Optimal Days for Hormone & Blood Tests Explained

If you or your practitioner suspects a hormonal influence on your symptoms, getting a hormone panel and some extra blood tests run can be very useful.

For best results, the test must be done on the correct day of your full menstrual cycle.

If you are menopausal, the day doesn’t matter.
If you are on birth control or hormone replacement, results may be skewed, so keep your practitioner informed; Day 21 is best.
If your cycles are very long, short or irregular, then the Day 2-3 test is best, as it’s too difficult to tell when you ovulated.
If your cycles are always less than 28 days, adjust the schedule accordingly by subtracting seven days unless they are less than 21 days, in which case do Day 2-3.

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What day to get a hormone test – Cycle Days explanation

Your menstrual cycle is calculated from Day 1 of your period to Day 1 of your next period. That is one full menstrual cycle.

Some of you call your period your ‘cycle’, but this can confuse the issue. You are always ‘on your cycle’; it just goes round and round.

Cycle Day 2-3 of your period (if Day 1 is the first day of your period)
Cycle Day 21 (if Day 1 is the first day of your period)

Day 2 or Day 21?

There are two main parts of a menstrual cycle that we look at hormones: Day 2-3 or Day 21 of a 28-day cycle.

Not everyone has 28-day cycles, so we adjust the days accordingly. For example, if you have 24-day cycles, the test would be taken on Day 17-18; if you have 32-day cycles, the test would be taken on Day 24-25. The test is to be taken seven days after ovulation in the luteal phase.

If your menstrual cycles are long, short or irregular, do the Day 2-3 test.

We recommend doing all blood tests fasting in the morning. That means nothing but plain water for the prior 10-12 hours.

What tests to get on what day

CYCLE DAY 2-3

Oestradiol/estradiol
Follicle-stimulating hormone (FSH)
Leutinising/luteinizing hormone (LH)
Free testosterone
Total testosterone
DHEAS
Sex hormone-binding globulin (SHBG)
Extra tests that are useful
Note on progesterone: until you ovulate, progesterone will always be low – not required on Day 2-3

Order a hormone panel (UltaLabs)

Order a hormone panel with CBC and CMP (UltaLabs)

Choose your own tests (UltaLabs)

CYCLE DAY 21

Oestradiol/Estradiol
Progesterone
Free testosterone
Total testosterone
DHEAS
Sex hormone-binding globulin (SHBG)
Extra tests that are useful

Order a Day 21 hormone panel (UltaLabs)

Order a Day 21 hormone panel with CBC and CMP (UltaLabs)

Choose your own tests (UltaLabs)

Extra tests that are useful

Complete Blood Count (CBC) or Full Blood Count (FBC)
Comprehensive Metabolic Panel (CMP), Metabolic Panel with differentials (white blood cells)
Liver function
Iron panel
Thyroid panel
Lipid panel
Vitamin B12 and folate
Zinc and copper
Homocysteine

The lab ranges say everything is fine – is it?

Lab reference ranges are very broad and don’t consider nuances in hormone cycles unless you work with a practitioner who understands optimal ranges. Optimal ranges are much narrower and depend on the cycle day, while varying between hormones.

Medical practitioners are looking for evidence of disease, and the ranges are broad so that if something is way off, it is caught. Medical practitioners don’t tend to care about oestrogen excess or deficiency unless it is extreme, and don’t discriminate on the cycle day. This may produce vague results.

Many doctors are not keen to do hormone testing because they A) don’t choose the right cycle day and B) don’t understand how to interpret the results in a subclinical context. It may not be their area.

However, naturopaths and functional medicine doctors tend to work in the subclinical, which means the grey area between healthy/normal and disease.

Please consult a practitioner for support in understanding your results and symptoms.

What symptoms mean I should get a hormone panel run?

Heavy or long periods (Day 2-3 or preferably Day 21)
Clotty periods
Short light periods
Long, short or irregular menstrual cycles (regularly under 24 days or over 32 days) (Day 2-3)
Mid-cycle or pre-period spotting
Periods drag on but are not heavy (brown blood) (Day 21)
Missed periods (Day 2-3)
Moderate to severe PMS, PMDD
Chronic yeast, BV, AV or CV
Those who regularly use antihistamines to control allergies or are high histamine
Infertility
Perimenopause – with symptoms or to test for perimenopause (Day 2-3)
Menopause – with symptoms (any day)
If you want to check that everything is in order

My doctor won’t do the hormone panel – what do I do?

Because medical practitioners are looking for disease, you may not fit the bill for a hormone panel, and you may meet resistance. This becomes a problem if you live somewhere with free healthcare, as your doctor must justify the test for it to be paid for by the government. This also applies to insurance. Medically, you may not meet these criteria.

If you have an understanding doctor, can have the tests run privately or have good insurance, your options open up.

Getting tests run privately – USA (excl. New York and New Jersey)

You can find tests online easily but compare prices and shop around. My Vagina practitioners use a service called UltaLabs which offers good prices and discounts on Quest tests.

We recommend doing all blood tests fasting in the morning. That means nothing but plain water for the prior 10-12 hours.

These tests must be run by your doctor in New York and New Jersey.

Using UltaLabs (USA only)

If you use our portal link (ultalabtests.com/partners/myvagina), you can provide us with your results and make an appointment/support request via your Killing BV membership to discuss your results.

Buy the test online and use any Quest lab to take the test at the correct time.

Getting tests run privately – Australia

Use a service called InstantScripts ($20 lab request) and visit any pathology lab for the tests to be covered on Medicare.

International tests

Getting the tests you want can be tricky unless your doctor deems that you medically qualify. Speak to your doctor and discuss your symptoms and why you believe your hormones are connected. Explain that you are seeking care with another practitioner who will support you with the results.

Always ask for a copy of your results. If you’re sending us test results not in English, please translate the tests to English and include the unit of measure (e.g. ng/mL, nmol/L). Each country has different units of measure.

Not sure what to do? Make a booking.