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by Dr. Daniel J. Heller
Two of the most common questions we hear, both in the doctor’s office and here on the PMS Comfort website is “Should I get my hormone levels checked?” or “Do I need a saliva test to check for a hormone imbalance?” If your concern is PMS or PMDD or another premenstrual symptom like breast tenderness or cramps, then you don’t need any hormone tests. This is because hormone levels in your blood or saliva don’t determine whether or not you’ll have premenstrual dysphoric disorder or premenstrual syndrome. Hormone levels, including estrogen, estradiol level, and fsh levels are normal in almost all women when these tests are performed.
However, if you do a saliva hormone test, there’s a good chance you’ll be told that saliva tests are more accurate and are more sensitive for detecting hormone imbalance. In fact, these tests rarely tell you more than what your symptoms are already telling you: that your hormones are out of balance.
We understand how confusing this can be. Your medical doctor may very well have done a blood test for hormones, perhaps at your insistence, and told you that you’re fine, everything is normal, and that your premenstrual symptoms aren’t being caused by a hormonal imbalance. Then you get a saliva hormone test, and it says that you do have a hormone imbalance, and that is what is causing your PMS symptoms or PMDD symptoms. Now we’re telling you that they’re both wrong? How can that be?
The problem is, hormones in your blood stream or your saliva don’t cause PMS or PMDD symptoms. It’s the specific way your individual hormones interact with the cells all over your body (not just your uterus or ovaries or brain) that determine how your hormones affect you—and there is no way to test for this cell-hormone interaction other than your symptoms. You could have very high estrogen levels, but that might not cause cramps or mood swings or fatigue in your case. Your friend may have low estrogen levels and have PMS cramps or premenstrual mood swings or PMDD fatigue. And this isn’t surprising, because it’s how the cells of your brain and your muscles and your whole body react to hormones that determines how you feel. And there is no test for that. Or, to put it another way, your body and feelings themselves are the most sensitive test there could ever be, meaning your symptoms tell you pretty much all you need to know.
This is why we created the PMS Comfort PMS & PMDD Symptom Quiz, the quickest and easiest way to find out if your symptoms may add up to PMS or PMDD. Unless you’ve already decided that you want to take hormonal drugs (even bioidentical hormones are drugs), we suggest you steer clear of hormone tests.