Female Hormone Blood Test, from our experts to you.
Dr Sam Rodgers MBBS, MRCGP

Chief Medical Officer meet our doctors

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What are
Female Hormones?

Female hormones are essential for a healthy female reproductive system. Other functions of female hormones include fertility, mood, and energy. Oestradiol is the main female sex hormone, which is a type of oestrogen produced in the ovaries. Other essential female hormones include follicle-stimulating hormone (FSH), luteinising hormone (LH) and progesterone. Testosterone is a crucial hormone for women because your body uses it to make estrogen. In women, hormone levels change naturally throughout the monthly menstrual cycle. Levels of oestrogen and progesterone can decrease with age, and women can experience a rise in FSH and LH levels during menopause.


What are the symptoms
of a hormonal imbalance?

A hormonal imbalance can lead to unwanted symptoms such as acne, weight gain, mood changes, tiredness, and changes to your menstrual cycle. If your hormone levels are imbalanced for a long time, you could be at higher risk of health problems such as osteoporosis.


Why check
my thyroid?

Women are much more likely to experience a thyroid condition compared to men. A thyroid condition can cause similar symptoms to a hormonal imbalance, such as feeling tired or fatigued. This blood test also checks that your thyroid is functioning normally.


What's included?

Hormones
Proteins
Thyroid hormones
Select profile for more information

Hormone phase Hormone phase is used to determine the appropriate range for hormone markers and is calculated using the date of last menstrual period and the date of the sample.
FSH Follicle Stimulating Hormone (FSH) is produced in the pituitary gland and is important for women in the production of eggs by the ovaries and for men for men in the production of sperm. In the first half of the menstrual cycle in women, FSH stimulates the enlargement of follicles within the ovaries. Each of these follicles will help to increase oestradiol levels. One follicle will become dominant and will be released by the ovary (ovulation), after which follicle stimulating hormone levels drop during the second half of the menstrual cycle. In men, FSH acts on the seminiferous tubules of the testicles where they stimulate immature sperm cells to develop into mature sperm.
LH Luteinising Hormone (LH) is produced by the pituitary gland and is important for male and female fertility. In women it governs the menstrual cycle, peaking before ovulation. In men it stimulates the production of testosterone.
Oestradiol Oestradiol is a female steroid hormone, produced in the ovaries of women and to a much lesser extent in the testes of men. It is the strongest of three oestrogens and is responsible for the female reproductive system as well as the growth of breast tissue and bone thickness. In pre-menopausal women, oestradiol levels vary throughout the monthly cycle, peaking at ovulation. In women, oestradiol levels decline with age, culminating with the menopause when the ovaries stop producing eggs. Low oestradiol can cause many symptoms associated with the menopause, including hot flushes, night sweats and mood swings. Low oestradiol can also cause osteoporosis.
Testosterone Testosterone is a hormone that causes male characteristics. For men, it helps to regulate sex drive and has a role in controlling bone mass, fat distribution, muscle mass, strength and the production of red blood cells and sperm. Testosterone is produced in the testicles of men and, in much smaller amounts, in the ovaries of women. Testosterone levels in men naturally decline after the age of 30, although lower than normal levels can occur at any age and can cause low libido, erectile dysfunction, difficulty in gaining and maintaining muscle mass and lack of energy. Although women have much lower amounts of testosterone than men, it is important for much the same reasons, playing a role in libido, the distribution of muscle and fat and the formation of red blood cells. All laboratories will slightly differ in the reference ranges they apply because they are based on the population they are testing. The normal range is set so that 95% of men will fall into it. For greater consistency, we use the guidance from the British Society for Sexual Medicine (BSSM) which advises that low testosterone can be diagnosed when testosterone is consistently below the reference range, and that levels below 12 nmol/L could also be considered low, especially in men who also report symptoms of low testosterone or who have low levels of free testosterone.
Free androgen index The free androgen index (FAI) is a calculation used to determine the amount of testosterone which is free (unbound) in the bloodstream. Most testosterone is bound to proteins sex hormone binding globulin and albumin and is not available to interact with the body's cells. The FAI is a calculation based on the ratio of testosterone and SHBG and is a measure of the amount of testosterone that is available to act on the body's tissues. The free androgen index is used in women to assess the likelihood of polycystic ovarian syndrome. In men, free testosterone gives a better indication of testosterone status.
Prolactin Prolactin is a hormone which is produced in the pituitary gland and plays a role in reproductive health. Its primary purpose is to stimulate milk production after childbirth, and in pregnant and breastfeeding women prolactin levels can soar.
SHBG SHBG (sex hormone binding globulin) is a protein which transports the sex hormones (testosterone, oestrogen and dihydrotestosterone (DHT)) in the blood.Hormones which are bound to SHBG are inactive which means that they are unavailable to your cells. Measuring the level of SHBG in your blood gives important information about your levels of free or unbound hormones which are biologically active and available for use.
TSH Thyroid stimulating hormone (TSH) is produced in the pituitary gland in order to regulate the production of thyroid hormones thyroxine (T4) and triiodothyronine (T3) by the thyroid gland. If thyroid hormones in the blood are low, then more TSH is produced to stimulate the thyroid gland to produce more of them. If thyroid hormone levels are high, then the pituitary produces less TSH to slow the production of thyroid hormones. If TSH is too high or too low, it normally signifies that there is a problem with the thyroid gland which is causing it to under or over produce thyroid hormones. Sometimes a disorder of the pituitary gland can also cause abnormal TSH levels.
Free thyroxine Thyroxine (T4) is one of two hormones produced by the thyroid gland. It works to speed up the rate of your metabolism. Most T4 is bound to carrier proteins in the blood - it is only the free, or unbound, T4 that is active in the body, which is measured in this test. Free T4 is the less active of the two main thyroid hormones. To have an impact on your cells it needs to convert to the more active T3 when your body needs it.

