Testing and is it necessary?

Some doctors do not require testing before starting patients on hormonal therapy but instead rely on symptoms only.  Some test before starting patients on hormonal therapy to confirm they are in menopause, but don't test for monitoring treatment.  Others prefer to test both to start and to follow patients on hormonal therapy.  So, there is no consensus whether testing is necessary.   

You may consider testing to a) help confirm you are entering menopause, and b) to see changes in levels of hormones with treatment.  However, it is important to note that there may be little change in blood levels of your hormones with topical creams, even when there are clear benefits and systemic effects.  In fact, measuring hormones with a finger stick (capillary blood) or saliva appears to be a more accurate reflection of changes in hormone levels than those measured in the blood at the lab with a venipuncture. 

Common hormones we could test for include estrogens, primarily estradiol, progesterone, FSH (follicle stimulating hormone), LH (luteinizing hormone), and testosterone (yes, the 'male' hormone!).  Other potential proteins or hormones we could measure include cortisol, DHEA, and thyroid hormones.  Menopause is characterized by low estradiol (< 30), low progesterone, low testosterone, and increased FSH.    We offer home testing for those who want to  know or follow their hormone levels (see below). 

All hormones can be determine by a blood test, but for some hormones, a blood test is not required and results can be obtained from saliva or even the urine.    As mentioned above, hormone levels measured by a finger stick (capillary blood) or a saliva sample appear to better reflect real changes in hormone levels  compared to a venipuncture when treating with creams (topical administration).   If you want to confirm you are in menopause, you can purchase a simple test at your local pharmacy which measures high levels of FSH (follicle stimulating hormone). 

You can test at a lab, or now from home!  We have partnered with lab clinical labs so that you can measure  important hormones with a simple Home test finger stick.  2 tests are available (at a 30% discount if you use our link!):  

A.  A basic but good test of Estradiol, and Progesterone, or 

B.  A more complete hormonal panel (and naturally more expensive) which also measures LH (luteinizing hormone), FSH (follicle stimulating hormone), Testosterone, Cortisol, TSH (thyroid stimulating hormone), T3, T4, DHEAS, and thyroid peroxidase antibodies.  

 Along with potential benefits, there are side effects and risks associated with BHRT and with hormone replacement therapies in general. It’s important to discuss these with your doctor.