As women progress through the stages of life, their hormones can fluctuate dramatically, precipitating a host of symptoms associated with both estrogen excess (PMS, weight gain, fibrocystic breasts) and estrogen deficiency (hot flashes, night sweats, sleep disturbances). During the reproductive years (teens to mid-forties), the most common hormonal issues can be associated with an imbalance in estradiol, and progesterone; usually too much estradiol, and too little progesterone. These symptoms usually worsen as women approach menopause and estrogen levels swing from high to low without the balancing effects of progesterone. As the ovaries settle into menopause, no longer producing estrogen and progesterone, a new subset of estrogen deficiency symptoms may surface.
Choosing the Right Test
There is much controversy surrounding hormone testing. Blood, urine and salivary testing all have their weaknesses and strengths. If salivary hormone testing is being recommended to you it is a simple test that involves collection of saliva done at home. For measuring endogenous levels in individuals not taking hormones, near-identical results are found from blood serum venipuncture.
All hormones have separate functions, but work synergistically at the same time. Estradiol is tested because it is the female hormone necessary for maintaining optimal function and well being. Undetected excesses or deficiencies produced in the body or through supplementation can cause the above symptoms and affect the health of the cardiovascular system, breast, bones, skin, and brain.
Progesterone works in synergy with estradiol to maintain its’ balance and optimize function in the body. Too little progesterone is often associated with estrogen dominance.
Testosterone is an important hormone in women, as it is in men. Too much testosterone, often caused by ovarian cysts, can lead to excessive facial and body hair, acne, oily skin and hair, and weight gain around the waist. Too little testosterone, often caused by excessive stress, medications, contraceptives, and surgical removal of the ovaries, can lead to androgen deficiencies including low libido, thinning skin, vaginal dryness, loss of bone and muscle mass, depression, and memory lapses.
Sex Hormone Binding Globulin
SHBG is a protein produced by the liver in response to any form of estrogen, including: those produced naturally by the body; from synthetic hormones (HRT and birth control); from foods such as soy and herbals (phytoestrogens); and environmental contaminants (e.g. xenoestrogens) found in plastics and petrochemical products. SHBG is an index of the body’s overall exposure to all of these estrogens.
Hormone testing is offered at EVND through a variety of ways based on the symptoms and concerns of our patients. We may recommend standard blood work, dried urine testing (DUTCH-Complete-Female-Sample), or salivary hormone testing.