Bloodwork, saliva, and urine testing can provide valuable insights into your body's hormone levels and overall health. 

These tests can reveal if you have low testosterone, high estrogen, elevated blood sugar, inflammation, or thyroid issues. 

But why measure hormones at all? Hormones regulate everything from sleep and metabolism to weight and energy. As hormone levels naturally decline with age, especially during menopause, testing is crucial to identify and correct imbalances.

Common Hormone Testing Methods

There are several hormone testing methods available. Understanding their differences helps you choose what’s best for your needs. The four most common types are:

• Blood 
• Saliva
• Urine
  
  

Blood Spot

Blood testing has both strengths and limitations. Many hormones are well measured in the blood, especially those that circulate in relatively stable amounts. Others are more complex.

Estrogen is a good example. A significant portion of estrogen production and activity happens in tissues, not just in circulation. Because of this, blood levels may appear “low” even when estrogen activity in the body is quite high. In other words, a large amount of estrogen never shows up in the bloodstream at all, which can make blood testing an incomplete picture when estrogen-related symptoms are present. So a lot of women in menopause ovarian production of estrogen goes down, but their tissue estrogen remains high. Estrogen is stored primarily as estrone in fat, which is less potent than estradiol (the active form). Storing estrogen in an inactive form prevents constant exposure to active estrogen, which could overstimulate tissues and disrupt normal cell function. There are a lot of arguments that estrone is insignificant because it is less potent, however, estrone can be converted into estradiol and vice versa. This ability allows for the body to make the type of estrogen it needs on demand. 

A recent study in The Journal of Clinical Endocrinology & Metabolism (2025) found that despite lower serum estrogen levels, postmenopausal women, especially those on hormone therapy (HT), often still had substantial amounts of estrogen in their fat tissue, where it can be converted back into active forms and influence the body over time. Researchers found:

• Women on HT showed 4‑ to 7‑fold higher concentrations of estrone and estradiol in both subcutaneous and visceral adipose tissue compared to non-users.
• Importantly, the ratio of estrogen levels in adipose tissue versus serum remained high in women on HT.

Since estrogen is made in the tissue, the most accurate way to measure it would be to assess the concentration inside tissues through a biopsy. However, biopsies are invasive, expensive, and impractical for routine use.

At Raena, we utilize precision at-home blood testing designed to be accurate, simple, and built for real life.

We use advanced microsampling technology that allows you to collect a high-quality blood sample from the comfort of your home.

These devices are microneedle-based and worn on the upper arm. Once activated, they use gentle vacuum-assisted collection to draw a small blood sample virtually painlessly and completely hands-free.

Here’s how it works:

1. Activate and apply the heat pack to your upper arm for one minute.
   (This increases circulation to support smooth collection.)
2. Clean the area with the provided alcohol wipe.
3. Attach the device to the warmed area on your upper arm.
4. Slide the actuator to begin collection.
   The microneedle and light vacuum system will automatically collect the sample. You don’t have to hold or pump anything.
5. The entire process takes just minutes. Next, ship it off with the prepaid label and get results in days.

Saliva testing and urine testing are also commonly recommended to measure hormones. Urine-based tests measure hormone metabolites rather than active hormones. This type of testing can provide insight into how hormones are processed, metabolized, and excreted. It can reflect liver detoxification patterns, gut metabolism, and elimination pathways. However, it does not accurately reflect real-time, bioavailable hormone levels or how much hormone is actively signaling at the tissue level. The hormones measured in urine are primarily glucuronidated or sulfated. For this reason, urine testing reflects liver metabolism far more than hormonal effect. Someone may show low estrogen metabolites on a DUTCH test while simultaneously having high circulating estrogen in the blood. This can lead to incorrect conclusions about true hormone status.

Urine is a secretion out of the body. What is being excreted does not necessarily represent what is present or active inside the body. Urine tests are not useless, but on their own, it is not the most reliable diagnostic biomarker. When combined with blood testing, it can provide helpful context. When used in isolation, it often creates confusion. 

Saliva testing presents many of the same limitations as urine testing, because both measure substances that are being excreted out of the body rather than what is actively circulating and signaling within tissues. Saliva reflects what has passed through the salivary glands, not what is present inside cells or available to bind to receptors. As a result, salivary hormone levels can be influenced by factors unrelated to true hormone status, including oral bacteria, food residue, inflammation, and enzymatic activity within the mouth. These variables can interfere with readings and reduce reliability.

