Recommended dosing should get you to adequate levels that will both relieve your symptoms and give you protective health benefits. If you are not getting relief with a certain type or dosage of HRT it is of more value to adjust this than to check your hormone levels.

Following your hormone levels via blood (or saliva) tests while taking HRT is generally not necessary if you are taking pharma regulated HRT.

The only circumstance in which checking hormone levels may be of value is if you are on custom-compounded non-pharma controlled hormone replacement therapy (i.e. Hormones that are not tested and approved by official authorities) and this is mostly to be sure that you are not getting excessive amounts of hormones)

What is most important is how you feel and how your symptoms are responding to a particular dose of HRT.

“Why don’t test results mean anything? Surely we need to know the levels?”

We know this is frustrating and we often want a clear answer in front of us in black and white, but the best course of action is to listen to your body and track any symptoms. If you are noticing symptoms do see your provider with tracking information - they can then adjust your HRT as needed.

Measuring levels can be inaccurate and often misleading. What is most important is how you feel and how your symptoms are responding to a particular dose of HRT. There really is no “standard” for hormone levels. an individual’s levels change throughout the course of a day and can be different day-to-day. Again, it's more about how you feel than any number or level.

“Testing hormone levels is not required to determine whether a woman has the “right amount” of hormones. The optimal hormone levels in postmenopausal women have not been established. How symptoms respond to a particular dose of hormones or non-hormonal menopause medication is the only reliable guide.

Saliva testing is often a part of custom-compounded “bioidentical hormone therapy” with hormones. But saliva testing is not only unnecessary; it has also not been proven to be accurate or reliable. Because hormone levels vary day to day as well as throughout the day, even a blood test cannot accurately reflect the body’s hormone levels.

The common hormone test that may be appropriate is for the level of follicle-stimulating hormone (FSH) to help determine if a woman is in menopause, especially for women who do not have a uterus and thus cannot tell by their menstrual pattern that they are menopausal*.

NAMS does not recommend saliva testing to determine hormone levels and does not recommend custom-compounded products over well-tested, government-approved products for the majority of women”

* This would not be applicable for those in surgical menopause as you become post-menopausal straight after surgery.

Visit for lots of evidence-based information and resources for those considering, going through or recovering from surgery for PMDD/PME.

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