Getting the doctor to agree to test hormones can sometimes be challenging. Personally, I have only ever managed to convince one doctor to test my hormones. This was many years ago (about 15 years ago at the time of me writing this post) when I was sick and struggling with the seizures caused by the Implanon birth control. I explained to her that my cycle and periods were completely different since coming off the Implanon and that I was afraid the Implanon had messed with my hormones. She agreed to test me when I told her my cycles were very long and that when I did get a bleed it was continuous brown spotting for 12 days and no actual period blood. I explained that prior to the Implanon my periods had been bright red and heavy and my cycles and my bleed only lasted 5 days. My cycles prior to the Implanon were very regular coming every 30 days on average, post Implanon I would only get breakthrough spotting about every 40-60 days. I know now that this was a lack of ovulation but I had no idea at the time and assumed that my brown spotting was my period. Under these circumstances, the doctor decided to test my hormones. There was no mention of where I was in my cycle (not that it would have mattered as I wasn’t ovulating) and when to test on the best day. When the tests came back, the doctor said “your hormones look low” and that was it. There was no advice moving forward. I asked what I should do and she said “just hope it gets better on its own.” I then asked if I could be referred to a specialist, but I was told “no” because apparently, my case wasn’t severe enough to bother the specialists. I then went to another doctor and asked to be referred to a specialist and was told the same thing.
I then became desperate and I went to the hospital and begged the receptionist to let me see a specialist endocrinologist but I was told I needed a referral. I explained that no one wanted to give me a referral and she said there was nothing I could do about it. It was a very scary low point for me because it actually felt like I was being denied help and I had no idea where to turn. I then went to see naturopaths who also had no idea what was wrong with me and I was left completely in the dark. This is the point where my own health journey started. I felt completely alone and terrified but I did my own research and started to make changes to my diet and lifestyle. About a year later, my ovulation returned and my cycles became regular again but my hormones were still not ok. I wanted to test myself again to see what was wrong with my hormones. I went to multiple doctors and would tell them that my hormones were not the same as they used to be but was refused testing every single time. They would say, “we don’t test hormones for women with regular cycles.”
Thankfully, after a while, I discovered Fertility Awareness Method and I began to study hormones in depth. I then learned how to figure out my own hormone imbalance using Fertility Awareness and for the first time in years, I finally understood what my hormones were up to. I then got specific with my treatment and turned to the right herbs, wholefood supplements and diet/lifestyle changes and finally balanced my hormones and significantly improved my quality of life. Fertility awareness also gives me the ability to monitor my hormones in real-time and make changes based on whatever it is that my body is going through at any given time. It has been a lifelong asset for me, and one which I love to teach to other women who want to take charge of their hormones, fertility, birth control and overall health. In my opinion, the fertility awareness method is superior to hormone testing because it doesn’t just look at hormones in a snapshot of time, but rather identifies patterns that point to various underlying hormone imbalances. It offers a more holistic and comprehensive approach to diagnosing hormone imbalances and is a valuable skill for life. However, as much as I love the fertility awareness method, I also understand that it is not for everyone, which is why blood tests are still important.
My story occurred many years ago but, I still hear many similar stories to my own where women are denied blood tests by doctors for various reasons. Because of this, there has been an opening in the market for different at-home hormone tests and private blood tests, urine and saliva tests all with varying levels of accuracy. Personally, I have educated myself in interpreting blood tests for women’s hormones but urine tests like the Dutch Test are also a good option, provided you also have a professional that knows how to interpret the results.
In all fairness, although blood tests are helpful, I can also understand why some doctors refuse to test. I held a lot of anger for how easily I was denied testing over the years, but the more knowledge I gained, the better I understood that blood tests are not always the best option. Blood tests only offer a snapshot of hormones at a given period of time and may not necessarily represent the bigger picture of hormone balance as a whole, especially as hormones fluctuate so widely during the menstrual cycle. Blood tests for hormones often need to be timed correctly on certain days of the menstrual cycle in order to give accurate results. Estrogen, FSH, LH and prolactin should be tested on days 2-3 of the menstrual cycle, thyroid should be tested on days 1-9 of the menstrual cycle and progesterone should be tested 5-7 days after ovulation. For most women, this is day 21-23 but it varies a lot depending on which day ovulation has occurred. Most women are not knowledgeable of where they are in their monthly cycle so a lot of the time hormone testing can be inconclusive.
Progesterone testing gets a lot of attention, especially for women with fertility struggles or recurrent miscarriages, however, progesterone blood tests do not really give an accurate indication of progesterone levels. This is because progesterone gets secreted from the corpus luteum with pulsatile LH pulses from the pituitary gland. The pulses are released every few hours. This means that progesterone levels go up and down all the time depending on the frequency and strength of the LH pulse. A blood progesterone test reflects the level of progesterone at the time of the blood test, and depending on where the LH pulse was, will reflect whether progesterone is high or low. The only thing progesterone testing can really do is confirm ovulation (because progesterone is only released after ovulation) but it can not give an accurate indication if progesterone levels are truly low or high unless testing is conducted multiple times during the day.
Below I have attached a brief guide to my favourite blood tests for women. This is not an exhaustive list of tests but enough for me to get a good picture of where hormones and certain nutrients are for my clients. The guide gives information on why the tests are important for women and also what time of the cycle to test. It is not necessary to test for all of these at once, but just the selection of tests that is relevant to you. Some of the tests I have added are very easily obtained from the doctor and are part of routine blood tests, and other tests may take a little convincing. I wish I could offer advice on how to talk to doctors in order for them to agree to test, but I have none. I personally hate confrontation and have a lot of anxiety when I have to visit the doctor. When I am there I usually just shut down and don’t say much at all. I have seen many other health practitioners share tips on how to talk to doctors and there are even books written about it for women’s health. If you need support in that area, there are others out there that can give you advice. My approach when it comes to health is to just do things myself so, if you are anything like me, for the tests that are not easily obtained from the doctor, I have added a link to my favourite private testing facility where you can order and pay for your own hormone tests online and then get sent a pathology request. The blood test results are then sent to you via email or SMS which you can then keep for yourselves or give to your health practitioner. The company I use is https://imedical.com.au/ and it offers blood testing Australia-wide. The only downside is that private testing costs money, so if finances are a concern, it is better to try and get blood tests done under a doctor through medicare (in Australia). Unfortunately, I am not knowledgeable about private testing outside of Australia, so if you don’t live in Australia, do research on the options available in your country.
I have added a downloadable pdf of the blood test guide with clickable links to private testing. I have also simply added the Jpegs to this post.
Download Blood Test Guide for Women here: