Sexual Health Reproductive Health Issues What Hormone Imbalance Tests Reveal About Women's Health Checking Estrogen, Progesterone, FSH, and More By Cathy Wong Cathy Wong Facebook Twitter Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman's World, and Natural Health. Learn about our editorial process Updated on June 25, 2022 Medically reviewed by Lauren Schlanger, MD Medically reviewed by Lauren Schlanger, MD LinkedIn Lauren Schlanger, MD, is a board-certified primary care physician. She is an assistant professor at the Alpert Medical School of Brown University. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents What's Tested Estrogen Progesterone Follicle Stimulating Androgens Thyroid Frequently Asked Questions A blood test for female hormones can reveal important information about your health. They can detect fertility problems, where you are in your menstrual cycle, or whether you're starting perimenopause. Hormone tests also can play a role in diagnosing medical conditions such as thyroid disease or diabetes. In some instances, they can show how well a medication is working. This article looks at the tests done for each sex hormone, when tests are needed, what's considered normal and abnormal, and what the results could mean. okskukuruza / Getty Images What's Being Tested? Hormone blood tests can look at several key female hormones: Estrogen Progesterone Follicle-stimulating hormone (FSH) Testosterone/DHEA Thyroid hormones In most cases, healthcare providers use hormone test results combined with other factors—such as symptoms, medical history, and other test results—to reach a diagnosis. Estrogen Estrogen isn't a single hormone. You have many types of estrogens. Only three of them are commonly tested: Estrone (E1): The main post-menopausal hormoneEstradiol (E2): The main female hormone before menopause and outside of pregnancyEstriol (E3): A form that increases during pregnancy E2 is the most often tested form. It's the major hormone responsible for sexual function and also plays a major role in: Healthy bonesFemale characteristicsOther aspects of health Estradiol is primarily produced by the ovaries and levels vary throughout the menstrual cycle. They're highest at ovulation and lowest at menstruation. E2 levels slowly decrease as you age. The largest drop occurs at menopause when the ovaries "switch off." Everyone has some estradiol in their bodies, regardless of their biological sex. When Estrogen May Be Tested You may need an estrogen test if you have symptoms of an estrogen-related condition or: You're having trouble getting pregnant Your periods are irregular Puberty appears to be delayed, regardless of biological sex You're having menopause symptoms You have vaginal bleeding after menopause You're biologically male but displaying female characteristics (such as developing breasts) When to Take a Pregnancy Test Estrogen Test Results What's considered normal for estradiol levels depends on your menstrual cycle and phase of life. Testing for fertility looks at three phases of the menstrual cycle: Follicular phase lasts from the first day of your period until ovulation, usually about 14 days. It's named for the follicle housing the egg before it's released during ovulation.Periovulatory phase is an approximately three-day period around the time of ovulation.Luteal phase lasts from ovulation until the start of menstruation. After ovulation, the follicle releases estrogen and progesterone to prepare your uterus for a fertilized egg to implant. Estrogen levels are measured in picograms (one-millionth of a gram) per mililiter (pg/mL). E2 TEST TIMING RANGE (pg/ml) Follicular phase 19.5-144.2 Periovulatory phase 63.9-256.7 Luteal phase 55.8-214.2 Postmenopausal 32.2 or lower Source: University of North Carolina Medical Center What the Results Mean Low estrogen levels may be a sign of: Polycystic ovary syndrome (PCOS) Decreased pituitary function (hypopituitarism) Anorexia nervosa Low body fat Certain medications, such as Clomid (clomiphene, a fertility drug), also can cause a decline in estrogen levels. Low Estrogen: Symptoms, Causes, and Treatments High estrogen levels may occur with conditions such as: Obesity Light or heavy menstrual bleeding Worsened premenstrual syndrome Fatigue Loss of sex drive Certain medications are also known to increase estrogen levels. These include steroid hormones, phenothiazines, tetracycline antibiotics, and ampicillin. Estrogens and Breast Cancer Progesterone Progesterone is essential for regulating menstruation and fetal development. During the luteal phase, it helps prepare the uterus to receive a fertilized egg. What happens next depends on whether the egg is fertilized: If the egg is not fertilized, progesterone levels plummet, and a new menstrual cycle begins. If the egg is fertilized, progesterone levels remain high. This stimulates the growth of blood vessels that supply the lining of the uterus (endometrium) and makes glands in the endometrium release nutrients to nourish the developing embryo. When Progesterone Levels May Be Tested You may need a progesterone test to determine: Whether you're ovulating normally Why you're having trouble getting pregnant Your risk of miscarriage or other pregnancy complications If you have a pregnancy outside of the uterus (ectopic pregnancy) Progesterone Test Results As with estrogen, what's considered normal for progesterone depends on the timing of the test. Midway through the menstrual cycle, progesterone levels start climbing. Between six and 10 days later, if there's no fertilized egg, levels drop off. If the egg is fertilized, levels rise through the earliest stage of pregnancy. Progesterone levels are measured in nonograms per mililiter (ng/mL) or nanomoles per liter (nmol/L). PROGESTERONE TEST TIMING RANGE (ng/mL) RANGE (nmol/L) Follicular phase 1 or lower 3.18 or lower Mid-cycle 5-20 15.9-63.6 1st trimester 11.2-90 35.62-286.2 2nd trimester 25.6-89.4 81.41-284.29 3rd trimester 48-above 300 152.64-above 954 Postmenopausal 1 or lower 3.18 or lower Source: University of North Carolina Medical Center What the Results Mean If progesterone levels are low during pregnancy, it could be a sign that you're at risk of miscarriage or premature labor. You may be given a synthetic form of progesterone to prevent early labor. High progesterone levels usually do not signal any health problems unless they continue for a long time. In those instances, high levels may indicate an increased risk of breast cancer. Follicle Stimulating Hormone Follicle-stimulating hormone (FSH) is produced by the pituitary, a pea-sized gland in the brain. FSH stimulates the growth of an egg in the ovary to get it ready for fertilization. FSH can be checked with either blood or urine tests. Healthcare providers may look at a single sample or, to look for fluctuations, several samples taken over a 24-hour period. The pituitary gland produces more FSH when estrogen and other hormone levels begin to drop before menopause, when the ovaries are losing their reproductive potential. How Does Artificial Insemination Work? When FSH Levels May Be Tested In adult females, the FSH test may be used in diagnosing: Abnormal menstrual bleeding Infertility The start of perimenopause or menopause Ovarian function issues and PCOS Pituitary gland tumors Ovarian cysts FSH Test Results This hormone also changes over the course of your menstrual cycle and lifetime. FSH is measured in milli-international units per milliliter (mIU/mL). FSH TEST TIMING RANGE (mIU/mL) Follicular phase 3.5-12.5 Ovulatory phase 4.7-21.5 Luteal phase 1.7-7.7 Postmenopausal 25.8-134.8 Source: Laboratory Corporation of America. What the Results Mean Abnormal FSH levels are often caused by a disease of the pituitary gland or the hypothalamus (a part of the brain). The hypothalamus has several functions, including: Balance Temperature regulation Hunger and satiation These glands can be affected by PCOS, cancer treatment, a congenital defect (a condition you're born with), or other diseases and disorders. The Hypothalamus and Your Menstrual Cycle Testosterone and DHEA While testosterone is usually regarded as the "male sex hormone," it's also part of the female hormonal makeup. In females, testosterone is produced in the ovaries and adrenal glands. Most of it is then converted to estradiol with the help of an enzyme called aromatase. Dehydroepiandrosterone (DHEA) is also classified as an androgen, but it is normally present in females as well. When Testosterone/DHEA Levels May Be Tested You may need a testosterone or DHEA test because of: Irregular or missed periods Possible ovarian conditions, including PCOS and ovarian cancer Weight gain Acne Development of male traits (excess hair growth, male pattern baldness, deepening voice) Infertility Decreased sex drive Testosterone/DHEA Test Results Testosterone doesn't fluctuate like female hormones, so the timing of tests isn't important. Testosterone is measured in nanograms per deciliter (ng/dL) or nmol/L. TESTOSTERONE RANGE (ng/dL) TESTOSTERONE RANGE (nmol/L) 15-70 0.5-2.4 