“Should I get my hormones tested”?

Published May 22, 2026

Written by Dr. Whitney Ypya, DNP

If you're a woman in your 40s or 50s dealing with mood swings, anxiety, trouble sleeping, or hot flashes, you've probably seen ads or social media posts telling you to "get your hormones checked." Maybe a friend went to a hormone clinic and swears by it. Maybe you've been told that a simple blood or saliva test can tell you exactly what's going on and what you need. So, should you get your hormones tested? The short answer, according to almost every major medical organization that has weighed in on this topic: probably not.

Let me explain why.

Your body already tells you what's happening. Menopause isn't some mysterious condition that requires a lab test to diagnose. If you're in your mid-40s to early 50s and your periods are becoming irregular, and you're experiencing symptoms like hot flashes, night sweats, mood changes, or sleep problems, then wham bam thank you ma'am we got menopause. Your physician/nurse practitioner/physician's assistant doesn't need a blood test to confirm what your body is already telling you. The American Board of Internal Medicine Foundation actually lists FSH testing during this stage of life as something doctors should not do. It's part of their "Choosing Wisely" campaign, which is basically a list of tests and procedures that are commonly done but aren't really helpful.

Why don't the tests work? Here's the thing about hormones during perimenopause, they are all over the place. Estrogen and FSH (follicle stimulating hormone) fluctuate wildly from day to day or week to week. A single blood draw is like taking a snapshot of a roller coaster. It tells you where things were at that exact second, but it doesn't tell you the whole story. FSH levels don't settle into a stable "postmenopausal" range for years after your last period. By that point, you already know you've gone through menopause because you haven't had a period in over a year.

What about saliva tests? Some clinics offer saliva testing and claim it can be used to create a "personalized" hormone plan just for you. Which sounds great, but the American College of Obstetricians and Gynecologists (ACOG) has been very clear on this. Saliva testing does not accurately measure hormone levels. Estrogen levels in saliva are extremely low and hard to measure reliably. There are currently no FDA-approved saliva or urine tests for measuring hormone levels.

So how does your physician, nurse practitioner, or physician's assistant decide if you need hormone therapy?

The answer is simpler than you might think. We listen to you. The goal of hormone therapy is to relieve your symptoms. If you're having bothersome hot flashes, night sweats, or vaginal dryness, your prescriber may recommend hormone therapy and then adjust the dose based on how you feel. That's it. That's all. That'll do babe. The North American Menopause Society, ACOG, and the European Society of Endocrinology all made similar recommendations. Treatment should be individualized based on your symptoms, history, and your personal preferences.

When IS hormone testing actually useful?

There are a few specific situations where testing makes sense:

If you're under 40 and your periods have stopped or become very irregular, testing can help determine if you're experiencing premature ovarian insufficiency.

If you're trying to get pregnant and having difficulty, hormone testing is part of a standard fertility workup.

If your doctor isn't sure whether your symptoms are from menopause or something else entirely (like a thyroid problem), targeted testing can help sort that out. But for the typical woman in her mid-40s to 50s with classic symptoms? Testing adds cost without changing what we would recommend.

A word about hormone clinics You may have noticed clinics popping up that specialize in "hormone optimization." Many of these clinics use hormone panels to justify prescribing compounded hormone preparations. These are mystery custom-mixed products that are not regulated or approved by the FDA. ACOG has warned that these compounded products may have inconsistent potency, meaning you could be getting too much or too little of a hormone with no way to know for sure. FDA-approved hormone therapy options already exist. These include bioidentical estrogen patches and micronized progesterone. These have been tested for safety, effectiveness, and consistent dosing. If hormone therapy is right for you, there are well-studied and reliable options available.

So how do we treat these hormonal changes in a safe evidenced based manner?

We screen for mood, anxiety, and sleep symptoms using validated tools

We prescribe medications like SSRIs and SNRIs that are shown to help with both mood symptoms and hot flashes

Provide non-medication related treatments like cognitive behavioral therapy (CBT), which research shows is effective for menopausal depression, anxiety, and even hot flashes.

We collaborate with your OB/GYN or primary care provider if hormone therapy is appropriate for your vasomotor symptoms. If your symptoms are affecting your quality of life, there are effective, well-studied treatments available. And the first step needs to be a conversation, not a lab draw.

You deserve care that is honest and evidence based. If someone is telling you that you need a panel of hormone tests before they can help you, it's worth asking if those labs will actually change your treatment plan.

-Dr. Whitney Ypya, Psychiatric Nurse Practitioner

Whitney Ypya is a board-certified psychiatric nurse practitioner, University of Illinois faculty member, and founder of Luna Integrative Psychiatry, PLLC- a women focused private practice located in Champaign, IL. Learn more at lunapsychnp.net

*The information in Full Circle is for educational purposes only and does not constitute medical advice or establish a provider-patient relationship. I deeply respect the expertise of physicians and believe the best care happens when disciplines work together. I am an independent board-certified psychiatric nurse practitioner with a doctorate degree. If you have questions about your own health, please consult your provider.

If you or someone you know is experiencing a mental health emergency, please reach out by either calling the Mental Health Hotline 988, calling 911, or going to the nearest emergency department