Female Hormone Tests: A Complete Guide to Assess Your Health and Fertility

Female hormones play a central role in virtually every stage of a woman’s life — from puberty, through menstrual cycles, fertility, and pregnancy, to the onset of menopause. They orchestrate reproductive processes, regulate ovarian function, modulate mood, influence metabolism, and even affect bone and cardiovascular health. For this reason, hormonal balance is not only important for those seeking to conceive but is a vital component of overall health and well-being. 

Monitoring hormonal health is essential to detect early changes that may compromise fertility or signal gynecological and endocrine dysfunctions. Hormonal imbalances often present silently — with irregular cycles, mood swings, fatigue, or difficulty conceiving — and can be easily diagnosed through routine laboratory testing. Regular evaluation of these markers enables a preventive, personalized, and accurate approach to women’s health, enhancing well-being, quality of life, and reproductive decision-making. 

In addition to reflecting the menstrual cycle’s functioning, hormonal tests are valuable tools to investigate infertility, assess ovarian reserve, identify endocrine disorders such as PCOS, and guide decisions at various stages of reproductive life. In this article, you will learn what these tests are, when to perform them, how to interpret the results, and why hormones like FSH, LH, estradiol, progesterone, AMH, and prolactin are so important for women’s health and well-being.

What Are Female Hormonal Tests and What Are They For? 

Female hormonal tests are blood-based laboratory analyses designed to assess hormone levels that regulate the menstrual cycle, ovulation, fertility, and other reproductive functions. These tests are crucial for investigating menstrual irregularities, hormonal disorders, infertility, premature menopause, and for monitoring assisted reproduction treatments (1). 

Female hormones regulate the menstrual cycle, egg development, emotional balance, bone density, and cardiovascular health. Disruptions in this balance, caused by conditions like polycystic ovary syndrome (PCOS), thyroid disorders, high prolactin levels, or diminished ovarian reserve, can lead to infertility, cycle irregularities, acne, weight gain, mood changes, and serious metabolic risks. 

The Importance of Hormonal Testing for Women’s Health 

A woman’s hormonal health directly affects not only her fertility but also her physical and emotional well-being. Changes in hormone levels, as revealed by female hormone tests, may indicate endocrine disorders, conditions such as polycystic ovary syndrome (PCOS), menopause, premature ovarian insufficiency, among others (2). 

Studies estimate that PCOS affects between 6% and 22% of women of reproductive age globally, emphasizing the need for continuous hormonal monitoring even outside fertility planning. 

Furthermore, infertility — defined as the inability to conceive after one year of unprotected intercourse — affects about 1 in 6 people worldwide, regardless of region or socioeconomic status (3). In women, most cases are related to ovarian or endocrine hormonal disorders, including PCOS, anovulation, and premature ovarian failure. 

Therefore, regular monitoring of hormones such as FSH, LH, estradiol, progesterone, prolactin, and AMH is crucial not only for those planning pregnancy but also to ensure reproductive health, disease prevention, and long-term quality of life. 

How Do Hormones Influence Fertility and the Menstrual Cycle? 

The menstrual cycle is a physiological process that prepares the female body for potential pregnancy. It is regulated by a complex interaction between the hypothalamus, pituitary gland, and ovaries. It typically lasts 28 days, though cycles ranging from 21 to 35 days are considered normal. The cycle is divided into three phases: 

• Follicular Phase (Day 1 of menstruation to ovulation): The hypothalamus releases gonadotropin-releasing hormone (GnRH), stimulating the pituitary to secrete FSH (follicle-stimulating hormone). FSH promotes growth of ovarian follicles, which produce estradiol. Rising estradiol levels exert negative feedback on FSH, leading to selection of a dominant follicle;

• Ovulatory Phase (around day 14): Sustained high estradiol levels switch to positive feedback, triggering a surge in LH (luteinizing hormone), which induces ovulation — the release of the mature egg from the dominant follicle;

• Luteal Phase (post-ovulation to menstruation): The ruptured follicle becomes the corpus luteum, producing progesterone (and some estradiol). Progesterone prepares the endometrium for possible embryo implantation. If fertilization does not occur, hormone levels fall, the corpus luteum regresses, and menstruation begins.

Key hormones involved include FSH, LH, estradiol, progesterone, and prolactin. They act in a coordinated manner to support follicular growth, ovulation, endometrial preparation, and early pregnancy maintenance. Hormonal imbalances can lead to anovulatory cycles, infertility, irregular bleeding, and implantation failure (4). 

Follicle-Stimulating Hormone (FSH) 

FSH is essential for initiating and regulating the menstrual cycle by stimulating follicle growth and maturation. Secreted by the anterior pituitary in response to GnRH, FSH also promotes estradiol production by granulosa cells and selects the dominant follicle (5). 