Source: Icahn School of Medicine at Mount Sinai Normal DHEA levels depend on your age. It's measured in micrograms per deciliter (mg/dL) or micromoles per liter (mmol/L). AGE DHEA RANGE (mg/dL) DHEA RANGE (mmol/L) 18-19 145-395 3.92-10.66 20-29 65-380 1.75-10.26 30-39 45-270 1.22-7.29 40-49 32-240 0.86-6.48 50-59 26-200 0.7-5.4 60-69 13-130 0.35-3.51 69-older 17-90 0.46-2.43 Source: Icahn School of Medicine at Mount Sinai What the Results Mean High testosterone could mean steroid abuse, PCOS, cancers of the adrenal glands or ovaries, and congenital adrenal hyperplasia. Low libido is associated with low levels of testoterone. A drop in testosterone can also indicate perimenopause. Testosterone in Menopause Testosterone naturally drops during menopause, causing myriad symptoms including:Diminished sex drive, sexual pleasure, and orgasmic responseLow energyDepression High DHEA levels on blood tests may be a sign of conditions such as congenital adrenal hyperplasia or cancer of the adrenal gland. Thyroid Hormones Thyroid function is determined by the levels of a group of hormones. These hormones are produced by the pituitary and thyroid glands. The three main ones are: Thyroid-stimulating hormone (TSH): A pituitary hormone that tells the thyroid gland to produce more hormone Thyroxine (T4): An inactive thyroid hormone that can be converted to an active state Triiodothyronine (T3): The active thyroid hormone, most of which comes from converted thyroxine Thyroid function tests are often included in a female hormone panel because thyroid diseases are more common in women than men. It may also be included to examine whether the thyroid is affecting fertility and pregnancy. When Thyroid Levels May Be Tested You may need a thyroid hormone test if you have symptoms of either an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism). Hypothyroidism symptoms include: Fatigue Unintended weight gain Puffy face Intolerance of cold Pain in the joints and muscles Constipation Dry skin Dry, thinning hair Decreased sweating Heavy or irregular menstrual periods Fertility problems Depression Slow heart rate Goiter (enlarged thyroid gland causing a lump in the front of your throat) Hyperthyroidism symptoms include: Anxiety Fatigue Frequently feeling cold or hot Irregular or light menstrual period Hair loss Unintended weight loss or gain Tremors Rapid heart rate Bulging eyes Goiter Hyperactivity Thyroid Test Results Healthcare providers may use TSH alone or a combination of TSH, T4, and T3 tests to diagnose thyroid disorders. TSH is measured in milli-international units per liter (mIU/L). There's a range for non-pregnant females as well as trimester-specific ranges in pregnancy. TSH TEST TIMING RANGE (mIU/L) Non-pregnant 0.5-5 First trimester 0.1-2.5 Second trimester 0.2-3 Third trimester 0.3-3.5 Sources: UCLA Health, study by Galoiu S. T4 is measured in micrograms per deciliter (µg/dL). T3 is measured in nanograms per deciliter (ng/dL). THYROID HORMONE RANGE T4 (Thyroxine) 5-12 µg/dL T3 (Triiodothyronine) 80-220 ng/dL Sources: UCLA Health What the Results Mean Interpreting TSH results can be confusing. That's because high TSH means low thyroid activity, and low TSH means high thyroid activity. Your provider may look at TSH alone or all three hormones together in order to reach a diagnosis. TSH T4+T3 DIAGNOSIS High Low Hypothyroidism High Normal Borderline hypothyroidism Low High Hyperthyroidism Low Normal Early or mild hyperthyroidism Low Low Pituitary disease Source: UCLA Health If results start out with low TSH and high thyroid hormones and then reverse with further testing, it indicates thyroiditis, which is inflammation of the thyroid gland. Autoimmune Thyroid Disease Testing for thyroid disease may include antibody testing. That's done to see if you have an autoimmune thyroid condition such as Hashimoto's or Graves' disease. Summary Hormone tests are often done as part of regular blood work, but your healthcare provider may order them if you're having menstrual issues, changes in sex characteristics, fatigue, loss of sex drive, or problems getting pregnant. Providers may specifically check estrogen, progesterone, FSH, testosterone/DHEA, and thyroid hormone levels. Abnormal readings can indicate that you have a condition such as PCOS, ovarian cysts, thyroid disease, or, possibly, cancer. Tests are one step in the process of diagnosing a condition. If the results are concerning, your provider may order additional tests. Frequently Asked Questions When should you get a hormone blood test? You may need one if you're having symptoms of a hormonal imbalance. These are often done during the first half of your menstrual cycle, when levels are more distinct. However, progesterone tests to check ovulation are typically done on day 21 of your cycle. How early can a blood test detect that you're pregnant? Blood tests can detect pregnancy between six and eight days after ovulation. By contrast, to be accurate, home pregnancy (urine) tests should be taken after your period is late. That's between 12 and 16 days after ovulation. 