Woman who suffer with skin conditions, weight gain, thyroid problems, PCOS, endometriosis, infertility, hot flashes, heavy periods, an ovulation (absent period) Irritable Bowel Syndrome (IBS), spastic colon, Crohn’s and celiac often have menstrual cycle or hormone imbalances that need to be addressed.
The Cyclical Pacing of the Ovaries
The human ovary releases its hormones in a cyclical manner, which is referred to as the menstrual cycle. The average cycle is 26-30 days. The timing and pacing of hormone release is governed by GnRH, FSH and LH, hormones from the hypothalamus and pituitary glands in the brain.
The two major classes of ovarian hormones released during the menstrual cycle are estrogens and progestogen, also known as the female steroid sex hormones.
The major and most active estrogen released is estradiol, while the major progestogen is progesterone.
The Female Cycle has Three Physiologic Phases:
- The follicular phase starts with the onset of menstrual blood flow and is of variable length. This phase is normally characterized by both low estrogen and progesterone output.
- The ovulatory phase is 1 to 3 days long, and the human ovum (egg) is released in this phase. This phase is preceded by high estrogen and LH levels.
- The luteal phase is rather constant in length, 12-14 days, and ends with menses. In contrast to the follicular phase, the luteal phase is characterized by high progesterone concentrations and a moderate increase in estrogens.
Functions of Female Sex Hormones
Estradiol and Progesterone affect several target organs involved in successful conception and pregnancy.
Additionally, these hormones maintain a number of secondary sexual characteristics, such as reduced body hair, soft skin texture, a higher voice pitch and possible release of certain pheromones.
About Saliva Testing
Saliva testing has many advantages over blood testing. Saliva specimen collection does not require a blood draw and there are no risks to patients. Saliva collections are convenient and can be done at work or at home. When stored properly, saliva samples are stable for several weeks.
With an accuracy of 92-96%, saliva testing is more accurate than blood testing. The ability to collect more than one specimen is another advantage of saliva testing because this can give providers more information than a single collection. Compared to blood testing, saliva testing is also more affordable.
There are several different ways of measuring the hormones in a person’s body. Most blood and serum tests look only at the level of hormones that are present in a person’s tissues. This is known as “bound hormone levels”.
Saliva testing looks at the “unbound hormone levels” also known as “free fraction hormone levels” which are the hormone levels that are available to be used by the body’s tissues. This gives providers a better idea of the levels of hormones that are actually influencing the tissues, rather than just the level of hormones that are present in the tissues.
Measuring free fraction hormone levels gives a provider more information than measuring bound hormone levels. Usually, when bound hormone levels are measured, a provider needs to guess at the level of hormones affecting the tissues. This is not the case when measuring free fraction hormone levels.
The accuracy of saliva testing, together with its, convenience, and the ability to collect multiple specimens makes saliva testing superior to blood testing.
Target Organs of Estrogen and Progesterone
The Uterus – Estradiol prepares the uterus for conception, produces a threefold to fivefold increase in the thickness of its inner lining and also promotes uterine gland development and mucus secretion. Progesterone causes a swelling of the uterine lining, an increase in glycogen (a complex sugar) content and an increase in the mucus secreted by the uterus. If conception does not occur, the uterine lining is shed, resulting in the menstrual flow.
Fallopian tubes – Sex hormones stimulate the Fallopian tubes to move the egg toward the uterus. The Fallopian tubes also secrete fluids that nourish the egg, the sperm and ultimately the embryo when fertilization occurs.
Vagina – Estrogens promote the thickening of the vaginal lining and increase its secretions, which makes the lining more resistant to infections.
Breasts – Before puberty, the breasts grow only in proportion to the rest of the body, but under the influence of estradiol and progesterone during puberty, the breasts develop to maturity. During the menstrual cycle, excess estradiol causes breast swelling and tenderness.
Bones – In the adult female, Estradiol and Progesterone play an important role in the inhibition of osteoporosis and improve the incorporation of calcium and magnesium into bone. This is often why doctors prescribe Estrogen for menopausal women.
Kidney – Estrogens cause the body to retain sodium, which results in fluid buildup. Conversely, progesterone causes a loss of excess sodium and retained fluid. Before the period begins, there may be a relative excess of estrogen over progesterone, which commonly leads to several of the PMS-associated complaints.
Liver – Estradiol has stimulatory effects on liver proteins which may reduce thyroid hormone availability and increases the risk for cardiovascular disease. Estradiol also slows the process of liver detoxification of various harmful substances.
Miscellaneous – Estradiol can elevate blood sugar in certain susceptible individuals. Progesterone can increase the appetite and has a general calming effect on the nervous system, especially at night.
What We Test
The Female Hormone Panel is a simple, non-invasive test done in the privacy of your own home. Eleven saliva samples are collected during specific time periods throughout the menstrual cycle. They are then evaluated to see where the cycle is “off”
Other Applications and Uses of Female Hormone Panel
The FHP™ can also be used to detect and monitor the following:
- Functional infertility
- Influence of diet, exercise and other lifestyle factors on the cycle
- Menstrual problems originating in the brain
- Early pregnancy problems- spontaneous miscarriage
- Cycle irregularities, following the use of birth control pills
- Dysmenorrhea- painful and heavy periods
- Migraine headaches
- Cystic ovarian disease
- Early osteoporosis
Can a cycling woman’s hormones be assessed accurately with just a single day’s blood test?
