Hormone Replacement: How to Balance Your Hormones Naturally. Dr. Cabot Sandra

Can Hormone Tests Be Useful?

       To determine if you are menopausal. Blood tests are better for this initial test, to check your FSH levels and baseline levels of total sex hormones.

       During the pre-menopausal years, if you have heavy and/or painful menstrual bleeding, fibroids or irregular menstrual cycles, as this could indicate a progesterone deficiency. The best time to measure progesterone levels is seven days before your menstrual bleeding is due, although if your cycle has become irregular and/or infrequent, it can be difficult to pinpoint this exact time. Salivary and blood tests should be done to check progesterone levels.

       If you are on hormone replacement therapy, to indicate if your response to treatment is adequate. These tests can be blood and/or saliva tests. The blood tests are done every three to six months; the saliva tests can be done more often. The tests are more necessary if you are on HRT and you still feel that your hormones are out of balance. For women on higher-dose forms of HRT, such as implants or injections, blood tests can be helpful to check that you are not receiving an excessive dosage. We do not want to produce very high blood levels of hormones that are above the normal ranges, so blood and saliva tests can check for over-dosing as well as under-dosing. If you are on HRT and feel well, you may not need any hormone tests at all.

      Useful Blood Tests and their Normal Ranges During the Menopause

HORMONE	COMMENTS	NORMAL RANGE DURING THE MENOPAUSE
Free testosterone	Measures the free component of testosterone, which is the active hormone.	Blood: 0.5 to 6pmol/L
DHEA – Sulphate	Measures the reserve amounts of DHEA.	Blood: 200 to 2700ng/ml or 0.5 to 7.3umol/L
Oestradiol	Blood tests measure the total circulating amount of the most powerful oestrogen, called oestradiol.	Blood: less than 150–200pmol/L in menopausal women not receiving any HRT.
Progesterone	Blood tests measure the total circulating amount of Progesterone, and not the free active component.	Blood: less than 3nmol/L in menopausal women not receiving any HRT.
Cortisol	Blood tests measure the total circulating amount of cortisol. Cortisol is made in the adrenal glands. Normally the levels of Cortisol are higher in the early hours of the day.	Morning: Blood: 220–720nmol/L Evening: Blood: 110–390nmol/L
Thyroid Stimulating Hormone TSH	TSH is a pituitary hormone which becomes elevated if the thyroid gland is underactive.	Blood: 0.3 to 5.0 mIU/L
Free T 4	This blood test measures the circulating amount of the free T4 hormone. The free component is the active hormone.	Blood: 9.0 to 24.0 pmol/L
Free T 3	This blood test measures the circulating amount of the free T3 hormone. The free component is the active hormone.	Blood: 2.2 to 5.4 pmol/L
FSH	FSH is a pituitary hormone which becomes elevated once the menopause arrives.	Blood: 30 to 280 U/L in menopausal women not on any HRT
Free Androgen Index (FAI)	This is a very useful blood test. The FAI measures the total amount of all the free androgens circulating in the bloodstream. This test accurately measures the activity of the male hormones in the body.The FAI may be elevated even if the levels of testosterone are normal, and provides a more accurate assessment of excess androgen activity in the body than measuring testosterone does.	Blood – 1 to 8 %
Testosterone	Measures the total amount of testosterone in the blood.	Blood – less than 1.0 to 4.5nmol/L
Sex Hormone Binding Globulin (SHBG)	Measures the amount of globulin protein in the blood that binds the sex hormones.	Blood – 30 to 90nmol/L