Who hasn’t heard the comments about women getting a bit crazy around “that time of the month”, or joked about the “joys” of menopausal hot flashes. Over the course of a woman’s life, there come days and seasons where we feel like we’re engaged in a complicated dance with our body’s natural hormonal rhythms… except it’s more like a stumbling mess than an elegant and vibrant expression of our inherent strength.

The good new is, our bodies are designed to maintain hormonal balance. Yet despite this reality, imbalances and dysfunctions affect millions of women around the world. Whether it’s weight gain, fatigue, low libido, mood swings, depression, premenstrual symptoms (PMS), or menopause, we experience hormonal disruptions in very real ways. If misdiagnosed or left unaddressed, these symptoms can lead to more serious, long-lasting problems.

To eliminate the guessing game, I find high value in getting hormone levels tested. There are many pieces to the hormone puzzle (for both men and women), many of them not immediately evident, and without the advantage of the information a reliable hormone test provides, getting to the bottom of the imbalance can become an unnecessarily prolonged journey. A good hormone test gives answers to many health challenges.

There are several ways of testing for hormonal imbalance.

  1. Serum (blood) testing:
    Pros – The most universally accepted testing method; relatively simple collection process; requires little patient involvement; has well-established reference ranges.
    Cons – fails to effectively test sex and adrenal hormones; doesn’t cover extensive metabolite testing for cortisol and estrogens; only provides a single “snapshot” of the wide hormonal fluctuations a patient has throughout the day.
  2. Saliva testing:
    Pros – Non-invasive; easily collectible; best used to evaluate the balance and flow of the estrogens and progesterone in menstrual, pre-menopausal women.

    Cons – Doesn’t measure metabolites; gives an incomplete hormonal picture of hormonal function for a more precise clinical diagnosis of hormonal imbalance and HRT monitoring.
  3. 24-hour urine testing:
    Pros – Measures hormone metabolites; excellent for evaluating adrenal health and function.
    Cons – Done over a 24-hour period; collecting it in the jars is a messy and often inaccurate process as several 
    factors may alter the outcome of the test; does not track the daily pattern of free cortisol, so a saliva test is often ordered with the urine test.
  4. DUTCH testing (“Dried Urine Test for Comprehensive Hormones”):
    Pros – Simple collection; 4-5 samples collected over a 12-14 hour time span; considered to deliver the most reliable and accurate assessment of sex and adrenal hormones and their metabolites (including the daily free cortisol pattern, organic acids, melatonin (6-OHMS), and 8-OHdG); dried urine samples stay stable for several weeks.
    Cons – No fluids 2 hours before a sample collection.

    In my experience as a Naturopathic Doctor, the DUTCH test provides the most comprehensive data I need to make solid clinical decisions for pin-pointing my patient’s specific hormonal and health needs.

Hormonal imbalance does not need to be your “normal”. Understanding what is happening in your body, and when, equips you with the information you need so you can better work with your medical provider to continue to track and evaluate hormone levels, ensuring they are at their optimum balance. 

If knowledge is power, then understanding the causes of our hormone imbalances empowers us to prevent them, and at the same time feel better, think better, and live life more fully.  

Dr. Sarah Sjovold is a Naturopathic Doctor practising at Livstil Wellness Clinic. She regularly sees patients in the Langley and Surrey area looking for help with hormonal balance, perimenopause and menopause, and women’s health.

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