menopause. If you still have a regular cycle, getting the levels checked between days 18-21 of a 28 day cycle will be the best time to determine if progesterone levels are in a healthy range. It will also tell you if estrogen levels are too high, as they should be declining at this point in the cycle. If you are at the point where you are not having a regular cycle and haven’t had a period for an extended time, then getting your blood work done at any point is acceptable.
It is important if you are planning on getting your hormone levels checked that you understand what the tests are and what the significance of them is. The following is a brief summary of the tests that I listed above.
LH (Lutenizing hormone): this is a hormone that comes from the pituitary gland and stimulates the ovaries to produce progesterone in the second half of the cycle. If the LH is elevated above the normal range, it will indicate that the ovaries are having a hard time producing progesterone and ovulation may not be taking place properly. Elevated levels of LH can be an indicator of menopause
FSH (follicle stimulating hormone): This is also a hormone that comes from the pituitary gland and stimulates estrogen production in the first half of the cycle. It will stimulate the growth of the follicle that is to be released at ovulation. Levels will become elevated in a woman that is menopausal.
Progesterone: This is the hormone that is predominant in the second half of the cycle and will regulate your menstruation. It has an effect on mood, sleep and libido. If the levels are low this will lead to issues with PMS in menstruating woman and menopausal symptoms such as insomnia, mood swings, night-sweats and low libido.
Estradiol: this is the strongest form of estrogen produced in the body and predominates in the first half of the menstrual cycle, peaking at ovulation. After ovulation, the estradiol levels should begin to decline. Estradiol also regulates the menstrual cycle, mood, vasomotor response, the health of the skin and mucous membranes, and bone health. Having levels that are too low or too high both carry significance. Low levels will result in hot flashes, night-sweats, depressed mood/mood swings, vaginal dryness. High levels can lead to mood swings as well and contributing to PMS issues.
Testosterone: Yes testosterone is found in women and is very important for hormone health. Testosterone in women is important for healthy libido, stamina, muscle strength and bone density. Low levels of testosterone can lead to decreased libido, fatigue, weakness, lack of muscle tone and osteopenia/osteoporosis.
DHEA (dehydroepiandrosterone): This is a hormone that is produced by the adrenal glands and can be converted into estrogen or testosterone. Once the ovaries shut down it is another way that your body can produce hormones. Low levels of DHEA is one indicator of adrenal fatigue.
Estrone: This is the least abundant form of estrogen in the body and is linked with breast and ovarian cancer. Checking the overall estrone levels is important to hormone health and in order to consider cancer risk.
Understanding what is going on in your body is the first step to moving through menopause successfully. Having a healthcare provider that is supportive of checking your hormone levels is important so that you are able to access the testing and information that you need to achieve hormonal balance.