How to prepare
for your test

Special instructions

Prepare for your Female Hormone Blood Test by following these instructions. Please take your sample before 10am. Take this test two to five days after the start of your period, ideally on day three. It can be taken any time if you do not have periods. Hormonal contraception can affect the results of this test. Taking a break from this and waiting for your periods to restart before your blood test will give more accurate results. Avoid taking your sample from a finger used to apply hormone gels/pessaries/patches in the past 4 weeks. Use gloves to apply these. Do not take biotin supplements for two days before this test, discuss this with your doctor if it is prescribed.


Hormonal changes in the menstrual cycle

 

For women who have periods, your female hormone levels control the menstrual cycle. Your cycle length is measured from the day your period starts, to the start of your next period. On average the menstrual cycle lasts for 28 days - but your menstrual cycle can last for anywhere between 21 to 40 days. A blood test can help you to track the hormonal changes which occur during your menstrual cycle.

 

How your hormone levels change throughout your cycle

 

Day one is the day your period starts. At this point, your female hormone levels are low. An egg begins to develop in one of your ovaries and gradually produces the hormone oestrogen. Around days 10 – 16, your oestrogen levels are at their highest. A rise in the hormones LH and FSH cause the egg to be released from your ovary. The egg implants itself in your womb and your body begins to produce the hormone progesterone and a smaller amount of oestrogen. By the end of your cycle (around day 28), an unfertilised egg breaks down, and your hormone levels will fall. This hormonal change causes your period to start, and the menstrual cycle to begin again.

 

Health conditions and female hormones

 

Polycystic Ovary Syndrome (PCOS) is a condition that stops eggs from developing normally in the ovaries. 

 

Symptoms of PCOS include:

  • Excessive hair growth
  • Weight gain
  • Irregular or missed periods
  • High levels of the male hormone testosterone.

Thyroid problems, such as an overactive or underactive thyroid, can also affect the development of eggs in your ovaries and hence affect your hormone levels. Testing your hormone levels can help you to understand whether a health problem, such as PCOS or a thyroid problem, is leading to hormonal changes in your body.

 

Hormonal changes in the menopause

 

Menopause causes a change in hormone levels, such as decreased levels of the hormones oestrogen and progesterone. On average, menopause usually occurs between 45 and 55 years of age. Menopause is a natural change which all women will go through, but it can have a big impact on a woman's sense of wellbeing. 

 

Symptoms of menopause include:

  • Hot flushes
  • Mood changes such as depression and anxiety
  • Night sweats
  • Tiredness and fatigue
  • Changes to your menstrual cycle
  • Reduced sex drive
  • Problems with memory and concentration
  • Vaginal dryness and pain

 

Hormone replacement therapy (HRT) can reintroduce hormones into your body to treat these symptoms. Most HRT is a combination of oestrogen and progesterone, which you can take by oral tablets, skin patches or gels. If you think you could be transitioning into menopause, a blood test can help identify whether low hormone levels are causing your symptoms. It can also help you to monitor the impact of HRT on your body. You can read more about menopause here and learn about the simple dietary and lifestyle changes that can improve your symptoms.

 

Female hormones in men

 

If men have high levels of female hormones, they can experience unwanted symptoms such as reduced sex drive, loss of muscle and increased body fat. It could lead to the growth of breast tissue called gynecomastia. Men are more likely to experience a fall in oestrogen levels in older age, which can occur along with a fall in testosterone levels. Sometimes this can be called 'male menopause', 'manopause', or andropause. Men may be interested to take our specially designed Male Hormone Blood Test.


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