Are At-Home Hormone Tests Accurate?

Key Points

• At-home hormone tests are convenient, but not all of them are 100 percent reliable.
• An at-home hormone imbalance test can be an easy way to gain insight into your body, especially if you're having any concerning symptoms.
• Regardless of the results, it's always best to confirm them with your doctor.

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If you're experiencing symptoms indicating hormonal problems, such as irregular or absent periods, difficulty conceiving, or a decreased sex drive, you might consider taking an at-home hormone test.

These tests can be convenient, but they're not all created equal—and they don't replace a doctor's expertise.

Here's a look at how these tests work and what to know before buying one.

What is an at-home hormone test?

At-home hormone tests are women's health tests that allow you to check the levels of certain key hormones without visiting a clinician or doctor's office.

Ovulation and pregnancy tests are the most common types of at-home tests. Most tests only measure one hormone at a time, but you can buy a home hormone panel test that assesses multiple hormones at once.

Why do people get a hormone test at home?

Ordering an at-home hormone imbalance test or ovulation prediction test can be an easy, discreet way to gain insight into your body, said Hana Patel, M.B.B.S., a general practitioner and mental health coach in London. These can particularly appeal to people with difficulty accessing a hormone specialist.

A home ovulation hormone test can be especially valuable for people hoping to conceive, said Jessica K. Lee, M.D., an OB-GYN at the University of Maryland School of Medicine in Baltimore.

People may take at-home tests for other reasons, too, according to Kathryn Rexrode, M.D., the chief of the Division of Women's Health at Brigham and Women's Hospital in Boston and a medical advisor at Lifeforce, health platform that uses at-home blood testing. A few of those reasons include:

• Tracking and understanding their menstrual cycle
• Gaining insight into hormonal changes related to perimenopause or menopause
• Assessing the effectiveness of hormone therapy, such as hormone replacement therapy (HRT) for menopause
• Monitoring hormones as part of maintaining overall health and wellness
• Understanding hormonal imbalances

Why do hormonal imbalances occur?

There's no perfect, one-size-fits-all level of hormones, Jessica Lee said. Everyone's levels vary slightly, and some, such as progesterone and estrogen, naturally fluctuate during a person's menstrual cycle and lifetime.

However, problematic imbalances can, and do, occur.

For instance, estrogen levels can become abnormal during perimenopause and menopause due to some medications (including hormonal contraceptives) and conditions such as polycystic ovary syndrome (PCOS), obesity and certain endocrine disorders, said Jennifer Peña, M.D., an internal medicine physician in San Juan, Puerto Rico, and the DaaS clinical advisor at IHDLab.

Excessive exercise can even affect estrogen levels, Rexrode said.

Estrogen dominance occurs when the body doesn't have enough progesterone to counterbalance estrogen. It's a common type of hormonal imbalance. In premenopausal people, it's usually a side effect of hormonal contraceptives or PCOS, according to Cleveland Clinic.

In postmenopausal people, estrogen dominance is more often associated with being overweight or obese.

Because of estrogen's role in various bodily systems—reproductive, metabolic and cardiovascular health among them—having too much can cause several unpleasant symptoms and raise the risk of certain disorders.

Medications, stress, diet, genetics, environmental factors and underlying conditions—including hypo- or hyperthyroidism—can also affect key hormones such as progesterone, testosterone, insulin, cortisol, thyroid hormones, luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

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What does a hormone imbalance do to a woman's body?

Hormonal disparities can cause myriad effects, depending on the key hormones involved and the severity of the imbalance, said Deborah Lee, M.B., Ch.B., a sexual and reproductive health specialist at Dr Fox, an online pharmacy in the United Kingdom.

Some effects of hormonal imbalances include the following:

• Menstrual irregularities
• Fertility issues
• Mood changes
• Cognitive challenges
• Weight fluctuations
• Fatigue and low energy levels
• Insomnia
• Skin problems
• Decreased sex drive
• Increased risk of osteoporosis
• Hair loss or growth

Depending on a person's life stage, any or all of the above symptoms could be side effects of menopause or a medical condition. These symptoms aren't always associated with off-kilter hormones, which is one reason to speak with a healthcare provider.

What is my hormone type?

Some people suggest there are different hormone "types" and that finding yours can help to improve factors such as metabolism, weight management and energy levels.

Certain types identify medically recognized hormonal changes, such as perimenopause or estrogen, as well as progesterone fluctuations in the menstrual cycle, Deborah Lee said. However, the classifications aren't scientifically standardized nor do they present any new information.

