Dr. Tabatha Barber explains which hormone tests to order and when. Get estrogen, FSH, testosterone, and SHBG on cycle day 3 or 10 to check ovarian function. Test progesterone on day 21 to confirm you ovulated. SHBG matters because it determines how much hormone is actually available to your body.
Testing hormone levels. Because even if your doctor tells you you can't, or there's no point in it, or they don't know how to interpret it, that's just not the case. Conventionally, we would do blood work to check your hormone levels and drawing your blood, say cycles day three or 10, you can get a good idea. If you made enough estrogen or too much estrogen, it can tell you your FSH level, which is follicle stimulating hormone. That's coming from your brain, talking to your ovaries and telling your ovaries how much estrogen to make. Follicle stimulating hormone is sometimes checked to see if you're going into menopause. Because as your body starts to no longer make as much estrogen, the FSH levels increase because your brain and your ovaries are always talking. And if your ovary isn't responding to what the brain says, the brain says make more estrogen, the ovary doesn't make more estrogen. Then the brain starts screaming, it starts saying it louder and louder. By producing more and more fsh, this FSH level gets higher when your ovaries are no longer producing enough estrogen. That's why FSH is elevated in menopause. It's also elevated premature ovarian insufficiency and diminished ovarian reserve. When you're dealing with fertility issues, checking those levels on cycles day three or 10 can be very beneficial. On cycle day 21, if you're having a normal 28 day period, we can measure your progesterone level, because your progesterone level will start to increase during the luteal phase. If you have ovulated, progesterone is actually produced in the ovary from the little cyst that released the egg and let you ovulate. So that corpus luteum, that cyst releases the progesterone and that level can get measured on day 21. So we can measure how much your body makes of a certain hormone. We can also measure free and total testosterone and sex hormone binding globulin. Sex hormone binding globulin is what transports your hormones around your body so that you can send those signals. So I like to think of sex hormone binding globulin is like a bus. The hormones get on the bus, they ride the bus around to different places and then the bus drops the hormones off to do their work and send their signals. But sometimes the bus is really big. And so a lot of hormones get on the bus and nobody gets off. Sometimes the bus is really small. And none of the hormones can get on and go to where they need to go. And so your sex hormone binding globulin level is important to know. If are your hormones all stuck and bound to this globulin, or are they free and available to send signals? And so that can impact whether or not the level of hormones you do have is actually able to do its job. So that's an important piece as well.
