Hormonal profile – woman

Symptoms: irregular or painful menstruation, infertility or miscarriages, premenstrual syndrome (mood swings, breast tenderness, water retention, uterine cramps), low libido, increased facial hair growth, acne, migraines

Who should not undergo testing: transgender individuals, individuals undergoing hormone replacement therapy (HRT), pregnant women, women undergoing preparation for artificial insemination

More detailed information about hormone profile testing in women

Hormone profile testing in women is often the first step in understanding female reproductive health and is the basis for effective diagnosis and treatment of many problems, such as menstrual cycle disorders, onset of menopause, or polycystic ovary syndrome (PCOS) (1). Hormonal imbalance can also be associated with diseases such as osteoporosis (estrogen deficiency) (2), metabolic disorders (insulin resistance), and cardiovascular disease (3). Hormones affect mood, sleep, and energy levels. Changes can manifest as depression or anxiety (4). Hormonal profile (e.g., FSH, estradiol, AMH) is essential for family planning (5).

For the correct interpretation of the results, it is important to always indicate the phase of the menstrual cycle (MC) in which the test was performed – ideally, indicate the day of the MC, with day 1 being the first day of menstruation. Alternatively, indicate that the patient is postmenopausal (6).

Hormone levels change significantly during the menstrual cycle, and it is very important to realize that an increased or decreased value of any of the parameters (hormones) tested does not automatically mean disease or a problem. Individual values may occasionally fall outside the reference range. If in doubt, the client should always visit a gynecologist for a professional consultation. The gynecologist may recommend further testing.

Hormonal profile in reproductive health

Hormonal balance is essential for reproductive health, the menstrual cycle, and fertility. Testing the hormonal profile in women is a key parameter in the diagnosis of menstrual disorders, the assessment of ovarian reserve, and family planning. Analysis of hormone levels such as FSH, LH, estradiol, progesterone, and AMH allows for the assessment of ovulation, cycle regularity, and the onset of menopause (1).

The test is recommended for the following conditions: menstrual cycle disorders, onset of menopause, premenstrual syndrome, hypopituitarism (a condition in which the pituitary gland produces insufficient amounts of one or more hormones), premature puberty, hirsutism (excessive growth of terminal hair – coarse, dark hair in women in areas typical for men), infertility, suspected polycystic ovary syndrome (PCOS)(1).

The test also includes testing thyroid hormones, which helps diagnose conditions such as hypothyroidism (thyroid hormone deficiency), hyperthyroidism (a condition in which the thyroid gland produces excessive amounts of the hormones T4 – thyroxine and T3 – triiodothyronine)(7), or indicate a possible autoimmune disease of the thyroid gland. These disorders can affect the menstrual cycle, fertility, and the course of a possible pregnancy. The symptoms overlap with other hormonal imbalances, so thyroid hormone testing is recommended to refine the diagnosis.

Testing is recommended for the following conditions: fatigue, feeling cold, changes in body weight unrelated to changes in calorie intake, depression, nervousness, and insomnia (7).

What will be testes

The levels of these hormones are determined in serum.

Estradiol

Estradiol is the most active female sex hormone in the estrogen group. It plays a key role in regulating the menstrual cycle, promoting ovulation, developing secondary sexual characteristics, and maintaining bone and skin health. Its level fluctuates significantly during the menstrual cycle, so it is important to indicate the day of the menstrual cycle before the test.

Progesterone

Progesterone is a key female sex hormone produced in the ovaries during the second phase of the cycle (in the corpus luteum), in the placenta during pregnancy, and to a lesser extent in the adrenal glands. It plays an important role in preparing the uterus for pregnancy and maintaining a healthy menstrual cycle.

Follicle-stimulating hormone (FSH)

FSH, follicle-stimulating hormone, is produced by the anterior lobe of the pituitary gland. It stimulates the growth and maturation of follicles in the ovaries that contain eggs and promotes the production of estrogen. Elevated FSH levels may signal decreased ovarian reserve or menopause.

Luteinizing hormone (LH)

LH, luteinizing hormone, stimulates the release of a mature egg from the follicle (ovulation) and subsequently promotes the formation of the corpus luteum, which produces progesterone. It helps determine whether ovulation has occurred (LH "peak" before ovulation). It aids in the diagnosis of polycystic ovary syndrome (PCOS) or premature ovarian failure.

Prolactin

Prolactin is tested to diagnose hormonal disorders such as hyperprolactinemia, which can cause irregular menstrual cycles, infertility, galactorrhea (non-physiological milk secretion), or signal the presence of a pituitary tumor (prolactinoma). The test also helps monitor the effectiveness of treatment and detect other conditions associated with hormonal imbalance.

AMH

AMH, anti-Müllerian hormone, is measured to assess ovarian reserve and reproductive capacity, diagnose polycystic ovary syndrome (PCOS), or as part of preparation for assisted reproduction. The sample collection is not dependent on the phase of the menstrual cycle.

DHEA-S

DHEA-S, dehydroepiandrosterone sulfate, provides information about adrenal gland function and androgen production. It helps in the differential diagnosis of hormonal disorders and causes of androgenic manifestations. Evaluation of excessive androgen production (e.g., hirsutism, acne, alopecia). Diagnosis of rarer disorders such as adrenal hyperplasia, Cushing's syndrome, or adrenal tumors.

Testosterone

Testosterone also plays an important role in women in regulating libido and sexual function. It contributes to maintaining the healthy hormonal balance necessary for ovulation and fertility. Optimal testosterone levels contribute to vitality, cognitive function, and emotional stability. Testosterone deficiency is associated with decreased libido, muscle strength, fatigue, and an increased risk of osteoporosis.

SHBG

SHBG, sex hormone-binding globulin, is a transport protein that binds sex hormones (testosterone and estrogens) and regulates their bioavailability.

fTST

fTST, free testosterone, refers to the fraction of testosterone in the blood that is not bound to proteins such as SHBG (sex hormone binding globulin) or albumin. This free form of testosterone is biologically active.

FAI

FAI (free androgen index) is calculated as the ratio of total testosterone (TST) to SHBG (sex hormone binding globulin) in the blood and is an indicator of the level of free androgens (especially free testosterone) in the blood. Elevated FAI may indicate excessive androgen activity, while low values indicate low testosterone availability.

Thyroid-stimulating hormone (TSH)

TSH, thyrotropin, regulates the production of thyroxine (T4) and triiodothyronine (T3) hormones. The test helps detect thyroid disorders at an early stage and provides information for further diagnostic and therapeutic decisions. The sample should be taken in the morning on an empty stomach.

ft4

fT4, the active form of thyroxine, affects metabolism, growth, and energy expenditure. The test provides accurate information about thyroid function and, together with TSH, is key to the diagnosis and monitoring of thyroid disorders. The sample should be taken in the morning on an empty stomach.