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Top 6 Functional Hormone Testing for Women

Written by Samantha Odake | Last updated:

Understanding female hormones is essential for healthcare practitioners aiming to provide the best care for their female clients. In this article, we’ll explore the top six functional hormone tests for women that offer valuable insights into hormonal health, guiding practitioners in their mission to improve women’s well-being.

What is functional hormone testing?

Functional hormone testing for women is frequently employed by health practitioners to gain deeper insights into their clients’ well-being. Unlike traditional hormone tests, functional testing offers a more comprehensive view of hormonal health.

This type of testing can pinpoint underlying issues contributing to hormonal symptoms and guide more precise treatment plans.

By adopting a personalized and functional approach to hormone testing, practitioners may achieve better results and potentially improve their clients’ overall health and well-being.

What are the top functional hormone labs for women?

Healthcare providers may use hormone test results combined with other factors, such as symptoms, medical history, and other test results, to reach a diagnosis with their clients.

The top functional hormone tests for women include:

  • Estradiol
  • Thyroid hormones
  • Testosterone
  • DHEAS
  • Pregnenolone
  • Follicle-stimulating hormone
  • Progesterone

For healthcare professionals, understanding the timing of hormone testing, especially during a woman’s menstrual cycle, is essential, as it can affect the accuracy and relevance of the results, allowing for more precise diagnoses and tailored treatments.

Estradiol

Estradiol (E2) is a sex hormone and the most active estrogen in the body. It’s needed for breast development, menstruation, pregnancy, and other non-reproductive roles such as:

  • Cholesterol and blood sugar levels
  • Body weight
  • Bone and muscle mass
  • Collagen production and skin moisture
  • Brain function

Measuring or calculating free blood estradiol levels can be challenging. As a result, the conventional approach involves predominantly evaluating bound estradiol levels in most blood tests.

What do estradiol test results mean?

Estradiol levels may increase in puberty, fluctuate naturally during the menstrual cycle, and decline with menopause.

The normal range in men is typically 7.6−42.6 pg/mL.

High estradiol can be caused by:

  • Obesity
  • Hyperthyroidism
  • Hormonal therapy (estrogen or testosterone)
  • Tumors in adrenal glands (in both men and women)
  • Tumors in the ovary or testicles
  • Scarring of the liver (cirrhosis)
  • Pregnancy

The following factors may cause low estradiol:

  • Menopause
  • Turner syndrome
  • Ovary dysfunction
  • Eating disorders, such as anorexia and bulimia
  • Chronic kidney disease
Menstrual phase Range
Follicular phase

19 – 144 pg/mL

Ovulation

64 – 357 pg/mL

Luteal phase

56 – 214 pg/mL

Postmenopausal

0 – 31 pg/mL

Thyroid hormones

Thyroid hormones play a pivotal role in a person’s overall well-being. They influence various aspects of health, including metabolic rate, body temperature, heart function, energy production, respiration, and fertility. Consequently, any imbalance in your thyroid function can significantly impact the entire body.

The main thyroid hormone tests are:

  • Thyroid-stimulating hormone (TSH): TSH is produced by the pituitary gland. It stimulates the thyroid gland to produce the thyroid hormones T3 and T4, which play vital roles in various processes, such as energy production, heart function, and reproductive health.
  • Thyroxine (T4): This hormone is made in the thyroid gland from iodine and the amino acid tyrosine. T4 acts as a precursor to the more active thyroid hormone, triiodothyronine (T3).
  • Triiodothyronine (T3): T3 is the active thyroid hormone. While the thyroid gland produces approximately 10-15% of this hormone, the remaining T3 is made from T4 in the liver, kidneys, central nervous system, pituitary gland, and muscles.

What do thyroid hormone test results mean?

These tests are typically conducted in combination to assess thyroid function and help in diagnosing conditions like hypothyroidism and hyperthyroidism.

Name Range
TSH
  • High: > 4.5 uIU/mL
  • Suboptimal: 2.5 – 4.5 uIU/mL
  • Optimal: 1 – 2.5 uIU/mL
  • Suboptimal: 0.4 – 1 uIU/mL
  • Low: < 0.4 uIU/mL
T3 (Triiodothyronine)
  • High: > 181 ng/dL
  • Optimal: 76 – 181 ng/dL
  • Low: < 76 ng/dL
T4 (Thyroxine)
  • High: > 11.9 ug/dL
  • Optimal: 5.1 – 11.9 ug/dL
  • Low: < 5.1 ug/dL

Read more about functional thyroid lab testing.

