Hormones help to regulate almost all of the body’s processes, including reproductive health and fertility. Testing your hormones regularly can give you insights into your overall health and help you track changes in your menstrual cycle and fertility over time. Here we’ve broken down which hormones you should test and why. 

Quick facts:

• Hormones are chemical messengers which make up the endocrine system.
• Sex hormones are involved in the regulation of the menstrual cycle, ovulation and overall health. 
• Which hormones you need to test depends on your individual health history, symptoms and fertility goals. 
• Get started with our Online Health Assessment which will recommend a hormone panel personalised to you.

What are hormones?

Put simply, hormones are small chemical messengers that travel through the blood to different parts of your body. They help control many different functions from growth and development to metabolism, the menstrual cycles, fertility and mood, just to name a few.

Hormones are made by special cells in the endocrine system. Some of the major endocrine glands are:

• The pituitary gland and hypothalamus, found in the brain
• The thyroid at the front of your neck
• The adrenal glands on top of the kidneys and pancreas 
• Sex organs, also known as the testes and ovaries

Why are sex hormones important?

Sex hormones are a group of hormones that help to regulate the female and male reproductive organs and fertility. They are important not only for reproductive health but for overall health too—often having multiple functions within the body. 

The main hormones involved in the female reproductive system are: 

• Oestrogen
• Progesterone
• Follicle-stimulating hormone (FSH)
• Luteinising hormone (LH)
• Anti-Müllerian hormone (AMH)
• Prolactin 
• Androgen hormones such as testosterone

Thyroid hormones can also impact your levels of reproductive hormones.

Why do you need to test your hormones?

Hormones are often involved in complex feedback loops with one another. This means if one hormone gets off balance, it can often disrupt the whole system and bring about multiple, often overlapping symptoms. 

Our hormones are also changing constantly, as we age and in response to things like lifestyle factors, medications or external stresses.

A change in your hormone levels could be the reason you’re feeling sluggish or slightly emotional, explain your irregular periods or why you’re struggling to get pregnant.

Our hormone levels can give us insight into both our overall reproductive health, show our risk factors for certain conditions, explain any unwanted symptoms, or indicate the health of our ovarian reserve and fertility. 

Which hormones should I test?

Which hormones you need to test and monitor will depend on your individual medical history, symptoms, biometrics and fertility goals. Luckily, our Online Health Assessment is built on a proprietary algorithm that does the leg work for you, recommending you hormone panel personalised to you. 

Let’s take a look at each of the main female sex hormones and what testing them could tell you. 

Follicle-stimulating hormone

One of the main hormones that regulate the menstrual cycle and fertility is follicle-stimulating hormone (FSH). Its main job is to stimulate your ovaries each month to mature a set of follicles (the sacs that house the immature eggs) into mature eggs. 

If FSH gets out of balance, ovulation can be affected, negatively impacting fertility and causing irregular cycles. 

FSH levels increase with age. High FSH is usually an indication that ovarian reserver is declining and more FSH is needed to encourage your eggs to grow. This is why monitoring FSH can help you understand the health of your ovaries. 

FSH levels will slowly increase with age as your ovarian reserve declines. When your ovarian reserve is finally depleted (and menopause occurs), FSH levels become substantially elevated. This is why FSH is used as an indicator of menopause. 

Persistently high FSH levels in someone younger than 40, along with irregular periods and vasomotor symptoms, could indicate premature ovarian insufficiency (POI). This is when someone experiences menopause before the age of 40.

FSH levels are usually not recommended as an indicator of menopause beyond the age of 45.

Oestrogen (Oestradiol)

Oestrogen is an important hormone for the growth and maturation of eggs and the thickening of the uterus lining each cycle. It’s also incredibly important for overall health, regulating bone, heart, skin and hair health, as well as mood. 

Oestrogen is made by the ovaries, so monitoring oestrogen levels gives a good indication of how well your ovaries, and menstrual cycle in general, are functioning.

Oestrogen levels will fluctuate and eventually significantly drop when your ovarian reserve becomes depleted and menopause occurs. Low oestrogen levels are therefore linked with many symptoms of menopause, such as dry skin and hair, vaginal dryness, hot flushes, brain fog, night sweats, difficulty falling asleep and fatigue. 

Luteinising hormone (LH)

LH is the hormone responsible for triggering ovulation, which is the release of the mature egg from an ovary each month. 

