Suggested Labs for Hormone Health
A List to Bring to Your Next Appointment
These are the labs our pharmacists suggest discussing with your prescriber, in addition to whatever your provider already recommends — a practical list to help you get more out of your next appointment.
The Labs
Hormones
Estradiol (sensitive or ultra-sensitive, if available)
The main estrogen during the reproductive years. Sensitive assays measure low levels more precisely, which matters around and after menopause.
Progesterone
A hormone made mainly after ovulation. Levels often fall as ovulation becomes less regular in perimenopause.
Estrone
The main estrogen after menopause, made largely in fat tissue.
Free testosterone
The portion of testosterone that is not bound to proteins in the blood.
DHEA-S
A hormone made mostly by the adrenal glands, which the body can convert into other hormones.
SHBG
Sex hormone binding globulin, a protein that binds testosterone and estradiol and affects how much of each is free.
FSH (follicle-stimulating hormone)
A pituitary hormone that prompts the ovaries to develop follicles. Levels often rise and swing more widely as ovarian function changes in perimenopause.
LH (luteinizing hormone)
A pituitary hormone whose mid-cycle surge triggers ovulation.
Thyroid
TSH
The pituitary hormone that signals the thyroid, and the most common thyroid screening test.
Free T4
The main hormone the thyroid releases, in its unbound form.
Free T3
The active form of thyroid hormone, in its unbound form.
Reverse T3
An inactive form of T3.
TPO antibodies
Antibodies against thyroid peroxidase, a marker of autoimmune thyroid conditions.
Nutrients and Metabolism
25-hydroxy vitamin D
The standard measure of your vitamin D status.
Vitamin B12
A vitamin needed for healthy nerves and red blood cells.
Ferritin
The protein your body uses to store iron. Read about low ferritin and hair loss
Fasting insulin
Your insulin level after fasting, one way to look at how your body handles sugar.
Optional Tests to Consider
Body composition scan
Measures the ratio of fat mass to fat-free mass (muscle, bone, water and organs), so you can see whether you are gaining or losing in the right places. One local option in Johnson City: DexaFit
DEXA scan
Measures bone mineral density.
ApoB (apolipoprotein B)
A blood test that counts the particles that carry cholesterol, such as LDL. Many clinicians consider it a more informative measure of cardiovascular risk than a standard cholesterol panel.
hs-CRP
A blood test designed to find low-grade, long-term inflammation.
How to Use This List
Bring it to your next appointment and ask which of these make sense for you. Your prescriber decides which labs to order and when, and interprets the results alongside your history and symptoms.
Your prescriber reads your results against your lab's reference ranges and your history, and decides what is optimal for you. For more on how testing fits into hormone therapy, see our hormone replacement therapy page.
Why Timing Matters in Pre- and Perimenopause
Before menopause, estrogen and progesterone rise and fall across every menstrual cycle, so the same test can read very differently depending on the day it is drawn. In perimenopause those swings become less predictable: cycles can get shorter or longer, and ovulation does not happen every month.
That is why your prescriber may ask you to test at a particular point in your cycle — often early in the cycle for estradiol, FSH and LH, and about a week after ovulation for progesterone — and may repeat a test rather than rely on a single result. FSH and LH are the signals from the pituitary gland that drive the cycle.
Hormone Changes Across a Typical Menstrual Cycle
Hover or tap the chart to see where each hormone is on a given day.
Illustrative only, based on published day-by-day reference data. Each hormone is drawn relative to its own peak, so the lines show timing, not how the hormones compare with one another; testosterone changes far less across the cycle than the others. Shown for a typical 28-day cycle; real cycles vary, especially in perimenopause.
Sources
- The Normal Menstrual Cycle and the Control of Ovulation. Endotext, NCBI Bookshelf.
- Stricker R, et al. Establishment of detailed reference values for luteinizing hormone, follicle stimulating hormone, estradiol, and progesterone during different phases of the menstrual cycle. Clin Chem Lab Med. 2006;44(7):883–887.
- Reference ranges for estradiol, progesterone, luteinizing hormone and follicle-stimulating hormone during the menstrual cycle. WikiJournal of Medicine (day-by-day curves based on Stricker 2006).
- Rothman MS, et al. Reexamination of testosterone, dihydrotestosterone, estradiol and estrone levels across the menstrual cycle and in postmenopausal women measured by liquid chromatography–tandem mass spectrometry. Steroids. 2011;76:177–182.
- Bui HN, et al. Dynamics of serum testosterone during the menstrual cycle evaluated by daily measurements with an ID-LC-MS/MS method and a 2nd generation automated immunoassay. Steroids. 2013;78:96–101.
- World Health Organization. Guideline for the prevention, diagnosis and treatment of infertility: Diagnosis of infertility. NCBI Bookshelf.
View as a table
| Phase | Estradiol | Progesterone | Testosterone | FSH | LH |
|---|---|---|---|---|---|
| Period (early follicular) | Low | Low | At its usual level | Moderate, rising slightly | Low |
| Late follicular | Rising to its peak | Low | Rising | Falling | Starting to rise |
| Ovulation | Falling from its peak | Starting to rise | At its peak | Brief surge | Surge (peak) |
| Mid-luteal | A second, smaller rise | At its peak | Slightly raised | Low | Low |
| Late luteal | Falling | Falling | Back to its usual level | Starting to rise | Low |
After menopause, cycles stop and these patterns level off. If you use hormone therapy, your prescriber may also ask you to test at a set time relative to when you apply or take it.
Where We Fit
Once your prescriber decides on hormone therapy, we compound it to their order, in the strength they specify. For hormone therapy we prepare hypoallergenic creams, an olive oil base topical and vaginal preparations, with oral capsules for progesterone and DHEA.
Everything is made to order at our PCAB-accredited pharmacy in Johnson City, Tennessee, and a pharmacist reviews the formulation before it is made. We have a 48-hour compounding time on most preparations; shipping time is additional. We are licensed in all 50 states and the District of Columbia.
More on what we prepare is on our women's health page. Already have a prescription? You can transfer it to us.
Call 423-975-0597 for current pricing and shipping options for your state.
Frequently Asked Questions
Why these labs?
Together they cover hormones, thyroid function, key nutrients and metabolic markers that often come up in midlife women's health. They are suggested in addition to what your provider already recommends.
Do I need all of them?
Your prescriber decides which tests make sense for you, and when to run them.
What should my results be?
Your prescriber reads your results in the context of your history and symptoms, and decides what is optimal for you.
Can ProCompounding order these labs for me?
Lab work is ordered and interpreted by your prescriber. Bring this list to your next appointment. We do not prescribe; we prepare the hormone therapy your prescriber orders.
Should I change my hormone therapy based on a result?
Share your results with your prescriber first. If they adjust your prescription, send us the new one and we will prepare it to match.
Can you ship to my state?
We are licensed in all 50 states and the District of Columbia, and we ship from our pharmacy in Johnson City, Tennessee.
Talk With Your Prescriber
A Better Conversation Starts With the Right Questions
Take this list to your next appointment. When your prescriber is ready, they can send a prescription to us — our details are on our prescriber page.