Testosterone

Testosterone is a hormone primarily made in men by the testes and in women by the ovaries. Normal testosterone levels are important for maintaining bone health, sex drive, and more:

  • Improves bone health, libido, and sexual function
  • Helps build and maintain muscle mass and strength
  • Increases red blood cell production and sperm production
  • Plays a role in mood and brain function

What do testosterone test results mean?

Testosterone levels may fluctuate naturally throughout the menstrual cycle. Starting around the age of 30, total testosterone levels begin to decline by 0.4-2% every year.

Potential causes of low testosterone levels:

  • Obesity
  • Insufficient or poor-quality sleep and sleep disorders such as sleep apnea
  • Diabetes
  • Alcoholism
  • Chronic liver disease
  • Chronic kidney disease
  • Zinc or vitamin D deficiency
  • Some genetic disorders
  • Damage to or diseases of the hypothalamus or pituitary gland

Potential causes of high testosterone levels:

  • Use of anabolic steroids or testosterone replacement therapy
  • Smoking
  • Alcohol
  • Polycystic ovary syndrome (PCOS) in women
  • Testicle, ovarian, adrenal, or brain tumors
  • Cushing’s syndrome
  • Some genetic disorders
Name Range
Testosterone, total
  • High: > 45 ng/dL
  • Optimal: 2 – 45 ng/dL
  • Low: < 2 ng/dL
Testosterone, free
  • High: < 4.2 pg/mL
  • Optimal: > 4.2pg/mL

Please keep in mind these ranges may vary slightly among different laboratories due to differences in equipment, techniques, and chemicals used.

DHEAS

DHEA is a steroid hormone produced primarily by the adrenal. The majority of DHEA is converted into DHEA sulfate (DHEAS), the precursor to the sex hormones testosterone and estradiol.

DHEA is important for:

  • Physical and psychological well-being
  • Immune system
  • Muscle strength
  • Insulin sensitivity
  • Bone density
  • Cognitive function
  • Preventing age-related skin damage

What do DHEAS test results mean?

DHEA levels have a daily cycle that is similar to cortisol’s, with morning levels higher, and evening levels lower. In contrast, DHEAS is stable throughout the day.

DHEA and DHEAS levels peak in the 20s and gradually decrease thereafter.

Name Range
DHEAS
  • Ages 18 to 19: 145 to 395 µg/dL
  • Ages 20 to 29: 65 to 380 µg/dL
  • Ages 30 to 39: 45 to 270 µg/dL
  • Ages 40 to 49: 32 to 240 µg/dL
  • Ages 50 to 59: 26 to 200 µg/dL
  • Ages 60 to 69: 13 to 130 µg/dL
  • Ages 69 and older: 17 to 90 µg/dL

Factors linked to lower DHEAS include:

  • Chronic stress
  • Autoimmune disease, such as lupus or Sjögren’s syndrome
  • Adrenal insufficiency (Addison’s disease)
  • Low pituitary function (hypopituitarism)
  • Serious illness or injury
  • Aging

On the other hand, factors linked to increased DHEAS include:

  • Acute stress
  • Cigarette smoking
  • DHEA supplementation
  • Polycystic ovary syndrome (PCOS)

Levels may also vary throughout the menstrual cycle.

Pregnenolone

Pregnenolone is the main steroid hormone derived from cholesterol that helps control various brain functions, such as cognition, memory, and depression. It is converted into different hormones, including cortisol, aldosterone, and sex steroid hormones.

What do Pregnenolone test results mean?

Lower pregnenolone levels can negatively affect sexual health and brain function.

The following factors can decrease pregnenolone levels:

  • Aging: Pregnenolone levels decrease with age
  • Stress: Cortisol signals the adrenal system to reduce the production of pregnenolone
  • Low cholesterol: Cholesterol is needed to form pregnenolone
  • Genetic defects that cause problems with pregnenolone production

Elevated pregnenolone levels might indicate an inefficient conversion of this hormone into other hormones.

These can increase pregnenolone levels:

  • Pain
  • Smoking marijuana (THC)
  • Congenital adrenal hyperplasia (CAH), a genetic disorder

A woman’s menstrual cycle or pregnancy may also affect pregnenolone levels.

Name Range
Pregnenolone
  • High: > 237 ng/dL
  • Optimal: 22 – 237 ng/dL
  • Low: < 22 ng/dL

Follicle-stimulating hormone

Follicle-stimulating hormone (FSH) is a hormone involved in reproduction that stimulates the growth and maturation of eggs in women and sperm in men.

