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Female Hormone Test List: Which Type Is Right for You?

Written by Dr. Michael Ruscio, DC on September 8, 2025

Written by Dr. Michael Ruscio, DC on September 8, 2025 — Reviewed by Hannah Wright

• Female Hormone Levels Matter|
• Female Hormone Test List|
• Testing Methods|

Hormonal imbalances or even normal fluctuations are a part of everyday life for many women, often causing symptoms that disrupt their well-being. Sleep issues, joint pain, memory loss, fatigue, and mood disturbances may signal that something may be off with your hormone levels. 

Testing your hormones to evaluate various sex hormones like estrogen, progesterone, or testosterone may provide insight into the source of your chronic symptoms. It can also help you screen for reproductive disorders, menstrual irregularities, and fertility issues such as:

• Premenstrual syndrome (PMS)
• Estrogen dominance
• Polycystic ovary syndrome (PCOS)
• Menopause
• Heavy menstrual cycles 

However, with so many types of hormone testing now on the market, it can be hard to know where to begin when getting your hormones checked. 

Our female hormone test list explains the lab tests available today—serum, dried blood-spot, urine, and saliva testing. We’ll review the research behind each method to help you choose the best option for your needs. 

Why Do Your Hormone Levels Matter?

Hormone tests are commonly used in women’s health to diagnose reproductive conditions, fertility issues, and endocrine disorders—symptoms caused by the body’s hormone-producing glands. Hormonal fluctuations and imbalances can give rise to many symptoms or conditions, such as:

• Weight gain 1 2
• Fatigue 1
• Migraines and other headaches 1
• Anxiety and depression 1
• Sleep disturbances 3
• Menopausal symptoms 3
• Heavy, painful, or otherwise irregular periods 4
• PCOS 2
• PMS 1
• Premenstrual dysphoric disorder (PMDD) 5

Unfortunately, standard one-time lab tests often miss hormonal imbalances, partly because women’s hormone levels naturally swing throughout the month and because labs don’t have consistent reference ranges 6. This leaves many women without clear answers about their symptoms.

As a result, some private labs now offer alternatives to one-time hormone tests, using cycle mapping to better account for female hormone fluctuations. 

Cycle mapping tracks hormone levels at multiple points across the month to give a fuller picture of hormonal health 7. 

Some labs also measure hormone byproducts (metabolites) 8, which may give more accurate results for women using birth control or hormone-replacement therapy (HRT) 9. 

With these newer options, female hormone testing has become more complex, making it harder to know which method is best. Below is an overview of the most common female hormone tests, what they measure, and when they may be useful. 

Female Hormone Test List: Common Types of Tests

Most female sex hormones are steroid hormones, which means they’re made from fats 10. They’re produced and secreted by different glands in the body, including the pituitary gland, adrenal glands, thyroid gland, and ovaries 11. 

The following list includes some of the most commonly tested female hormones and markers 11. 

1. Estrogen 

What It Is: Estrogen is a key reproductive hormone that helps regulate the menstrual cycle, support fertility, reduce stress, and maintain bone, cardiovascular, and vaginal health 12. Largely made in the ovaries, estrogen levels fluctuate throughout a woman’s life, generally rising during the reproductive years and declining in menopause.

Who Needs Testing: You may need an estrogen test if you have 13:

• Trouble getting pregnant
• Irregular menstrual cycles (bleeding between periods, cycles that are shorter than 28 days or longer than 35 days, cycles of inconsistent lengths, or bleeding that lasts longer than normal or for more than 7 days)
• Delayed puberty 
• A fertility evaluation
• Menopause symptoms (like night sweats, low sex drive, irregular periods, or hot flashes) 
• Unexplained vaginal bleeding after menopause
• Hormone replacement therapy 

2. Progesterone

What It Is: Produced mainly in the ovaries, progesterone prepares the uterine lining for egg implantation, helps sustain early pregnancy, and balances the effects of estrogen 14. It also plays an important role in the health and function of bones and nerves.

Who Needs Testing: Women trying to conceive often test progesterone to confirm ovulation or check for difficulties. It may also be helpful for those with or worried about 15:

• Irregular menstrual cycles
• Getting pregnant
• Signs and symptoms of a luteal phase defect (bleeding between periods, basal body temperature that rises slowly, more frequent periods, or less than 11 days between ovulation and your period)
• Repeated miscarriages
• Pregnancy complications, such as ectopic pregnancy, where the fertilized egg implants outside the uterus

3. Testosterone

What It Is: Though often thought of as a “male hormone,” testosterone and its precursor DHEA are important for women’s fertility, libido, muscle strength, mood, and hormone balance 16 17. In the female body, testosterone is made in the ovaries, adrenal glands, and other tissues like the liver, kidney, fat, and skin. Too much or too little can cause significant symptoms.