Saliva testing also becomes less accurate with age. As women get older, particularly in perimenopause and menopause, fewer hormones pass into saliva. This can create the appearance of deficiency even when circulating hormone levels in the blood are adequate or elevated. In these cases, salivary results may underestimate true hormone exposure and lead to inappropriate conclusions.

In addition, saliva and urine testing are limited in scope. They do not measure as many hormones as blood testing, nor do they reliably assess key markers such as thyroid hormones. For example, thyroid hormones are too large to pass through salivary glands, making saliva testing inappropriate for evaluating thyroid function altogether.

When it comes to interpreting lab tests, it’s important to consider that lab tests are snapshots, not conclusions. All hormone tests offer only a snapshot in time. This is why symptoms must always be considered alongside lab results. 

What We Measure

At Raena, testing is about understanding the pattern behind your symptoms. Hormones have effects in cascades. Your thyroid affects your cholesterol. Your stress hormones influence your sex hormones. Your vitamin D status changes how your cells respond to everything else. Nothing operates in isolation.

So instead of running one marker and calling it a day, we measure many important hormones.

Sex Hormone Kit

Progesterone

Progesterone supports mood, deep sleep, thyroid function, bone strength, and metabolic balance. It also helps buffer the effects of excess estrogen. Low progesterone is incredibly common in perimenopause and hormonal ailments. 

Estradiol (E2)

The primary form of estrogen. Estradiol is for growth and temporary stimulation. But when it rises without enough progesterone to balance it, it can contribute to heavy cycles, breast tenderness, fluid retention, mood swings, and that “wired but exhausted” feeling.

Cortisol

Your main stress hormone. Cortisol affects blood sugar, thyroid function, sleep, and reproductive hormone production. Chronically high cortisol can leave you anxious and wired. Chronically low cortisol can leave you depleted and flat. Either pattern can disrupt everything downstream.

Testosterone

Yes, women need testosterone too. It supports muscle tone, confidence, drive, and libido. Too little can feel like loss of motivation or strength. Too much can show up as acne or unwanted hair growth.

DHEA-S

An adrenal hormone and precursor. DHEA gives us insight into adrenal resilience and whether your body has the raw material it needs to produce balanced hormones.

Prolactin

Elevated prolactin can interfere with ovulation, suppress progesterone, lower libido, and signal stress at the level of the pituitary. If cycles feel “off,” this is sometimes why.

Vitamin D

Vitamin D influences immune regulation, mood stability, bone health, and how sensitive your cells are to other hormones. Low levels can quietly amplify other imbalances.

Thyroid Hormone Kit

TSH (Thyroid Stimulating Hormone)

This is the brain’s signal to your thyroid. If TSH is elevated, your body may be asking for more thyroid hormone. If it’s suppressed, it may suggest overstimulation. 

Free T3 (FT3)

The active thyroid hormone. This is the hormone that actually enters your cells and drives energy production and heat generation. You can have a “normal” TSH and still have low T3. That’s why we measure it directly.

Free T4 (FT4)

The storage hormone. T4 must convert into T3 to become active. Measuring both helps us understand whether production is adequate.

TPO Antibodies (TPOab)

These can signal autoimmune thyroid activity, like Hashimoto’s. Many cases of thyroid dysfunction are immune-driven.

Thyroglobulin Antibodies (TGab)

Another autoimmune marker. Testing both antibodies gives us a clearer picture of whether the immune system is targeting the thyroid.

Why We Also Measure Cholesterol

Thyroid health and metabolism are deeply connected.

Before thyroid dysfunction becomes obvious, cholesterol patterns often shift. So we include a full lipid panel.

LDL Cholesterol

Often rises when thyroid function slows because thyroid hormone helps clear cholesterol from the bloodstream.

HDL Cholesterol

Very protective molecule, influenced by metabolic and hormonal health.

VLDL & Triglycerides

Markers of how your body is handling fats and blood sugar. Elevated levels can reflect metabolic slowdown or insulin resistance.

Total Cholesterol

Persistently elevated cholesterol can be an early thyroid clue.

Hormone results are tools. A lab value can tell you what your physiology is doing in that moment.

Hormones fluctuate. They respond to stress, sleep, nutrition, inflammation, body composition, age, and even the time of day. 

Used correctly, hormone results help us:

• Identify patterns
• Confirm what symptoms are suggesting
• Track trends over time
• Make thoughtful adjustments
  
  

At Raena, we provide insights with the results. For more hands-on guidance, our team is trained to look beyond isolated values and think physiologically. Thyroid in relation to cholesterol, cortisol in relation to progesterone, estrogen in relation to tissue storage and balance. They’ll walk you through your results, explain what’s meaningful, and help you decide what (if anything) needs to be supported.

Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.