Instead of Asking Your Doctor to “Check Your Hormones,” Ask for This
Cheese bubbled and browned under the oven light, filling the kitchen with that warm, garlicky smell that meant ten more minutes until dinner. Ten more minutes I could spend ignoring the crusted pot soaking in my sink, grease congealing on the spoon I’d used to brown the ground beef. Part of me hoped my husband would wander in and just start scrubbing without me having to ask.
Instead, I grabbed my phone, thumb on autopilot, scrolling Facebook even though I always tell myself I need to stop doing that. Then a post in a crunchy women’s group stopped me cold: “I’m going to ask my doctor to check my hormones, what else should I ask her to order?”
To be completely transparent, it left me a tad bit annoyed. I see this question about 10 times a month because a health and wellness influencer has convinced her she needs her hormones checked. But I’m also annoyed because doctors aren’t doing their jobs properly.
The Problem With “Check My Hormones”
There’s two problems though:
- Your doctor has no idea what “check my hormones” even means. There’s at least 50 major and known hormones in the human body. It’s not feasible to check all 50. “Can you check my hormones” means something different to everyone.
- Doctors order labs for a reason. A symptom or complaint prompts the test. “Just wanting to check my hormones” isn’t something insurance covers, and isn’t something your doctor understands. They check specific hormones in relation to specific complaints. Which is why if someone goes in and asks their doctor to check their hormones, they often get a shrug or a rushed, incomplete work up.
I can’t feel annoyed with the women who post questions like this in a Facebook group though.
Where This Phrase Actually Comes From
Maybe you learned about hormone testing from a podcaster, or maybe you learned about it scrolling Instagram. I have a very specific wellness podcaster in mind, although I won’t name names because there’s hundreds of them out there telling you this exact thing, to get your hormones tested. Very few of them have the clinical background to recommend this to millions of listeners, but love to hand out a vague directive.
So the listener listens. She shows up to her appointment armed with the phrase, “can you test my hormones,” and nothing else. The provider doesn’t know what to do with it. The listener leaves feeling dismissed and blames conventional medicine for failing her.
If you’re going to walk into that appointment, I want you to walk in with something better than a phrase you heard on a podcast. I want you to walk in with a list.
What to Actually Ask For – The Checklist
Since there are dozens of hormones, I’m going to take a guess and say that you’re wanting your sex hormones tested. Here are the key players:
- Estradiol: a type of estrogen that is predominant in your childbearing years. This hormone rises during the first half of your cycle and peaks around ovulation.
- Progesterone: a calming hormone that rises after you ovulate and dips before your period starts. This is the pro-gestation hormone that helps maintain pregnancy. Contrary to popular belief, it does NOT confirm ovulation.
- DHEA-S: a steroid hormone that is the building block of other sex hormones. DHEA-S helps make estrogen and testosterone. Without it, your estrogen and testosterone can be low.
- Prolactin: a hormone that triggers milk production in women. If this hormone is high, which can happen for a myriad of reasons, it can lead to an inability to ovulate and other fertility issues.
- Total testosterone: while it’s a well-known male hormone, women also need testosterone, just in smaller amounts. It could be too high or too low, which can lead to a whole host of problems.
Why the Labs Come Back “Normal” Anyway
Maybe your doctor already ordered these, or maybe you’ve just taken this list to your doctor, and everything comes back “normal” even though you clearly don’t feel normal. This is the same old tale and song we see over and over again. The labs come back within the “normal” conventional range and your doctor tells you all is good. But that isn’t necessarily the case. Now you have a stack of numbers and still no explanation for the stalled weight loss, chin hair, missing periods, or any other symptoms you know are not normal to have.
This is because your hormone lab results are only as good as your provider’s interpretation.
Timing Changes Everything
First off, if your provider did not tell you to have these hormones tested on a certain cycle day, it’s going to throw off the entire interpretation. All sex hormones, with the exception of progesterone, need to be drawn on day 3 of your cycle (days 4 or 5 are okay too, but ideally day 3). Progesterone needs to be drawn on the 7th day after ovulation.
Hopefully your provider told you to follow the above instructions. However, there’s a good chance they told you to have the labs done on just any day. And if you’re lucky, they may have mentioned having progesterone drawn on cycle day 21. Really, though, we want to see what progesterone is doing 7 days after you’ve ovulated, and not all women ovulate on day 14 of their cycle (7 days after cycle day 14 is cycle day 21). Which means it’s a good idea to learn when you ovulate using a cycle tracking method.
Secondly, hormones are best interpreted through a functional lens, one where we’re looking at optimal function, not just whether they fall within the normal range. Hormones function optimally when they fall between specific values, and when they’re drawn on the correct day.
| Marker | Cycle day | Optimal range | Conventional range |
|---|---|---|---|
| Total testosterone | Day 3 | 20–45 ng/dL | 15–70 ng/dL |
| DHEA-S | Day 3 | 150–250 µg/dL | 65–380 µg/dL |
| Estradiol (E2) | Day 3 | 20–100 pg/mL | 12.5–166 pg/mL |
| Prolactin | Day 3 | Under 15 ng/mL | 4.8–23.3 ng/mL |
| Progesterone | 7 days post-ovulation | Over 11 ng/mL | 1.8–23.9 ng/mL |
A Snapshot in Time
While I do love looking at hormone testing in my clients, it’s just a snapshot in time, and a snapshot in time reveals very little. Your symptoms and cycle charting tell me way more than one blood draw ever will. The real answers to how we help our clients live here.
The Script for Your Next Appointment
Keep this handy for when you make an appointment with your doctor:
“Lately I’ve been struggling with these symptoms: [list symptoms here], and I was wondering if you could check a few of my sex hormones, including estradiol, DHEA-S, prolactin, and testosterone? I would also like to check my progesterone levels after I ovulate.”
If your doctor says there’s no need to check your blood work, ask them to explain why. If your doctor offers you a birth control pill, tell them you would like to know what your hormones are doing before you make any treatment decisions.
What Comes After the Labs
Here’s what usually happens next. Your labs come back “normal” or even abnormal, and your doctor’s next move is a birth control pill, or letrozole (or clomid) if you’re trying to conceive. This is because it’s considered the “standard of care” and is often the only tool in the box for managing symptoms.
Yet, this right here is where we do things differently. We look at a broader panel than most doctors will order, including thyroid markers and fasting insulin, plus your symptoms and your cycles, so we’re not missing anything. Then we build a plan around what we find: nutrition changes, lifestyle and temporary supplement strategies, and root cause solutions, instead of a prescription that manages symptoms while the underlying issue keeps going.
If you’re ready for a plan that goes past basic hormone labs, “your labs are normal,” or being offered medication, apply to work with us and let’s build it together!
P.S. What About DUTCH Testing?
You may have heard of DUTCH testing, because the wellness podcaster/influencer told you to do this too. While DUTCH testing can be really informative about your hormones and how they’re being converted and broken down in your body, it’s not my go-to. Again, DUTCH testing only shows one snapshot in time (kind of like blood work), and it’s expensive. I’m not entirely opposed to DUTCH testing. If my client wants to spend the money on it, cool, I’m not going to fight her on it. I just think there’s much better functional testing to do if you want some fancy tests to reveal root causes. And as always, your symptoms + cycle charting + a simple blood panel can tell us so much about what’s going on.
This post is for learning purposes only and is not medical advice. If you have symptoms that worry you, please talk with your healthcare provider.
