The claims about balancing hormones are everywhere. After all, hormones are big in the wellness industry. And for midlife women going through many hormonal changes, they matter a lot.
Yet it’s easy to get confused about whether it’s really your hormones causing problems or something else. And before spending money on some product that makes a promise, why not test your levels to see what it is you need.
This is where hormone biomarkers come in. Today I’m going to share with you six of the most important hormone tests for midlife women. This is straight from The Midlife Woman’s Biomarker Guide, which you get for free when you sign up for my Midlife Strong Newsletter.
At midlife, many women want to know if there’s a test that can tell if they are in perimenopause or menopause. In 2018, the FDA approved the only test that helps determine menopause called PicoAMH Elisa.
This test measures the amount of anti-Mullerian hormone (AMH) in the blood. This along with other measures can help determine when menopause will occur or in some cases if the final period has already been reached. (24)
AMH signals a woman’s ovarian reserve, which is how many eggs she has left. This is a good test to get if you have heavy bleeding and are 44 or older and would like to know about how much time you have left. It could make the difference between getting an IUD and waiting it out. For more info see Meno Check.
Follicle-stimulating hormone (FSH) is a hormone that increases as women go through perimenopause and menopause.
According to the North American Society for Menopause “When a woman’s FSH blood level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year, it is generally accepted that she has reached menopause.” (25)
But they also note that a single FSH test can be misleading, as it fluctuates throughout a woman’s cycle. An FSH test along with other tests can help women and their health care providers make decisions about treatment.
DHEA is a steroid hormone made from cholesterol and produced from the adrenal glands. It’s stored as DHEAs (the blood test to check status) until it is needed.
DHEA is a precursor to hormones like estrogen. This is especially important once a woman goes through menopause and relies on the adrenals to make estrogen for body functions.
DHEAs levels outside the optimal range are associated with chronic health conditions, low immunity, and compromised well-being. (26) DHEA levels peak around age 30 and gradually decrease with age although a boost is seen right around the menopause transition. (27)
Tracking your DHEAs can help you make decisions about your health. Although supplements are an option, there are natural ways to increase DHEA such as exercising, getting good nutrition, and positively managing stress.
Sex hormone-binding globulin (SHBG) binds to sex hormones including estrogen and testosterone transporting them to where they are needed in the body.
It helps maintain the balance between estrogen and testosterone. Optimal levels, not too high or too low, not only keep hormones balanced and athletic performance optimal, but help decrease the risk of insulin resistance, diabetes, and osteoporosis. (28)
At midlife women become more sensitive to the effects of stress. In fact, one study showed that nightly cortisol levels increase in women during the menopause transition. (29)
Cortisol, referred to as the “stress hormone,” is also produced by the adrenal glands. We need cortisol to respond to acute stress; but when stress is chronic, levels can become high even at rest. Over time, if this isn’t corrected, the body adapts by producing less cortisol.
The ratio of cortisol to DHEAs is telling. When cortisol is high but DHEAs is below normal, it is associated with poorer outcomes. At the beginning of the stress response, DHEAs will remain normal, but eventually decline. Remember that other factors can affect cortisol levels such as steroid medications, a recent illness, overexercising, hormonal birth control, and menopausal hormone therapy.
The best time to have cortisol tested is in the morning after an overnight fast.
As an anabolic hormone, testosterone plays a key role in muscle mass, bone density, energy levels, mood, and sex drive.30 After menopause, the ovaries continue to produce testosterone for up to ten years. Women who have had their ovaries removed are at increased risk for low testosterone. (30) The adrenals also produce testosterone.
Symptoms of low testosterone include fatigue, muscle weakness, depression and other mood disorders, and low sexual desire.
If you are an avid exerciser, the testosterone-to-cortisol ratio can give you key information about how you are recovering. A low free testosterone-to-cortisol ratio means you’re not getting enough recovery time after training which can increase the risk of heart disease.
If you are interested in these tests, it’s best to work directly with your health care provider or a company like Inside Tracker who can explain results to you.
Most health organizations recommend tracking symptoms (along with bleeding patterns to help determine sex hormone changes) over measuring estrogen and progesterone. Women considering or taking menopausal hormone therapy may get in-depth testing.
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