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    fertility basics

    All You Need to Know About Hormone Blood Tests

    • 11495 views
    • 4.5   (1 Votes)
    Medically Reviewed by Dr. Deepika Tiwari - MS, MBBS on 11 Jun 2019 - Written by Dr. Jyoti Bhaskar - PGDMLS, MRCOG, MBBS - Grammatically Approved by Dr. Kavita Jaggi Agrawal - MS, MBBS

    Hormone blood tests are done to check for the progesterone, estrogen, and testosterone hormone levels. The cause of hormone imbalance in the body can be detected by these tests. Female hormone panel blood test includes hormone testing levels of Estradiol, Estrogen, Lipid, CBC and other tests.

    The process of testing hormone levels is medically multifaceted and the question of which testing method is advanced over another is highly-debated. It is considered to be the best step towards better health. Testing hormone levels is a good idea for an improved working of the human body. Hormone blood testing is particularly essential while using bio-identical (natural) hormone therapy. It is used in natural hormone therapy in order to avoid imbalances that may not be seen even if the symptoms in patients are tracked over time. This may lead to adverse symptoms or conditions with long term hormone use. Testing of hormones can prove to be helpful in providing information about the hormonal status of the patient. It can also help to guide the respective health care professional in choosing the most appropriate hormone therapy based on the unique medical conditions of the patient. There are numerous types of tests for a doctor to choose from in order to detect the particular cause for hormonal imbalance. Patient symptoms will surely assist the doctor in the right direction. A blood test is considered to be the most common and effective methods to conduct hormone tests. A hormone blood test is performed to detect estrogen, cortisol, testosterone, and thyroid levels in the human body. A simple saliva test can help in detecting several types of hormones as well. With these tests, doctors can look at the patients’ estradiol, progesterone, and testosterone levels. In cases where there is an issue with a specific gland in the body, an ultrasound scan can prove to be a great option and is often recommended by the doctor. This generally happens in the case of thoroughly testing the ovaries, pituitary gland, testicles, uterus, and thyroid in the concerned individual. Depending on the results of these medical tests, certain additional tests may be recommended by the doctor in order to obtain a better diagnosis of the current status of the patients.

    This article gives detailed information about:

    1. What is a hormone?

    Hormones are chemical substances signaling molecules produced by the endocrine glands in multicellular organisms. These chemical substances are transported by the circulatory system to target distant organs to regulate physiology and functioning of the concerned organs. (1)Hormones travel to different parts of the body where they help in controlling the working of organs and cells. For instance, insulin hormone is made by the beta cells in the pancreas. (2)They are responsible for controlling a variety of functions like common basic needs like hunger to complex systems such as reproduction, and even the mood and emotions. Understanding these major hormones and their role in the body will help patients bring effective changes in their lifestyle in order to improve their health. (3)

    What is a hormone

    Hormones are those impactful messengers of the body that work slowly, over time, and affect several different processes, including:

    • Reproduction: Reproduction is a dynamic biological process in which two kinds of reproductive cells are involved. These cells are also popularly known as gametes. It is a fundamental part of the functioning of the body. Sperm, the male gamete and egg or ovum, the female gamete meet and combine in the woman’s reproductive system of a woman which leads to pregnancy.
    • Growth and development:Human development is a lifelong process of physical, cognitive, behavioral, and emotional growth and change. During the early stages of life—from babyhood to childhood, childhood to adolescence, and adolescence to adulthood—tremendous changes take place.(4)
    • Sexual function:Sexual function is the manner in which the body reacts in various stages of the sexual response cycle, or even in cases where the male individual faces sexual dysfunction. The different aspects of sexual function defined as being relevant to the assessment include erection, sexual desire, ejaculation, and orgasm.
    • Metabolism:Metabolism is the procedure by which the human body converts the items they eat and drink into energy. It is a set of life-sustaining chemical processes in organisms. During this complex biochemical process, calories in food and beverages are combined with oxygen to release the energy for the proper functioning of the body.
    • Mood:Mood is considered to be an emotional state in psychology. Moods are usually defined as emotional changes which can be seen in an individual based on certain life or health situations.

