Having Your Hormone Levels Measured: The Salivary Hormone Test
by Ann Louise Gittleman - 9/1/2002

The result of a hormone levels test lets you know immediately if something is seriously out of line. When you know what your hormone levels are, you can then seek treatment, if you need it, on an individualized basis. The test result gives you a baseline with which later test results can be compared, so that you can monitor your hormone- levels over time. When you have a hormone imbalance or low level and start treating it naturally, you should feel your symptoms ease and gradually fade away.

Most doctors test only the levels of follicle-stimulating hormone (FsH) and luteinizing hormone (LH). FSH and LH levels are elevated during menopause but rise and fall steeply during perimenopause. Thus, if you happen to be tested on a high-level day, the lab test result will suggest that you are menopausal. To get an accurate and usable hormone profile, you also need to be tested for levels of estrogen, progesterone, and testosterone. But keep in mind that the levels of these three hormones fluctuate, too, so that a test on one day may yield very different results from an- other a week later. Because your estrogen level is at its lowest on the day before and during menstruation, don't get tested at this time.

Your hormone levels vary with the time of day as well as with the day of your menstrual cycle. To make a future test compare reliably with a test taken today, the future test should be taken at the same time of day and on the same day of your menstrual cycle as your first test-or as close as you can get to it. Another approach is to take tests on different days of the menstrual cycle, spaced apart so that a more accurate overall hormone profile can be constructed.

Blood and urine tests were the only kinds available until recently. To have blood drawn or to deliver a urine sample usually involves a visit to a doctor's office. A less expensive, more convenient method has recently become available: the saliva test. You can take a saliva test on your own, in the privacy of your home.

The results from saliva tests tend to be more accurate than those from blood tests, particularly for progesterone. Blood tests tend to give less-than-accurate estimates because the progesterone that binds with red blood cells gets discarded along with them before the measurement is made. This is not of great consequence when a powerful drug like Provera is being taken, but gentler, low- dose natural progesterone creams, such as Progesta-Care may be made to look ineffective. Saliva tests, on the other hand, register the increased hormone level when natural progesterone cream is used.

About 95 percent of the hormones are bound to proteins, forming particles too large to pass into saliva. Only 3 to 5 percent of a hormone is in a free, biologically active form-and this is what is measured in the saliva test. But you need to watch out that bleeding from gums or from a mouth or lip cut does not contaminate the saliva sample. Another way for a saliva sample to become contaminated is through remnants of hormonal creams on your hands, face, or neck. If you use these creams, wash thoroughly be- fore taking a saliva sample.

While ten years of research back the validity of saliva tests, they are still new to clinical practice. They are highly endorsed by Dr. Christiane Northrup. If your doctor recommends them, he or she will supply you with sample collection materials, instructions, and prepaid mailers to send samples to a laboratory. If you have no health concerns that require a doctor's visit but would like to know your hormone levels, you can order saliva tests for up to six hormones at a time, without a physician's reference, through Uni Key Health Systems or call 800-888-4353.

There is a separate fee for each hormone tested. Test results take about five to seven business days. For interpretation of the results, you may need to talk to a health care provider. Uni Key points out that its direct-to-consumer hormone levels tests are not for diagnostic purposes and are meant to be used only to monitor changes in hormone levels. When tests are not ordered by a health care provider and are not for diagnostic purposes, they are not covered by most medical insurance policies.

Taking a Saliva Sample

Taking a sample of your saliva is a simple, noninvasive test that you can perform conveniently and privately at home. Hormones in saliva are stable at room temperature for several weeks and so can be stored before being sent by regular mail to the lab.

Taking a sample simply consists of chewing a sugarless gum to generate saliva, spitting into a tube, and capping the tube. You should fill out the date, day of your menstrual cycle, and time of day immediately, since accuracy in recording these is important.

To establish a baseline for any specific sex hormone, the best time to collect a saliva sample is in the early morning before you eat or drink anything, and before you brush or floss your teeth or use mouthwash.

To assess peak levels of estrogen and progesterone, a sample should be taken during days twenty to twenty-three after the beginning of your last period. if you are currently on contraceptive pills or hormone replacement therapy, collect a sample just before the usual time of taking the drugs.

The salivary hormone test measures the levels of up to six hormones – estradiol, estriol, progesterone, testosterone, DHEA, and cortisol.