What do FSH test results mean?

In women, FSH levels increase during the first half of the menstrual cycle and in menopause. In contrast, FSH levels decrease after ovulation.

High FSH levels in women may suggest ovarian malfunction or failure. FSH production increases when the ovaries do not produce enough estrogen.

Other potential causes of high FSH levels include:

  • Aging
  • Menopause
  • Autoimmune diseases, including thyroid disorders
  • Damage to ovaries or testes due to injury, radiation, or chemotherapy
  • Lack of functional ovaries/testes
  • Chromosome disorders, such as Klinefelter or Turner’s syndrome
  • Ovarian or testicular tumors

The most common causes of low FSH levels include:

  • Anorexia
  • An under-active thyroid gland (hypothyroidism)
  • Polycystic ovary syndrome (PCOS)
  • Hormonal drugs
  • Hyperprolactinemia
  • Meningitis
  • Alcoholism
  • Kallmann syndrome
Name Range
FSH
  • Follicular phase: 2.5 – 10.2 mIU/mL
  • Ovulation: 3.1 – 17.7 mIU/mL
  • Luteal phase: 1.5 – 9.1 mIU/mL
  • Postmenopausal: 23 – 116 mIU/mL

Progesterone

Progesterone is a hormone that is essential for reproduction. It regulates the menstrual cycle and helps the body prepare for pregnancy in women. In men, progesterone is important for the development of sperm.

Besides its reproductive functions, progesterone may help protect the brain and maintain neurotransmitter balance.

A progesterone blood test is commonly used to monitor a pregnant woman’s health, diagnose a failing pregnancy, determine the cause of infertility, or detect the cause of abnormal uterine bleeding.

What do progesterone test results mean?

Progesterone levels normally fluctuate over the course of a woman’s cycle. More precisely, levels may increase in the second half of the cycle and during pregnancy.

Causes of high progesterone include:

  • Stress
  • Overproduction of progesterone by the adrenal glands
  • Adrenal cancer

Additionally, factors that may decrease progesterone include obesity and menopause.

Name Range
Progesterone
  • Follicular phase: < 1 ng/mL
  • Ovulation: 2 – 30 ng/mL
  • Luteal phase: 2.6 – 21.5 ng/mL
  • Postmenopausal: < 0.5 ng/mL

Other important female hormone labs

Healthcare practitioners may also assess other important female hormone lab markers, including:

  • Insulin
  • Ghrelin
  • Cortisol
  • Prolactin
  • Luteinizing hormone (LH)

Female Hormone Lab Analysis: Tips & Tools

Understanding the markers mentioned above is an important step in assessing a person’s hormonal health. However, it’s essential to remember that each individual is different, and additional lab tests may be required for a comprehensive assessment.

Factors such as lifestyle, other lab results, and genetic predispositions may help guide health practitioners choose which hormone labs to assess in women. For example, understanding the unique genetic predispositions that influence hormone behavior may be crucial in tailoring the best care for individuals.

Remember, tracking hormonal health is an ongoing process. To simplify this, healthcare practitioners can turn to tools such as SelfDecode Pro, which streamlines the analysis and management of client health data.

This platform enables practitioners to upload lab results to conduct in-depth analyses, providing valuable insights and personalized recommendations to improve each marker.

In addition to storing and tracking lab results, SelfDecode offers genetic insights and provides personalized recommendations based on DNA, labs, and lifestyle. Furthermore, the platform suggests additional lab tests based on the individual’s DNA, ensuring a holistic approach to hormone and overall health.

In the dynamic landscape of women’s health, practitioners can stand out by using personalized data-driven strategies to finely tune treatments to a client’s needs, leading to better, more effective healthcare.

Key takeaways: Functional hormone testing for women

Hormone testing for women provides invaluable insights into women’s health and hormonal balance. As healthcare practitioners, it’s important to recognize that while these tests offer a starting point, they should be just one part of a comprehensive assessment.

Every patient is unique and influenced by genetic predispositions, lifestyle factors, and individual health goals. A holistic approach to hormone testing, incorporating personalized data analysis, genetic insights, and lifestyle considerations, helps practitioners provide tailored care, potentially leading to improved patient outcomes.

By keeping up-to-date with the latest advancements and utilizing data-driven strategies, healthcare professionals can significantly improve patient outcomes and contribute to a healthcare system that prioritizes individual well-being.

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