    In all these cases, a comprehensive hormone blood test is performed to find out a detailed understanding of the hormones impacting menstrual cycle and fertility levels of a woman.(5)

    2. What is hormone imbalance?

    Hormone blood tests are beneficial and trustworthy ways to examine and evaluate the possible reasons for hormonal imbalance in the body. These tests are performed when hormones in the body are not produced properly and this leads to a deficiency of the respective hormone. Hormones get out of balance due to two obvious reasons. Sometimes there is a deficiency observed in the given hormone and there are times when there is a steep rise in hormonal levels in the body. The hormone blood test results play a vital role in determining suitable treatment for each of the patients undergoing the suggested medical tests. Due to the variations in the functionalities of hormones, it is challenging to find a single way to detect any related medical condition for chromosomal abnormality. This is one of the reasons why a patient’s best bet is to get his or her hormone blood test done without thinking a lot over the same. Hormonal imbalance in women include the changes in progesterone, estrogen, and other hormone levels. Hormones are produced in the endocrine glands serving as messengers. They are also responsible for coordinating and controlling functioning throughout the body. Hormonal balance is very crucial for pregnancy, carrying a baby to pregnancy term, and having a successful healthy baby delivery. (6)

    What Is Hormone Imbalance

    Hormones are the powerful chemicals which travel around the bloodstream informing and guiding tissues and organs their respective function. They help control certain crucial processes of the body, including the proper working of metabolism and reproduction. When someone has a hormonal imbalance, they have too much or too little of a certain specific hormone. Women undergo several periods of hormonal imbalance during their lifetime. Most importantly, these transitions are observed by a woman during puberty, menstruation, pregnancy, and at the time of menopause. Even a little shift in the working of hormones can have substantial effects throughout the system of the human body. Some hormone levels fluctuate throughout the lifetime of humans and can be the result of natural aging. Other changes in hormone levels occur when their endocrine glands get the working system wrong. Women may experience hormone imbalances in cortisol, insulin, androgens, and thyroxine levels. Depending on a patient’s unique symptoms and medical conditions, the doctor will suggest the appropriate hormone imbalance test. Hormone blood tests are done to effectively detect estrogen, testosterone, insulin, progesterone, thyroxin, cortisol, and TTH levels in the blood. A pelvic exam is performed to check for any cysts or lumps present in the respective patient. (7)

    Symptoms of a hormone imbalance specific to women include:

    • Heavy or irregular periods, including missed periods, absent period, or frequent period
    • Hirsutism, or excessive growth of hair on the face, chin, or other parts of the body
    • Acne on face, chest, or upper back
    • Thinning hair or hair loss
    • Sudden weight gain or trouble losing weight
    • Darkening of skin, especially along neck creases, underneath breasts, in the groin, and skin tags
    • Vaginal dryness
    • Vaginal atrophy
    • Pain during sex
    • Night Sweats

    3. Causes of hormonal imbalance:

    The possible causes of hormonal imbalance are:

    • Hyperfunctioning Thyroid Nodules
    • Hormone Therapy
    • Tumors (Benign or Cancerous)
    • Congenital Adrenal Hyperplasia
    • Unhealthy eating habits
    • Medications
    • Stress
    • Adrenal Insufficiency
    • Pituitary Tumor
    • Injury or Trauma
    • Cancer Treatments
    • Diabetes
    • Hypothyroidism, Or Underactive Thyroid
    • Hyperthyroidism, Or Overactive Thyroid
    • Hypogonadism
    • Cushing Syndrome
    • Thyroiditis

    4. Significance of hormones in Fertility

    Hormones help in controlling each of the crucial functions in the human body from their appetites to their moods to their fertility. When humans experience a sudden drastic difference in their appetite or moods, it’s easy to determine something is wrong in their system. However, changes in fertility levels are difficult to track unless women know the physical signs they’re looking for. There are four major hormones which are responsible for a successful pregnancy: estrogen, progesterone, Luteinizing Hormone (LH), and Follicle Stimulating Hormone (FSH). An imbalance of even one of these hormones will bring the rhythm of systematic reproduction off-track and this won’t allow the pregnancy to happen. Hormones play an important role when it comes to fertility levels in women. High levels of Follicle-Stimulating Hormone (FSH) in a woman’s body could minimize the chances of conceiving in such women. Abnormal levels of estradiol, which is an important form of estrogen, decreases chances of In Vitro Fertilization (IVF) success. Insufficient levels of Luteinizing Hormone (LH), which stimulates ovaries to release an egg and start producing progesterone, can also be a cause of fertility problems among women. Normal levels of progesterone, which are responsible for preparing the uterus for a fertilized egg arrival, must be present in order to allow a woman to get pregnant.
    Significance of hormones in Fertility
    The clinical definition of female infertility defines it as an inability to conceive a child after 12 months of regular unprotected intercourse. The term 'female infertility' is often used as a general term to describe a situation where a woman is unable to become pregnant. Infertility can be a very stressful and poignant issue for couples. It is important that advice and professional counseling is sought for dealing with the respective case in an effective manner. Some causes of infertility in women are highly treatable with the advent of Assisted Reproductive Technology procedures such as In Vitro Fertilization (IVF) and Intrauterine Insemination (IUI). The most common hormone-related causes of female infertility usually involve the following scenarios:

    • Polycystic Ovarian Syndrome (PCOS):
      PCOS affects between 6-15 percent of women during their reproductive age. PCOS is a common cause of ovulation problems, weight complications, and miscarriages. Once PCOS is recognized and treated, a good percentage of women are successfully able to become pregnant.
    • Low Egg Reserve
      Declining egg production is the primary reason for age-related infertility in women. A low egg reserve can also be caused due to premature ovarian failure.

    5. Role of hormones in Pregnancy:

    Many hormone levels are affected in the body during pregnancy, with various hormones playing significant roles during pregnancy. The hormone blood test panel offers a broad scope of detecting hormone levels in the body. It helps in determining factors related to aging and fertility issues in women. The role of hormones is explained in detail.

    Role of hormones in Pregnancy

    1. Human Chorionic Gonadotropin hormone (hCG): Human Chorionic Gonadotropin (hCG) hormone blood test is performed to detect the hormone hCG in blood or urine. Some hCG tests are performed to measure the exact amount while others may be done to check the presence and existence of the hormone. HCG hormone is produced by the placenta during pregnancy. (8) The test can be used to detect if a woman is pregnant. This hormone is produced only during pregnancy almost exclusively in the placenta. hCG hormone levels which are found in maternal blood and urine rise dramatically during the first trimester. These hormones may also contribute to causing nausea and vomiting often linked with pregnancy as pregnancy symptoms. hCG hormone blood test is usually done between 15 and 20 weeks of pregnancy to detect the levels of three or four substances in a pregnant woman's blood. The triple screen detects hCG, alpha-fetoprotein (AFP), and a type of estrogen (unconjugated estriol, or uE3). (9) The average range of hCG hormone levels in a pregnant woman’s blood is mentioned as follows:
      - Non-pregnant women: less than 10 U/L
      - Borderline pregnancy: 10-25 U/L
      - Positive pregnancy test: more than 25 U/L
       
    2. Human Placental Lactogen (hPL): Human placental lactogen (hPL) hormone test is usually performed for measuring the amount of hPL in the blood. (10) Human placental lactogen (hPL) hormone is produced by the placenta. This hormone is helpful in the process of providing nutrition to the fetus. hPL also plays an important role in stimulating milk glands in the breasts in anticipation of breastfeeding. hPL is present in a woman’s body only during pregnancy, with maternal serum levels increase in relation to the growth of the fetus and placenta. Maximum levels are reached near term and that point of time usually reaches to 5–7 mg/L. Higher levels are noted in women with multiple gestations. Little hPL enters the fetal circulation. Its biological half-life is about 15 minutes. hPL hormone blood test is considered as an important indicator of fetal growth and required well-being. It is one of the reliable sources for determining the growth and development of the fetus.
       
    3. Follicle-stimulating hormone (FSH): Follicle Stimulating Hormone (FSH) is responsible for controlling the menstrual cycle and egg productions in a woman. FSH levels are tested on day 2 or 3 of a woman’s monthly cycle to determine her ovarian function and evaluate egg quality. In general, women with elevated FSH levels found in their blood on day 2 or 3 of the monthly cycle have reduced chances of live birth, as compared to women of the same age. This happens even in cases where IVF and ovulation induction are taken into consideration. Currently, several laboratory methods are used to measure FSH blood levels, and measurement of these levels may vary considerably depending on the laboratory and method used. Therefore, it is difficult to compare blood levels that are measured at different medical laboratories. As women get older, FSH levels increase, until they reach a level of 40 mIU/mL or higher than this during the menopause phase of a woman. Sometimes, increased Follicle Stimulating Hormone (FSH) levels are measured by FSH hormone blood test to confirm the presence of menopause. When a woman's FSH blood level is constantly elevated to 30 mIU/mL or higher, and she did not have a menstrual period for each of the months for a year or more, it is usually accepted by doctors that she has reached menopause. (11)
       
