“Are you sure you want to do a home hormone test?” my editor asked. “Are you sure it’s not too personal?” Why would that be personal, I think. This is stuff I make without trying. It’s not even as revealing as keeping a food diary. Then two tests arrived from medical test-by-post company Thriva; one female baseline hormone test and one menopause test, so I realised that actually, yeah, that is pretty personal.
There are a couple of reasons why someone might want to test. If you’re trying to figure out why you’re not getting pregnant, you can wait a long time for investigations on the NHS. If you’re having menopausal symptoms, you might want to confirm the hunch so you can make a decision about hormone replacement therapy (HRT). If you’re just curious… well, this is what happened with me.
If you’re still menstruating, you have to test on day three of your cycle, but I did the menopause test on day 28. That one came back with extremely low everything: low vitamin D (winter, innit), and follicle stimulating hormone (FSH) and luteinising hormone, which play a role in egg production and egg release respectively. In proper menopause, those would all be high. Then I speak to Maisie Hill, the author of Period Power, who explains this is all completely normal at the end of a cycle. It’s partly user error (I should have read instructions on the website more carefully), but there’s a bit of a design flaw here: if your periods aren’t regular, which in perimenopause they often aren’t, you’d never know you were on day 28.
Test two, the female baseline, I did at the exact right point – day three – and it came back with much higher FSH and luteinising hormone, two hormones that surge as you head towards menopause. Since people trying to get pregnant (which I’m not) want FSH readings of less than 10, and mine was 20, I assumed this meant perimenopause. But not necessarily, says Hill.
It turns out that all of this is pretty complicated: first, you should always repeat the test twice to verify results. Second, the levels of certain hormones don’t give you the whole picture.
Should I be considering HRT? I speak to Dr Jan Toledano of the London Hormone Clinic. “You wouldn’t want to go on HRT unless you’re low in oestrogen,” she says. Oestradiol, or E2, is the oestrogen hormone I have been tested for, and that is within range. “You’re in your mid-40s, so it’s probably progesterone you’re short of,” Dr Toledano concludes. This test doesn’t do progesterone.
The problem with these kits is that I didn’t really understand where I was until I’d spoken to some more specialists, and even after that, I was still on a quest for more information. Knowledge is power, I concluded, but numbers aren’t necessarily knowledge.
What I learned
The Dutch test is the most comprehensive, but, with multiple samples, quite an undertaking.