If your LH levels are too low or too high, it can interfere with ovulation. High LH levels are often seen in those with polycystic ovary syndrome (PCOS), which can cause irregular ovulation and issues with periods and fertility.

Anti-Müllerian hormone (AMH)

Anti-Müllerian Hormone (AMH)  is a super important hormone for fertility and overall reproductive health. AMH is made by the small sacs, called follicles, in your ovaries. These follicles house your eggs. 

Since AMH is made by the follicles, your AMH levels can therefore give you an insight into your ovarian reserve, or how many eggs you have at the time of testing. 

We were all born with all of the eggs we’ll ever have, and as we age, both our egg quality and quantity decline. Generally, our AMH levels will decline with age as our egg count diminishes, unless we have an underlying condition or lifestyle factor which is affecting our AMH levels (like PCOS). 

High AMH levels can be an indicator of polycystic ovaries and can be used to diagnose PCOS based on recently updated clinical guidelines.

On the other hand, low AMH along with high FSH and low oestrogen is usually an indicator of low ovarian reserve. 

AMH is often also used to predict someone’s chances of success during fertility treatment, such as egg freezing and IVF. However, it’s important to remember that AMH can only tell you about the quantity, and not the quality, of your eggs.

Testosterone

Testosterone can be converted to produce the wonder hormone oestrogen and is also associated with libido, maintaining muscle mass, vaginal health, breast health and bone health. 

High levels of testosterone can cause symptoms such as excess body and facial hair, acne, and irregular or absent periods. These symptoms are often seen in women with PCOS which can cause high testosterone. Low levels of testosterone may be seen after menopause and it can affect mood and libido.

Prolactin

Prolactin is most commonly associated with stimulating breast milk production after childbirth and naturally, levels are low in someone who is not lactating. 

However, when prolactin levels are too high (also known as hyperprolactinemia), due to stress, for example, it can stop the production of FSH and LH, affecting ovulation and leading to irregular or absent periods. 

One of the most common symptoms to look out for are milky white discharge from the nipples, headaches or migraines, irregular periods, visual disturbances and nausea or vomiting. 

Sex hormone binding-globulin (SHBG)

Sex hormone-binding globulin (SHBG) is a protein which binds to (and therefore regulates) androgen hormones, like testosterone.  

As a result, high levels of SHBG may lead to a reduction of androgen hormones such as testosterone. This is why contraception, like the combined oral contraceptive pill, is prescribed to help symptoms associated with high testosterone, since it increases SHBG levels.

On the other hand, some conditions like PCOS can cause a decrease in SHBG levels leading to an increase in testosterone levels causing hyperandrogenism. This condition refers to an excess of androgens and can lead to symptoms such as oily skin, acne and excessive hair.

Thyroid hormones 

Thyroid-stimulating hormone (TSH) is produced by the pituitary gland in the brain. It controls your thyroid health by telling your thyroid gland to produce the hormone Thyroxine (T4) which is eventually converted to Triiodothyronine (T3). 

These three hormones play a vital role in many important functions in your body such as your fertility, metabolism, heart function, nervous system and mood. 

If your TSH levels are too low or too high, it suggests too much or too little thyroid hormone is being produced. This can prevent ovulation, making your periods irregular or stopping them together. 

Low TSH and high T4 levels are a sign that your thyroid is overactive, a condition called hyperthyroidism. Common symptoms can include feeling irritable and anxious, feeling tired and being sensitive to warm temperatures. 

On the other hand, high TSH and low T4 levels indicate that your thyroid is underactive, a condition called hypothyroidism. Some commonly experienced symptoms are feeling very cold, struggling with weight gain and excessive fatigue.

How often should I test my hormones? 

Regular testing is a good way to see how your hormone levels change over time. This is why we recommend retesting once every 12 months and once every 6 months if you’re older than 35 or have an underlying condition which may affect your fertility. 

It could also help you understand how your lifestyle changes or medications might be affecting your symptoms so you can manage them more effectively.

How can I test my hormones? 

Proactively keeping tabs on your hormones in the traditional healthcare system is expensive, convoluted and confusing. That’s why we started Hertility—to make checking in on hormones and fertility accessible to as many people as possible. 
Get started by filling out our Online Health Assessment today.

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• Al-Chalabi, M, Bass, AN and Alsalman, I. Physiology, Prolactin.  StatPearls. Treasure Island (FL)2021.
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• Hyperprolactinaemia
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