There are so many times women tell me there is something wrong with their hormones. They are mostly referring to reproductive hormones of oestrogen and progesterone. But we have many more hormones in our body which are regulating a myriad of functions, all of which are intricately inter-related.
Lara Briden explains this very well in her article below:
Some of the most important tests for hormonal health aren’t the hormones themselves, at least not estrogen and progesterone.
I do sometimes test ovarian hormones. But I’m usually far more interested in what controls them: thyroid, androgens, nutrient status, and metabolic health. These are the systems that determine whether ovulation can occur and, therefore, whether estrogen and progesterone can be made.
I also routinely test FSH, LH, and prolactin for the upstream story they can tell about what’s really going on.
Because estrogen and progesterone are the consequence of ovulation, not the cause.
Properly timed estrogen testing can show:
- Too-high day 2 estradiol suggests perimenopause or low ovarian reserve.
- Too-low ~ day 10 estradiol suggests poor maturation of the dominant follicle.
- Too-low luteal phase estrogen suggests a weak or short-lived corpus luteum.
- Too-high estrone in post-menopause is a potential risk for inflammation and breast cancer (see below).
- Too-high urinary 4-OH-E1 (an estrogen metabolite) suggests estrogen is going down a more reactive, inflammatory breakdown pathway.
Properly timed progesterone testing can show:
- Too-low mid-luteal* progesterone means ovulation did not occur. (Note: * Mid-luteal is NOT always “day 21.” Read The right way to test progesterone.
What estrogen & progesterone testing cannot show:
- Optimal (or sub-optimal) progesterone, because blood levels fluctuate. BBT-tracking is a better way to assess optimal progesterone.
- True estrogen deficiency, for several reasons — including the instability of urinary estrogen metabolites, which can produce a falsely low reading.
- Why ovulation is not occurring (or did not occur in that cycle).
Tests to assess WHY ovulation is not occurring:
- LH, FSH, prolactin
- Thyroid function
- Insulin, ALT, and metabolic tests
- Testosterone and SHBG
- Iron & nutrient status
- Celiac serology
It is for the above reasons that I always recommend you consult a qualified fertility trained naturopath for assessment and advice.