Best Ways to Test For Hormonal Imbalances (Timing, Labs to Ask For & DUTCH Testing)
If you’ve been feeling “off” lately, whether it’s fatigue, mood swings, stubborn weight gain, poor sleep, or irregular cycles, you’ve probably wondered if your hormones could be the reason. The truth is, they probably are. Hormones act like messengers in your body, regulating everything from your metabolism and mood to your skin and reproductive health.
When they’re in balance, you feel energized, focused, and steady. When they’re not, your body starts throwing signals that something is off. The challenge? Many women are told their bloodwork is “normal” from their doctors when their symptoms clearly aren’t. That’s where hormone testing for women comes in.
In this guide, we’ll cover why testing matters, which tests to ask for, the best time to test, and why functional options like the DUTCH hormone test are becoming the gold standard.
Why Test for Hormonal Imbalances?
If you’re experiencing ongoing symptoms that feel out of place and you’re not getting answers from your doctor, a more holistic and specific hormone imbalance test can provide the missing data you need.
Testing can help you:
Identify if your symptoms are linked to estrogen, progesterone, testosterone, thyroid, cortisol or vitamin deficiencies
Catch hormonal imbalances early before they turn into bigger issues like PCOS, perimenopause challenges, or thyroid disease
Get a clear picture of how stress is impacting your body
Create a targeted plan for nutrition, lifestyle, or supplements instead of guessing
Signs and Symptoms That May Indicate a Hormonal Imbalance
So how do you know if it’s time for a hormone test? Here are some of the most common red flags of hormonal imbalances:
Irregular, missing, or painful periods
PMS or PMDD symptoms that disrupt your life
Unexplained weight gain, especially around the belly or face
Inability to lose said weight gain no matter what you do
Persistent fatigue or feeling “wired but tired” at night (can’t fall asleep)
Anxiety, depression, or mood swings
Low libido or painful sex
Hair thinning, acne, or unwanted facial hair
Hot flashes or night sweats
Trouble sleeping or frequent waking
If you’ve nodded “yes” to several of these, it’s worth exploring how to test for hormonal imbalances to get clarity.
When Is the Best Time to Test for Hormone Imbalance?
Hormones fluctuate day to day and month to month, so timing matters for accurate results.
For women with regular cycles:
Progesterone is best tested on days 18–22 of a typical 28-day cycle (the luteal phase).
Estrogen, FSH, LH are often tested around day 3 of your cycle.
Cortisol should be tested in the morning (around 8 a.m.) to see its natural peak.
For women with irregular cycles or no cycles:
Hormones can be tested anytime, but interpretation is more nuanced. A practitioner will connect results with your symptoms and history.
For thyroid testing:
Timing matters less, but morning draws while fasting are ideal for consistency.
Bottom line: The best time to test for hormone imbalance depends on which hormone is being measured. Working with someone who understands cycle mapping makes your results far more meaningful and actionable.
Types of Hormone Tests: Blood, Saliva, and Urine
When figuring out how to test for hormonal imbalances, you’ll run into three main methods:
Blood Tests for hormones
The most common option, usually offered by conventional doctors. Good for:
Estrogen, progesterone, testosterone
Thyroid panel (TSH, Free T4, Free T3)
FSH, LH, prolactin
Fasting insulin and glucose
Pros: Quick, covered by insurance, widely available.
Cons: Only captures one snapshot in time, doesn’t show daily rhythms.
Saliva Tests
Often used for cortisol since you can measure multiple times throughout the day. Shows “free” hormone levels, which are biologically active.
Pros: Non-invasive, maps daily cortisol rhythm.
Cons: Less reliable for sex hormones, not always recognized by conventional providers.
Urine Tests (like the DUTCH hormone test)
The DUTCH tests hormones through dried urine samples collected over a day. It shows both total levels and methylation - how your body is using and clearing hormones.
Pros: Comprehensive; measures cortisol patterns, estrogen metabolism, and melatonin.
Cons: More expensive, often not covered by insurance, requires a practitioner to interpret.
Hormonal Imbalance Lab Tests to Ask Your Doctor For
If you’re starting with conventional care, here are labs worth requesting:
Reproductive hormones: Estradiol, Progesterone, Testosterone (total and free), DHEA-S, FSH, LH, Prolactin
Thyroid panel: TSH, Free T4, Free T3, Reverse T3, thyroid antibodies (TPO, TGAb)
Adrenal: Morning cortisol or 4-point saliva test
Metabolic markers: Fasting glucose, fasting insulin, HbA1c
Other helpful labs: SHBG (sex hormone-binding globulin), Vitamin D, ferritin, CRP
Not all providers will automatically run these, so advocate for yourself. If your labs come back “normal” but your symptoms persist, that’s a sign it may be time to look at functional testing.
What Is DUTCH Testing and Why Is It So Comprehensive?
The DUTCH hormone test (Dried Urine Test for Comprehensive Hormones) is one of the most advanced ways to assess hormone health.
It measures:
Estrogen, progesterone, testosterone, and DHEA
How your body metabolizes estrogen (important for understanding estrogen dominance or detox issues)
Cortisol and cortisone patterns throughout the day
Melatonin and some organic acids related to nutrient status
Unlike a single blood draw, the DUTCH test captures a fuller picture of how your hormones fluctuate and how your body is processing them.
This is why so many women who feel dismissed by traditional labs finally get answers with DUTCH testing. It’s especially helpful if you suspect adrenal fatigue, PCOS, perimenopause, or estrogen dominance.
Choosing the Best Hormone Test for Your Needs
So, how do you know which test is right for you?
If you’re just starting out: Basic blood work with your doctor is a good first step.
If stress and energy are your biggest concerns: A 4-point cortisol saliva test or DUTCH can give deeper insight.
If your symptoms are complex or persistent: The DUTCH test often provide the most clarity.
If you want convenience: An at home hormone test (blood spot, saliva, or urine kits) can be mailed to you and provide useful insights, though interpretation is still key. I really like the Raena at home hormone tests! You can use code MADDY10 to save.
The best option often depends on your symptoms, budget, and whether you’re working with a conventional or functional practitioner.
Next Steps After Hormone Testing: Understanding and Taking Action
Once you’ve done your hormone testing, the next step is translating results into action. This is where working with a provider who understands both conventional ranges and optimal ranges matters.
Review results with context. “Normal” doesn’t always mean optimal.
Identify root causes. Is stress, poor sleep, or nutrition driving your imbalance?
Build a personalized plan. This may include diet changes, targeted supplements, lifestyle shifts, or in some cases medication.
Retest when needed. Hormones change over time. Retesting helps track progress and refine your plan. I always recommend doing this once per year so you know where you’re at.
If you’ve been struggling with stubborn symptoms and wondering about hormone testing, know that you have options. From conventional blood work to functional tools like the DUTCH hormone test, there are multiple ways to uncover what’s happening in your body.
Testing helps you to stop guessing, start connecting the dots, and finally create a plan that supports your energy, metabolism, mood, and long-term health.
So, if your body is telling you something is off, listen. A hormone imbalance test might be the first step to finding balance again.
👉 Want help figuring out which test is right for you? I guide my clients through both conventional labs, what to ask your doctor and have partnered with a DUTCH Test practitioner depending on your goals, plus I help them interpret results in a way that actually makes sense. Book a free consultation today and let’s get you answers.