Who Needs Testing: Testing may be important for women with 16 17 18:

• Symptoms of PCOS (irregular menstrual cycles or absent periods, acne, weight gain, unwanted hair growth, or male-pattern hair loss)
• Low sex drive
• Trouble getting pregnant
• Low energy and sexual function related to menopause

4. Luteinizing hormone (LH)

What It Is: Luteinizing hormone (LH) is made in the brain’s pituitary gland. It triggers ovulation, helps the ovaries release hormones, and supports progesterone production after ovulation 19.

Who Needs Testing: Getting your LH tested may be important if you’re having 20:

• Trouble getting pregnant
• A fertility evaluation
• Irregular menstrual cycles
• Menopause symptoms 

5. Follicle-stimulating hormone (FSH)

What It Is: Similar to LH, follicle-stimulating hormone (FSH) is made in the pituitary gland. This hormone stimulates the production of estrogen and the growth of ovarian follicles, which hold eggs 21. FSH is a central marker for ovarian reserve and reproductive aging 22.

Who Needs Testing: FSH may be tested in women with symptoms like 23:

• An inability to get pregnant
• An irregular period
• No period (amenorrhea)
• Abnormal breastmilk production
• Menopause symptoms

6. DHEA sulfate

What It Is: DHEA (dehydroepiandrosterone) sulfate, or DHEAS, is a hormone made mostly by the adrenal glands. This building block of both estrogen and testosterone in women helps regulate immune function, metabolism, bone and muscle health, cardiovascular health, and reproductive well-being, with low levels linked to aging and disease 24. 

Who Needs Testing: Checking DHEA levels can give clues about adrenal function 25, especially in women with 26:

• Abnormal periods or no periods
• Unwanted hair growth or male-pattern hair loss
• Trouble getting pregnant
• Severe acne and oily skin

7. Sex hormone-binding globulin (SHBG)

What It Is: Sex Hormone-Binding Globulin (SHBG) is a protein made by the liver that binds to excess estrogen and testosterone, regulating how much is available for the body to use 27. High or low SHBG levels may indicate various conditions, including thyroid disorders, PCOS, or insulin resistance.

Who Needs Testing: Testing may help women who have 28:

• Trouble getting pregnant
• Irregular menstrual cycles
• Unwanted hair growth
• Low sexual desire
• Signs of thyrotoxicosis (too much thyroid hormone) like unexplained weight loss, fast heart rate, shakiness, and increased sweating
• Signs of PCOS
• Signs of insulin resistance

8. Prolactin

What It Is: Prolactin promotes breast milk production after childbirth—when levels are too low, breastfeeding can’t happen. But when levels are too high outside of pregnancy, prolactin can cause excessive milk production and suppress fertility 29.

Who Needs Testing: It may make sense to get prolactin testing if you have 30:

• Irregular periods or none at all
• Trouble getting pregnant
• Unusual breast tenderness
• Unexpected breastmilk production

BOTTOM LINE: Among their other important roles in the body, the above hormones are responsible for the menstrual cycle, fertility, and reproductive health in women. Female sex hormones can influence immune, digestive, and psychological functions, and they strongly contribute to an overall feeling of wellness. 

Assessing female hormones can be effective for diagnosing certain conditions, like PCOS and infertility, and may give insight into what lies behind symptoms of chronic fatigue, insomnia, cognitive issues, and mood swings.

9. Thyroid Hormones

Though different from female sex hormones, thyroid hormones play a significant role in women’s health. Checking for thyroid disease typically involves measuring several hormonal and other markers of thyroid health, such as:

• Thyroid-stimulating hormone (TSH)
• Free T3 (triiodothyronine)
• Free T4 (thyroxine)
• Thyroid antibodies

Impaired thyroid function, such as in hyperthyroidism and hypothyroidism, can contribute to female hormonal disorders and symptoms.

Female Hormone Testing Methods

Now that we know how important balanced hormones are, let’s look at the different lab tests available to find the most accurate way to assess your symptoms. 

Serum Testing

Serum blood tests are the standard for checking hormone levels. A blood draw is sent to a lab, with established reference ranges and common insurance coverage. They’re reliable for screening conditions like menopause or PCOS, but they’re invasive and don’t easily track changes across a full cycle.

Some argue serum can’t measure hormone metabolites, while dried urine tests (like DUTCH or ZRT) can 31—a distinction that may matter for women on HRT. Research using liquid chromatography–mass spectrometry shows little difference in estrogen metabolites between serum and urine 32. However, the Endocrine Society and the American Association for Clinical Chemistry caution that metabolite testing is hard to standardize, especially at very low levels  33 34. 