A newly available one-day, cycling female hormone saliva test certainly sounds like a good — or at least convenient — alternative to testing throughout the cycle. However, the reality is that an individual woman’s menstrual cycle in no way compares to another’s, and a female hormone testing protocol that places mere expedience over accuracy is not of value for any woman.
Whole-Cycle Testing Vs. a One-Day Snapshot
For many years, Diagnos-Techs™ has offered female hormone panels specifically designed to deliver an accurate picture of a woman’s cycling hormones, without burdening her with unrealistic testing schedules and methods. Our Female Hormone Panel™, for instance, takes a snapshot at 11 discrete points in the menstrual cycle, providing cycle-wide data. Women simply collect saliva at approximately two- to three-day intervals through their cycles, a design that’s been well accepted over the years by patients and widely praised by healthcare practitioners for its accuracy and ease-of-collection. Some labs have introduced a one day menstrual cycle test which involves collecting four vials of saliva on the 21st day of a woman’s cycle. The test consists of a circadian cortisol rhythm assessment, plus pooled testosterone, estradiol, and progesterone values. The latter two values are processed with a mathematical formula, purportedly to diagnose luteal phase failure and estrogen dominance.
5 Reasons Why a One-Day Female Hormone Blood Test Doesn’t Make the Grade
Without doubt, such a one-day hormone test promotes patient compliance and fits in nicely with a busy schedule. But the relevant issue is whether the data gathered by this test gives an accurate account of a woman’s entire cycle. We don’t think so, and here’s why:
1. Every woman’s cycle is unique.
Duration, ovulatory timing, luteal phase length, and estradiol and progesterone patterns vary so much
that a single-day sample, no matter how “complete,” can’t compare to the detailed data offered by a multi-sample test. In sports terms, a one-day test is like evaluating a quarterback’s performance during a game using four photographs taken in the third quarter.
2. Hormones follow a circadian rhythm.
To reflect this rhythm accurately, specimens are collected throughout the cycle at the same time of day, determined by the patient’s convenience.
3. A single-day snippet of a woman’s month-long cycle may or may not correctly identify luteal phase failure or estrogen dominance.
Though the one-day saliva test in question has been compared to our 11-vial FHP™, it doesn’t offer the same detailed picture of hormonal changes over the cycle, necessary for a confident diagnosis of either luteal phase failure or estrogen dominance.
4. One size does not fit all when testing female hormones.
The pattern of progesterone deficiency (follicular and/or early, middle, or late luteal phase), which may produce menopausal or menstrual problems, must be evaluated completely. This pattern then points the way toward an appropriately designed treatment program, which may include biphasic progesterone supplementation.
5. A one-day assay is meaningless for evaluating women with fertility problems.
This single test does not provide invaluable sequential FSH and LH measurements, nor does it address multiple issues that may be interacting to cause infertility[/expand] [expand title=”Menopausal Hormone Testing”] Literally, menopause means the cessation of the monthly menstrual cycle; it signals the end of a woman’s natural childbearing years. Menopause is neither a disease nor an illness—it is a natural and usually gradual change in glandular function. It has its origins in the beginning of menses and culminates in a series of hormonal changes that result in the cessation of menstrual flow. This transition produces a variety of bodily manifestations and symptoms, due to changes in the production of hormones and the timing of their release.
The right balance of hormones is important to long-term emotional, mental and bodily health.
Various body parts undergo change and can produce one or more of the following symptoms:
- Bleeding irregularities
- Vaginal dryness
- Hot flashes or sweats
- Changes in sex drive
- Nervousness or irritability
- Mood changes
- Skin aging or cosmetic changes
- Altered fat and carbohydrate metabolism
- Nervous system
- Metabolic changes
What Can You Do About It?
There are several therapeutic options which may minimize or even eliminate many of the symptoms:
- Treat symptoms using synthetic hormones without hormone-level testing.
- Treat symptoms using natural hormones without any testing.
- Treat and correct symptoms using natural hormones with testing for hormone levels before and after treatment.
Because Hormone levels from woman to woman can vary from 200% to 1,500%! We always recommend testing!
How Can We Help You?
Let us take a common example:
A woman suffers from several symptoms—migraines, hot flashes and emotional fragility. She is having irregular periods, one every 6-8 months. Her doctor treats her with natural estrogens, but he does not do any testing to determine quantities or types of hormones that will meet her specific needs. The symptoms are under control, but her risks are increased.
Risks of treatment without actual testing of hormone levels includes:
- Increased blood pressure
- Endometrial cancer (uterine cancer)
- Fibroid growth
- Gallbladder disease
- At least twice the risk of breast cancer over 15 years
What could we have found out if we had tested her saliva hormone levels? We would have known that she has too much estrogen, not enough progesterone to balance the estrogen, low DHEA and marginal testosterone. But she felt good on the estrogen, many will say. Yes, however, the silent killers (cancer, blood pressure, heart disease) rarely make anyone feel badly at the start. Her best course is a new treatment plan, designed around the objective saliva hormone measurements.