    4. Estrogen: Estrogen hormone is responsible for the growth and development of female sexual characteristics. Normally formed in the ovaries, this hormone is also produced by the placenta during pregnancy to help in maintaining a healthy pregnancy. Estrogen hormone blood test is done to detect any hormonal imbalance in the body. Conditions under which estrogen hormone test is done are abnormal vaginal bleeding, unusual sex organ development, or lack of menstrual periods. In estrogen hormone blood test, a woman’s blood sample is correlated with her monthly cycle. In cases related to pregnancy, the gestational age of the baby is considered as a dominant factor. There are many factors responsible for affecting the test results such as age, sex, and unique medical history. The three types of major naturally occurring estrogen hormones are present in significant quantities in the blood. These are namely Estradiol (E2), Estrone (E1) and Estriol (E3). The expanded female hormone panel blood test includes Total Estrogens, Cortisol A.M., Sex Hormone Binding Globulin, DHEA-s, Progesterone, and Testosterone tests. Estradiol hormone levels are measured in picograms per milliliter (pg/ml). In premenopausal women, normal estradiol levels are 30-400 pg/ml. (12)
       
    5. Progesterone: During pregnancy, progesterone hormone is produced by the ovaries and by the placenta. This hormone stimulates the thickening of the endometrial lining in anticipation of implantation of a fertilized egg. (13)A progesterone hormone blood test helps in measuring the amount of the hormone progesterone present in a blood sample. Progesterone is a female hormone produced by the ovaries when ovulation takes place. Progesterone hormone is largely produced by the corpus luteum until around ten weeks of gestation. When the pregnancy reaches term gestation, progesterone hormone levels range from 100-200 ng/ml and the placenta produces over 250 mg/day.Most of the progesterone hormone which is produced by placenta enters the placenta. This does not happen in the case of estrogen. (14)Progesterone hormone level is measured in nanograms per milliliter (ng/mL). In general, progesterone hormone test results fall in the following ranges: men, postmenopausal women, and women at the starting of their monthly cycle: 1 ng/mL or below. Women in the middle of their monthly cycle: 5 to 20 ng/mL. Pregnant females in their first trimester have a progesterone level of 11.2 to 90 ng/mL.

    Role of hormones in Pregnancy

    Frequently Asked Questions (FAQ's) related to Hormone Blood Test:

    1. How early can a blood test detect pregnancy hormone?
      Pregnancy blood tests are a reliable source to detect pregnancy at much lower ranges of circulating pregnancy hormone in the blood. These tests can, therefore, catch a pregnancy in its very early stages. However, in urine tests, the levels of pregnancy hormone need to be much higher to be detected in a urine or home pregnancy test. Hormone blood tests are considered to have nearly 99 percent accuracy rate and they are almost always accurate.
       
    2. Do you need to fast for a hormone blood test?
      Fasting is needed before commonly ordered tests for glucose (blood sugar) and triglycerides (part of the cholesterol, or lipid, panel) in order to obtain accurate results. The tests which are usually not affected by fasting are measurements of the liver, kidney, blood counts, and thyroid.
       
    3. What does FSH mean in a hormone blood test?
      Follicle Stimulating Hormone (FSH) hormone blood test assists in measuring the level of FSH in blood. It is a hormone released by the pituitary gland, present on the underside of the brain. The FSH test, along with others, is often considered as a great way to check for egg quality to get a complete picture of a woman’s fertility.

    If you have any concerns related to hormone levels or wish to know more about the hormone blood test, Elawoman can help you out. Medical tests play an important role in the effective execution of the required medical treatment. For further information about hormone blood tests or any other information related to infertility or IVF treatments, visit elawoman.com or talk to the best fertility experts at +918929020600.

    Dr. Jyoti Bhaskar

    Written by

    PGDMLS, MRCOG, MBBS, MD
    Obstetrician, Gynecologic Surgeon
    Ghaziabad

    Dr. Jyoti Bhaskar is a gynecologist and obstetrician specializing in IUI, IVF, Hysterectomy, High-risk pregnancy care and Menopausal Care. She completed MBBS and MD in Obstetrics and Gynecology from Lady Hardinge Medical College, Delhi in 1987 and 1993 respectively. Then, she went on to pursue MRCOG from Royal College of Obstetrics and Gynecology in 2009 and PGDLMS from Symbiosis Institute of Medical Sciences in the year 2016. She has also won several awards and recognitions for her work in the field of obstetrics and gynecology. This has helped her to create a mark in the field of obstetrics and gynecology. Dr. Jyoti Bhaskar is presently practicing her expertise at Max Super Speciality Hospital and Dr. Jyoti Bhaskars Clinic, Ghaziabad. For more information, visit elawoman.com

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