For most women, serum testing with mass spectrometry is sufficient and more likely to be covered by insurance. 

Serum blood testing may be the best choice if you: 

• Want to use health insurance to cover labs 
• Are not on hormone replacement therapy (HRT)
• Don’t need detailed cycle mapping

Dried Blood Spot Testing

This method uses a finger prick to place a few drops of blood on a paper card, which is mailed to a lab. Unlike serum tests (which use blood from a vein), it measures hormones in capillary blood, where levels can differ slightly.

Some labs claim blood spots are more accurate than serum, urine, or saliva because they can measure hormone metabolites 8, which may be particularly useful for women on HRT 9.

This method works well for tracking hormones like FSH, LH, and progesterone across the menstrual cycle—helpful for fertility monitoring, ovulation detection, and evaluating irregular or heavy periods 35 36. It’s still invasive but more convenient than repeated blood draws.

Dried blood-spot testing may be best if you:

• Have abnormal menstrual cycles (heavy, painful, or irregular)
• Struggle with fertility issues
• Suspect a hormonal imbalance is causing chronic symptoms
• Don’t plan to use insurance for testing 

24-Hour Urine Collection 

This method, one of the oldest after serum testing, measures hormone output over a full day, giving a clearer picture of total daily production. It’s less invasive than blood draws and works well for people who dislike needles.

The downsides: It can’t show changes across the menstrual cycle, making it less useful for diagnosing cycle-related disorders. It also may not reliably measure hormone metabolites, so it may not be the best option for women on HRT 8. Collecting every urine sample for 24 hours is inconvenient, but on the upside, this test is often covered by insurance.

24-hour urine testing may be best if you:

• Don’t need cycle mapping
• Are not on HRT 
• Want to avoid a blood draw
• Want to use insurance to cover labs

Dried Urine Testing

This method uses small urine samples collected on filter paper at home over a day or several weeks, then mailed to a lab for analysis. Unlike 24-hour urine collection, it doesn’t measure total daily output, but industry-funded research shows four dried urine spots across a day can give a reliable estimate 37.

These studies also suggest dried urine is about as accurate as 24-hour urine for detecting hormone levels 38 39. It measures LH, estrogen, and progesterone, making it useful for predicting ovulation, cycle mapping, and assessing menstrual issues like PMS, PMDD, or irregular, heavy, or painful periods 7 40. It also measures hormone metabolites, which is helpful for women on HRT related to menopause 41 42.

Currently, dried urine testing is offered mainly by two private labs: Precision Analytics (DUTCH Test) and ZRT Labs. ZRT has qualified for the CDC’s hormone standardization program 43. These tests can provide detailed insights, but they’re costly ($300–$700).

Although both tests are good options for alternative forms of hormone testing, there’s currently not enough evidence to show they are effective tools for screening and diagnosis.

Dried urine testing may be a good option if you:

• Want cycle mapping
• Are tracking ovulation for pregnancy planning
• Are on HRT and need monitoring
• Don’t plan to use insurance for testing 

Saliva Testing

Saliva offers a simple, noninvasive way to measure hormones like cortisol, testosterone, progesterone, estradiol, and DHEA. It may be useful for stress monitoring, hormone disorder diagnosis, and personalized medicine. While results can vary and technical challenges remain, ongoing research and standardization are making saliva testing a reliable alternative to blood tests 44.

However, saliva hormone levels often don’t match hormone levels in the blood 45, and saliva testing isn’t reliable for young women because hormone levels in their saliva are naturally very low 46.

Saliva testing may be helpful if you:

• Are addressing fertility issues
• Think you may be entering menopause
• Want a simple, non-invasive method of cycle mapping
• Don’t plan to use insurance for testing  

A Comparison of Female Hormone Test Methods

Choosing the right female hormone test can feel overwhelming. Working with a knowledgeable provider is best, but this table offers a starting point to guide your decision. 

Remember, there are no strict rules for testing hormone levels. This list is only a guide to help you choose, not a final answer.

Your Female Hormone Test List: The Results Are In

There’s no “best” way to test hormone levels. 

Dried blood-spot and dried urine tests may be useful for cycle mapping, menstrual issues, and women on HRT since they track metabolites, but they can be costly and time-consuming. Serum blood tests are quick, affordable, and reliable for diagnosing most hormone-related disorders. 

Saliva tests aren’t suitable for young women, but may help assess infertility and menopausal symptoms. Since no test fits everyone, the best approach is to discuss your options with a healthcare provider. If you’re considering hormone testing and would like help addressing your ongoing symptoms, reach out to our functional health clinic today.