During the perimenopausal years symptoms vary greatly from one woman to another and will typically ebb and flow during the years. Given these fluctuations and vast difference in symptoms it may be recommended to pursue testing in order to determine which hormones are out of balance. Periodic testing helps to monitor treatment and determine if treatments like bioidentical hormones are appropriate.
Serum– this is the simplest, least expensive, and most commonly utilized testing. We use Lifelabs in BC and while testing is covered under MSP if you have it ordered by your GP it is an out of pocket expense to patients seeking naturopathic care. Often we will do thyroid testing (TSH, Free T4 and Free T3), FSH and LH to determine if the woman is in perimenopause or menopause, Day 3 Estradiol and Day 21 Progesterone for cycling females, and perhaps other tests like liver enzymes (AST, ALT, GGT), Cholesterol, and fasting Glucose.
Saliva – traditionally Saliva testing has been utilized to test cortisol and dhea (to measure adrenal function), progesterone, estrone, estradiole, estriole, LH, FSH, and testosterone. It is easy to collect samples at home and typically is a one day saliva collection.
Dried Urine – In recent years this has become the ‘gold standard’ of comprehensive hormone testing as it is easy to collect the dried urine samples at home, the testing items covered are very comprehensive and the results extremely detailed. In addition to testing the 3 estrogens (estrone, estradiole, estriol), progesterone, testosterone, DHEA, cortisol, cortisone, most DUTCH (Dried Urine Test for Comprehensive Hormones) tests also include markers for vitamin levels (B12, B6, glutathione), oxidative stress, and organic acids. It may be recommended for patients with a strong family history of cancer, women wanting to try bioidentical hormones, or those who have more involved and prolonged symptoms during perimenopause.
Naturopathic doctors at Sage Clinic have access to all these lab testing options and will advise based on the patient’s complexity of symptoms, family history and personal health history.