Hormone testing explained: When it helps vs when it doesn’t
Because testing feels like the only way to get an answer, but it's not the whole story.
"Can we just test my hormones?"
This is one of the most common requests I receive - and honestly, I get it. When your cycle is unpredictable, your moods are all over the map, and you're wondering if you could actually be in perimenopause in your 30s (yes, that's absolutely possible) or just what the eff is going on, it's natural to want answers.
Hormone testing feels like it should give you those answers. It feels scientific, definitive, reassuring.
But here's the thing: Hormone testing might not actually give you the information you think it's going to, and it rarely gives us the clear diagnosis we're hoping for. Especially during perimenopause, it can sometimes create more confusion than clarity.
So should you get your hormones tested? Let's dive into when testing actually helps - and when it doesn't.
When to Test Hormones: Situations That Actually Make Sense
Hormone testing can be genuinely helpful when:
You have no cycles to track such as when you have a hysterectomy, ablation, or IUD
We need to rule out other medical conditions (like thyroid disorders, PCOS, or insulin resistance) that can cause similar symptoms
We're wanting to assess ovulation such as when we're working on fertility
It will change the plan, not just satisfy curiosity (Side note: If you ever feel like you're testing something you may not need, ask your doctor this question: "How will the results change our plan moving forward?")
What to Test Instead: Ruling Out Other Causes First
For most women experiencing fatigue, mood issues, or cycle changes, I start by ruling out other causes that can mimic hormonal symptoms:
Tired or having mood concerns? Check ferritin (iron stores), Vitamin B12, Vitamin D, blood sugar, and TSH
Bleeding more than before? Check ferritin (iron stores) to assess impact of heavy bleeding and TSH, consider pelvic imaging to rule out structural causes
Sleep issues? Check for sleep apnea, evaluate stress
Weight changes/metabolism concerns? Comprehensive metabolic panel, insulin resistance markers
Anxiety that feels different? Rule out hyperthyroidism, check ferritin, B12, and Vitamin D deficiency
Hair loss/skin changes? Check thyroid, ferritin, Vitamin D, and androgens
Cycle changes in your 30s? Focus on tracking symptoms and patterns, not hormone testing
These tests give us actionable information and often reveal treatable causes for your symptoms. Even if we are suspecting hormone involvement, we want to ensure there is nothing else going on that is making your life harder.
Why Your Symptoms Tell the Story
Here's what I want you to remember: You are more than just a lab number, and we need to be treating the person in front of us - not just the labs.
When it comes to perimenopause and menopause, we have a pretty good idea of what the hormones are doing and the patterns that are happening. The information we collect from your symptoms and cycle tells us a lot about how we can support you.
What matters most:
Your cycle patterns (even if they're becoming irregular)
Your symptom timeline and tracking symptoms to see if they're related to your cycle
Your lived experience (you know your body better than any lab test)
Other contributing factors (iron, blood sugar, thyroid, nutrients)
When Testing Becomes a Problem
Hormone testing becomes a problem when we hold back treatment or support and leave a woman to suffer needlessly while waiting for hormone blood test results to tell them or their doctor "it's time."
I see this pattern constantly: women spend months seeking the "right" test or waiting for numbers that indicate they now deserve treatment. They suffer until that number is hit.
Meanwhile, they're powering through night sweats, brain fog, and unpredictable cycles - waiting for lab "permission" to feel better when support should be offered for symptoms. You need care that addresses how you're actually feeling, not lab validation for your experience.
A Real Example
I recently worked with a 46-year-old who had "normal" hormone testing results but was waking drenched in sweat, crashing at 3 PM, and dreading her period every month. We didn't need more testing - we needed a targeted plan. Within six weeks, she was sleeping better and feeling like herself again.
The Bottom Line
Your symptoms are real. Your experience matters. And the right provider will work with you regardless of what any test shows - because you don't need labs to give you permission to get support or feel better.
Ready to stop chasing numbers and start feeling better? That's exactly what I help women do.
✨Confused about hormone testing or feeling lost with your symptoms or both?! I work with women navigating these questions every day. Book a discovery call to explore how we can support your journey to feeling like yourself again.