23 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Khattar D, Sodhi C, Parmod J, Dutta A. Correlating estrogen levels and cognitive functions in regularly menstruating females of reproductive age group and post menopausal women of North India. J Family Reprod Health. 2015;9(2):83-88. Saran S, Gupta BS, Philip R, et al. Effect of hypothyroidism on female reproductive hormones. Indian J Endocrinol Metab. 2016;20(1):108-113. doi:10.4103/2230-8210.172245 Ajayi O, Charles-Davies M, Anetor J, Ademola A. Pituitary, gonadal, thyroid hormones and endocrine disruptors in pre and postmenopausal nigerian women with ER-, PR- and HER-2-positive and negative breast cancers. Med Sci (Basel). 2018;6(2):37. doi:10.3390/medsci6020037 National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Estrogen levels test. Victoria State Government, Victoria, Australia: Better Health Channel. Menstrual cycle. Schorr M, Miller KK. The endocrine manifestations of anorexia nervosa: mechanisms and management. Nat Rev Endocrinol. 2017;13(3):174-186. doi:10.1038/nrendo.2016.175 Ko SH, Kim HS. Menopause-associated lipid metabolic disorders and foods beneficial for postmenopausal women. Nutrients. 2020;12(1):202. doi:10.3390/nu12010202 Endocrine Society. What is estrogen? Mesen TB, Young SL. Progesterone and the luteal phase: a requisite to reproduction. Obstet Gynecol Clin North Am. 2015;42(1):135-151. doi:10.1016/j.ogc.2014.10.003 National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Progesterone test. Haas DM, Hathaway TJ, Ramsey PS. Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology. Cochrane Database Syst Rev. 2018;10(10):CD003511. Published 2018 Oct 8. doi:10.1002/14651858.CD003511.pub4 National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Follicle-stimulating hormone (FSH) levels test. Mikhael S, Punjala-Patel A, Gavrilova-Jordan L. Hypothalamic-pituitary-ovarian axis disorders impacting female fertility. Biomedicines. 2019;7(1):5. doi:10.3390/biomedicines7010005 Davis S, Wahlin-Jacobsen S. Testosterone in women—the clinical significance. Lancet Diabetes Endocrinol. 2015 Sept;3(2):980-92. doi:10.1016/S2213-8587(15)00284-3 National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Testosterone levels test. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. DHEA sulfate test. Vegunta S, Kling JM, Kapoor E. Androgen therapy in women [published correction appears in J Womens Health (Larchmt). 2020 Nov;29(11):1487]. J Womens Health (Larchmt). 2020;29(1):57-64. doi:10.1089/jwh.2018.7494 Achilli C, Pundir J, Ramanathan P, Sabatini L, Hamoda H, Panay N. Efficacy and safety of transdermal testosterone in postmenopausal women with hypoactive sexual desire disorder: a systematic review and meta-analysis. Fertil Steril. 2017;107(2):475-482.e15. doi:10.1016/j.fertnstert.2016.10.028 National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Hypothyroidism. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. TSH (thyroid-stimulating hormone) test. Society for Endocrinology: You and Your Hormones. Laboratory tests: Introduction to laboratory tests. U.S. Department of Health & Human Services. Knowing if you are pregnant. U.S. Food and Drug Administration. Pregnancy. Additional Reading Galoiu S. First trimester of pregnancy reference ranges for serum TSH and thyroid tumor reclassified as benign. Acta Endocrinol (Buchar). 2016;12(2):242-243. doi:10.4183/aeb.2016.242 Icahn School of Medicine at Mount Sinai. DHEA-sulfate test. Icahn School of Medicine at Mount Sinai. Testosterone. Laboratory Corporation of America Holdings: LabCorp. Follicle-stimulating hormone (FSH). University of California Los Angeles: UCLA Health. What are normal thyroid hormone levels? University of North Carolina Medical Center, UNC Health Care. Serum progesterone. University of North Carolina Medical Center, UNC Health Care. Estrogen, serum (estradiol). By Cathy Wong Cathy Wong is a nutritionist and wellness expert. 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