5 Smart Reasons To Choose Saliva Hormone Testing For Women

Menopause Matters: Kate Wells

Hormones are chemical messengers that tell other systems throughout your body what to do, how to do it, and when to do it.

There are thousands of body processes that occur because of your hormones. This means that if one hormone is out of whack it might throw off other processes related to it, causing a domino effect. Hormones work in harmony to maintain the body’s balance.

When the correct amount of the right hormone is working at the right place and at the right time, you feel and look great!

From Bloodstream To Bone Cell: The Journey Of A Hormone:

Hormones are released into your bloodstream from organs, glands, and cells. Hormones travel to specific locations in the body via the bloodstream and through the lymphatic system. Once hormones get to their target cells in the body they knock on the cell wall and ask to be let in.

Cell walls have little doors called receptors and it’s through the receptor that the hormone gets into the cell. Think of a lock and key: the lock being a receptor and the key being a particular hormone. Once a hormone reaches a specific target cell membrane it needs to fit into the receptor to unlock the mechanism; then the hormone goes inside and starts telling the cell nucleus what to do.

For example, the hormone progesterone reaches a receptor on a bone cell, passes through the cell membrane and signals the bone cell to do a little growing. 

Through our teens, twenties, and thirties hormones fly all over the place with their various messages and, in general, all is good in our hormone world. But, come perimenopause (which can start as early as our late  30’s), as hormone levels change, the hormone messaging also changes. That’s when symptoms start to occur. Understanding how these hormone levels are changing is where testing comes into play.

Why Saliva Hormone Testing For Women Is A Smarter Choice:

For most doctors – the go-to is blood testing. It’s standardized; it’s often covered by insurance; and it’s pretty straightforward. But hang on, while it’s often the standard, blood testing may not be the best route to take to get the most accurate picture of your hormone levels. Blood tests can give an overall indication of hormone levels and imbalances, but they have their limitations.

1. There are two categories of hormones: 

• Unbound hormones which are free to roam around the body and find their target cells and fit into the receptor sites and are active.
• Bound hormones, on the other hand, are attached to protein molecules. Although they can still travel through the bloodstream, they’re too large to bind to receptor sites and are therefore  inactive.

Blood tests measure all the hormones, both the active and the inactive, and a total amount of hormone is reported. What is needed is not the number of inactive hormones; we want to know how many active, usable hormones are actually available to do their job.

1. Hormones are pulsatile – they are released in different pulses throughout the day so there are lots of fluctuations in levels over the course of 24 hours. A blood draw at one point in any one day may give a false high or a false low.
2. Your hormones – estrogen, progesterone, and testosterone – change a lot throughout your cycle. If you don’t know where in the cycle you are during hormone testing, then how can you know what levels are appropriate? Blood draws rarely, if ever, consider where a woman is in her cycle at the time of testing.  

Saliva Testing Is An Alternative Option For Hormone Testing:

• Saliva is a great option when it comes to testing hormone levels.  Saliva testing has been used in clinical research, including studies conducted at the National Institutes of Health (NIH), for more than 30 years.
• Saliva testing is much more specific and correctly identifies the level of active hormones available at the cell level. Saliva testing works very well for people using topical creams because the hormones in the creams are quickly absorbed into the cells and the fluid around the cells. 
• Saliva testing is also very convenient, as samples are collected at home at the appropriate times throughout the day. This gives the person lots of flexibility and removes the need to go to a lab. There are also optimal times to collect the samples during the month if a woman is still getting her period (days 19-23 of the cycle). While saliva testing is a specialty test, and often not covered by insurance, many people can be helped by this simple, straightforward testing method.

Urine Testing:

Because hormones are metabolized (broken down) and excreted from the body in urine, urine testing can be used to measure the hormone metabolites. Some of these metabolites are harmless and others can increase risks for DNA damage – and that’s a pathway into potential tumor development.

So, this type of testing gives a practitioner some insight into how the body is breaking down hormone metabolites.  A practitioner might use urine hormone testing to look for more information on a complex patient.  What urine hormone testing doesn’t provide is the actual bioavailable levels of hormone in the body.  

Stress And Cortisol:

Oh ladies, who doesn’t have stress going on in their lives these days!  Measuring your cortisol levels can bring into stark reality just how much stress you are living with.

Cortisol should have a regular pattern throughout the day: from very low as you wake up and open your eyes, to a peak at 30 minutes after you wake up, then a noticeable drop within 60 minutes and then a gradual decline to a low level as you go to sleep. This pattern is known as the cortisol awakening response (CAR).  Anyone under long-term stress will very likely not have this pattern and the more stress, the flatter this pattern will be.

Saliva testing helps track this by collecting samples at four key points throughout the day, allowing a clear picture of how hormone levels fluctuate over time. A single blood test will not provide this level of useful information.

I hear from so many women who have the experience of visiting their doctor with symptoms, getting their hormone testing done in blood, only to be told; you are fine, everything is in range, it’s all normal.  

Blood Testing Has Serious Drawbacks:

Well, hello! These women would not be sitting in the doctor’s office if everything felt normal. Blood testing for hormones during and after perimenopause has some serious drawbacks, especially if a woman is using topical hormones, and can deliver the false message that everything is normal.

It’s important to remember that normal does not equal optimal. Yes, of course, it is normal for hormones to fluctuate during perimenopause – but that doesn’t mean they’re optimal. There are many methods of hormone supplementation to help women through these fluctuations, and to support them after the menopause transition. Testing provides information on where the gaps are. If this is you, asking for a saliva hormone test is well within your rights as a patient.

Some doctors aren’t aware that saliva testing is a well-researched and useful clinical tool. Many have been taught that saliva testing is not accurate; that simply isn’t true.  Others know that it is a useful tool, but don’t know how to interpret the results.

This shouldn’t prevent you from advocating for clinical testing that really fits your needs. Unlike our mothers and grandmothers, there are so many more options available for understanding hormone levels these days. Stand up for yourself and request the best ones for you!

Recap: 5 Essential Reasons To Choose Saliva Hormone Testing For Women:

1. It Measures Active Hormones Only:

Saliva testing shows the hormones your body can actually use, not just what’s floating around inactive in your bloodstream.

2. It Tracks Hormone Fluctuations Throughout the Day:

Unlike a one-time blood draw, saliva samples collected at key points reveal how your hormone levels shift over time.

3. It Works Best for Topical Hormone Users:

If you’re using creams, saliva testing reflects the hormone levels absorbed into your tissues, where the action actually happens.

4. It’s Convenient and At-Home:

No labs, no waiting rooms. Just you, a collection kit, and accurate timing. On your own schedule.

5. It’s Backed by Decades of Research:

Saliva hormone testing has over 30 years of solid clinical research behind it, including studies from the NIH.

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About the Author:

Kate Wells is a hormone expert and true biochem nerd who has been educating practitioners about hormones for many years. Starting out as a High School science teacher, and then pivoting to the business world, Kate new she wanted to combine her passions for science and business and found the perfect match in leadership roles at labs specializing in hormone testing and hormone formulation.

She currently runs her own bioidentical hormone product companies where she writes educational articles and continues to educate practitioners on the role of hormones in optimal longevity. Beyond nerding-out on the latest research, Kate is an avid hiker, regularly putting in 20-mile hikes in the beautiful wilds of Colorado, loves to build stuff, swing dance, and work with fabric to make colorful quilts. Kate is the author of A Forecast for Health and is the CEO and co-founder of Parlor Games LLC. Kate holds a BS, MBA, and has completed a Fellowship in Herbal Medicine.