Best At-Home Hormone Tests for Women

The best at-home hormone test for most women is a finger-prick blood kit. In studies, finger-prick results closely matched a lab blood draw for FSH, LH, AMH, TSH and other key hormones. Saliva tests for estrogen, progesterone and testosterone are not reliable enough to diagnose anything. If you are over 45 with hot flashes and irregular periods, UK NICE guidance says perimenopause can be diagnosed from your symptoms alone, so you may not need to buy a test at all.

Which at-home hormone test should I buy?

Pick the kit by the question you want answered, not by how many markers it lists. A 10-marker kit is no help if the one hormone you care about is AMH, the marker labs use to estimate egg reserve.

Prices on these sites change, so check the current price before you order. You do all three kits at home with a finger prick, and the comparison lists HSA and FSA payment for Modern Fertility and LetsGetChecked.

Are finger-prick hormone tests as accurate as a blood draw?

Yes, for most hormones. In a study of 130 women aged 18 to 40 tested on cycle day 3, finger-prick and arm-draw results matched almost exactly (a correlation of 0.99 to 1.0, where 1.0 is a perfect match) for AMH, estradiol, FSH, LH, prolactin, testosterone, TSH and free T4. The authors called the two methods interchangeable.

Two things to keep in mind if you are older: Modern Fertility paid for that study, and it only included women up to age 40.

Estradiol is the weak spot. In an earlier study of women aged 18 to 35, finger-prick blood spots tracked FSH, LH and progesterone well, but tracked estradiol less closely. The authors called the estradiol results "more varied."

How you collect the sample matters too. In that same study, two badly mismatched progesterone results came from blood spots where the drops were oversaturated or overlapping. Fill each circle cleanly with one drop.

Are saliva hormone tests worth it?

Not for estrogen, progesterone or testosterone. A lab medicine review found that saliva levels of these hormones swing too fast for one sample to mean much. It concluded that saliva tests for them do not meet the bar for routine diagnostic tests.

Testosterone is the worst match. In two studies of women, saliva results lined up poorly with free testosterone in the blood, with correlations of 0.42 and 0.36. That matters if a quiet sex drive is your reason for testing, because a saliva number may not tell you much about your blood level.

Cortisol is where saliva testing has the strongest support. The same review found good evidence for saliva cortisol as a screening test for Cushing's syndrome, a condition where the body makes too much cortisol. In the Everlywell kit, you collect saliva four times in one day, so the report shows a daily cortisol pattern.

If you do collect saliva, wait at least 30 minutes after brushing, flossing, eating, drinking or chewing gum. Brushing can leave blood in your saliva and push testosterone readings up for about 30 minutes.

Do I need a hormone test to know I'm in perimenopause?

Usually not, if you are over 45. UK NICE guidance says women over 45 with menopause symptoms should be diagnosed with perimenopause or menopause on their symptoms alone, without lab tests. Perimenopause is diagnosed from hot flashes or night sweats plus irregular periods. Menopause is diagnosed after 12 months with no period when you are not on hormonal birth control.

FSH (follicle-stimulating hormone) is the hormone commonly used to flag menopause, and it bounces around in perimenopause. In a long-running study of women in Massachusetts, FSH levels before and after the final period overlapped so much that no single number could tell the stages apart. The common cutoff of 40 was not reliable on its own.

Testing makes more sense when you are younger. NICE suggests considering an FSH test for women aged 40 to 45 with symptoms that include a change in their cycle, and testing FSH for women under 40 with symptoms. Under 40, early menopause should be diagnosed from symptoms plus two raised FSH results taken 4 to 6 weeks apart, never from one test.

Skip FSH testing if you take the combined pill. The pill changes FSH levels, and NICE says FSH should not be measured in women using it. For women over 45, NICE also says AMH and estradiol should not be used to diagnose menopause.

What if my results look normal but I still feel off?

A result inside the normal range does not cancel out hot flashes, poor sleep or a sex drive that has gone quiet. Your symptoms are real information, and they belong in the conversation about treatment.

Hot flashes and night sweats affect about 8 in 10 women going through menopause. Other symptoms include mood changes, trouble concentrating, joint stiffness, vaginal dryness and lower libido.

One woman got brushed off when she brought up libido. When she posted that her doctor asked why she cared about her libido, the top replies included "if you were a man, this would be a crisis" and ""Because I want to enjoy my libido" should be reason enough."

Bring your symptoms, plus any results you already have, to your clinical team. Our clinical team can prescribe bioidentical estrogen, PT-141 or kisspeptin if one fits your goal, and they decide whether you need labs first.

If your symptoms already tell you what is going on, you can skip the $249 kit. Take the quiz to tell our clinical team what you are feeling and see which plan fits your goal, whether that is cooler nights, better sleep or getting your sex drive back.