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How does the hormone testing process work via telehealth?

The pandemic has changed the face of healthcare and how patients access their doctors. Telemedicine isn't new, but COVID-19 has put technology front and center since last year—with a 50% increase in telehealth visits in March 2020 during the start of the pandemic (Centers for Disease Control and Prevention, 2020).

What does this mean for mid-life women who are look ing for hormone help? How does the hormone testing process work via telehealth?

The truth is that hormones fluctuate up and down according to many different “rhythms” in a woman’s body—daily, monthly and seasonally. Women are a beautiful orchestra of hormones and neurotransmitters, all working together and separately to create the music of life.

​​When it comes to perimenopause (the time near menopause when symptoms start to occur; also known as the climacteric), there are no hormone blood or urine tests that will either confirm or deny the onset of menopause. ​​A number on a lab test is simply a snapshot in time and does indicate whether a woman is through, or right in the throes of, menopause.

​​Hormonal levels are assessed entirely with symptoms and this is true for in-person and telemedical care. If a woman is having hot flashes, night sweats, insomnia, vaginal irritation/dryness and feeling irritable or anxious (more than her usual PMS), these are an indicator that estrogen levels are falling. Ovulation may or may not have occurred in that cycle and progesterone levels are directly related to ovulation so progesterone may be low as well.

​​There may be providers who offer expensive blood or salivary tests but evidence-based, guideline-driven medical care does not recommend or condone this type of testing. It is not needed and does not provide very much additional information beyond what a woman’s body is already revealing—that menopause is close. Menopause, by definition, is a full year beyond the final menstrual period. Whether a woman is “menopausal” is also clinical diagnosis that does not need confirmatory lab tests.

Need menopause guidance? Get on the waitlist for the online workshop Meaningful Menopause—get the answers you deserve from a gynecologist who has heard (and experienced) it all!


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