"There is no concrete scientific evidence to support the concept of 'hormone type,' albeit advertised as a way to describe how certain hormonal profiles relate to certain health profiles or overall well-being," Peña said. "Hormonal variations can be due to myriad factors that make it difficult to attribute them to a specific type of individual."

When is the best time to test for hormone imbalance?

"The best time to test hormones depends on the type of hormone being tested and why it is being evaluated, as these can fluctuate depending on various factors," Peña said.

Hormones such as estrogen, progesterone, LH or FSH must be tested at specific points during the menstrual cycle.

People with a 28-day menstrual cycle should usually take an ovulation test around days 10 to 14, Jessica Lee said. The first day of a period is day one.

If you decide to purchase one of these kits, ensure the provider works with a certified lab and offers guidance from a healthcare professional.

When evaluating progesterone, it's best to test around day 21 of a 28-day cycle, Rexrode said.

With some hormones, the time of day is important because levels fluctuate from morning to night. Cortisol testing, for example, is usually performed in the morning, Peña said.

"It's important to consult with your medical provider or laboratory as to the best time to draw specific hormone labs for your specific symptoms or condition," Peña said.

How to check hormone levels

Checking hormone levels requires a sample collection. You can see the results immediately if you're taking an over-the-counter pregnancy or ovulation test. Otherwise, you or your healthcare provider must send the collection to a lab for analysis.

Whether you're taking a hormone test at home or at a doctor or clinician's office, discuss your test results with a medical provider.

At home

Ovulation and pregnancy tests are available at pharmacies, and most remote providers send a kit to your home. In either case, you'll need to collect a sample and follow the instructions carefully, Rexrode said.

Ovulation and pregnancy tests require a urine sample. If you need a blood sample, the provider will likely provide a lancet to perform a finger prick. For a saliva test, you'll receive a swab.

Most providers send the results to a lab for testing and deliver results via mail, email or secure portal, Peña said.

In a doctor's office

Pregnancy and ovulation tests require a urine sample in a doctor's office, too. For other tests, doctors usually draw blood and then send the sample to a lab for analysis.

Once your doctor receives the test results, they may deliver the results to you via mail, email, phone or secure portal, or they may schedule a consultation to discuss the findings and possibly arrange further testing.

How accurate are at-home hormone tests?

Over-the-counter ovulation and pregnancy tests are generally accurate, Jessica Lee said. At-home hormone tests for other purposes, including assessing estrogen, progesterone, FSH, LH and testosterone levels, are less likely to be reliable.

"I don't recommend those at-home tests because a lot of them are not FDA-approved and may not be as accurate as the test I would order from my office," Jessica Lee said.

It's best to speak with a doctor if you feel you need one of these tests.

If you want to order an at-home hormone test, look for products that are FDA-approved or certified by the Clinical Laboratory Improvement Amendments program or the College of American Pathologists.

Keep track of your symptoms, and remember that hormone levels alone might not explain them.

Quality testing services should provide physician support and allow you to save and share your results with a third-party medical provider.

At-home hormone tests, like any medical tests, aren't foolproof. And the results should not be used as a sole basis for diagnostic or treatment decisions, Peña.

Consult with a qualified medical provider about the results, especially if your symptoms are significantly impacting your health and well-being.

"Patients cannot transform themselves into doctors overnight," Deborah Lee said. "The risk is they will order the wrong test, spend a lot of money and get a result which is either inappropriate for their problem or could be negative and give false reassurance. They also risk missing a more serious medical condition."

What doctor checks hormone levels?

Any medical professional can order a hormone test, but primary care providers, endocrinologists, gynecologists and urologists are most likely to do so, Peña said.

Depending on the condition or suspected condition, a provider might refer you to a specialist for further testing and treatment.

Does health insurance cover hormone testing?

Insurance doesn't cover most at-home hormone tests, but you may be able to use money in your health savings account (HSA) or flexible savings account (FSA) to cover the cost.

Insurance doesn't usually cover proactive fertility testing.

However, suppose a doctor orders a test to investigate issues such as menstrual irregularities or a potential thyroid disorder. Insurance should cover it in that case, provided it's conducted through the doctor or clinician's office.

The bottom line

Ovulation prediction and pregnancy tests are consistently reliable. However, many other at-home hormone tests are less so. If you decide to purchase one of these kits, ensure the provider works with a certified lab and offers guidance from a healthcare professional.

Ensure you can save and share your results with other physicians if you need further assistance or a second opinion. Keep track of your symptoms, and remember that hormone levels alone might not explain them, Peña said.