Baseline FSH levels, typically measured on day 3 of the menstrual cycle, are widely used as early biomarkers of ovarian reserve. High FSH suggests diminished follicular reserve and poor response to fertility treatment, whereas low FSH indicates normal hypothalamic-pituitary-ovarian axis function. However, interpretation is limited by cycle variability and lack of a universal cutoff (6-8). 

Luteinizing Hormone (LH) 

LH, also secreted by the anterior pituitary, works alongside FSH to stimulate follicle growth and is primarily responsible for triggering ovulation through its mid-cycle surge. Post-ovulation, LH supports the corpus luteum, which produces progesterone to sustain the endometrium. LH imbalances can impair ovulation and fertility, particularly in PCOS, where LH is often elevated relative to FSH (9, 10). 

Estradiol 

Estradiol is the main estrogen produced by the ovaries. During the follicular phase, it is synthesized by granulosa cells under FSH stimulation. It promotes endometrial proliferation and prepares the uterus for implantation. High sustained estradiol triggers the LH surge for ovulation. Elevated early-cycle estradiol may mask high FSH, complicating ovarian function interpretation (2, 9, 10). 

Anti-Müllerian Hormone (AMH) 

Anti-Müllerian hormone ia a TGF-β family glycoprotein secreted by granulosa cells of pre-antral and small antral follicles and is a key biomarker of ovarian reserve. It inhibits excessive follicle recruitment, helping maintain follicular pool over time (11, 12). 

AMH levels reflect the number of growing follicles and provide accurate, cycle-independent assessment of reproductive potential. AMH correlates well with ovarian response in IVF. Low AMH suggests poor ovarian reserve; high AMH may indicate PCOS (4, 8, 10). 

Progesterone 

Progesterone is crucial during the luteal phase and for early pregnancy, preparing the endometrium for implantation, inhibiting uterine contractions, and regulating the hypothalamic-pituitary axis. Its measurement, typically 7 days post-ovulation, confirms ovulation. Low luteal progesterone may suggest anovulation or corpus luteum insufficiency (9, 10). 

Prolactin 

Produced by the anterior pituitary, prolactin mainly supports lactation, but elevated levels (hyperprolactinemia) can suppress GnRH, reducing FSH and LH, impairing ovulation and causing amenorrhea and infertility. Prolactin testing is useful in evaluating irregular cycles, amenorrhea, and unexplained infertility. Mild elevations may result from stress, medications, or improper collection, requiring careful interpretation (1, 9). 

What Is Ovarian Reserve? 

Ovarian reserve refers to the pool of available follicles in the ovaries, reflecting both the quantity and quality of oocytes (13, 14). 

This is influenced by age, genetics, and environmental factors (13). Ovarian reserve declines irreversibly at varying rates among women and affects menopause onset (6, 10). 

Ovarian reserve testing, combining hormone levels and imaging, emerged in the late 1980s to predict ovarian response to stimulation and IVF success. Common tests include AMH, FSH, and antral follicle count (AFC) by ultrasound. 

These tests aim to identify infertile women at risk of poor ovarian response to gonadotropin stimulation (10). 

How Does Anti-Müllerian Hormone (AMH) Testing Help Evaluate Ovarian Reserve? 

Anti-Müllerian hormone (AMH) testing has become one of the most reliable tools for assessing ovarian reserve, as it directly reflects the number of growing follicles in the ovaries. Produced by granulosa cells of pre-antral and small antral follicles, AMH is considered an early and sensitive marker of the remaining follicular pool (6, 11, 16). 

AMH serum levels are nearly undetectable after menopause and strongly correlate with antral follicle count (AFC) and a woman’s age (17, 18). Since AMH levels remain relatively stable throughout the menstrual cycle and do not depend on gonadotropin action, it can be measured at any phase of the cycle, facilitating its clinical use (19, 20). 

In addition to accurately estimating ovarian reserve, AMH is used to predict response to ovarian stimulation in IVF cycles. Studies show that low AMH levels are associated with poor stimulation response, while high levels may indicate a risk of ovarian hyperstimulation (8, 21). 

Although AMH is not a good predictor of pregnancy outcomes as it does not reflect oocyte quality, its usefulness as a quantitative marker of ovarian reserve is widely recognized. Still, interpretation must consider factors such as variation between test kits, lack of international standardization, and the influence of clinical variables such as contraceptive use, obesity, or ethnicity (2).

When Is Anti-Müllerian Hormone Testing Indicated? 

AMH testing is recommended for women who want to assess their ovarian reserve, especially in the following situations: 

• Women over 35 years old;
• Family history of early menopause;
• Women with polycystic ovary syndrome (PCOS);
• Family planning purposes;
• Monitoring assisted reproductive treatments (e.g., IVF);
• Before and after ovarian surgery or chemotherapy.

How to Interpret Serum AMH Test Results? 

AMH reflects the number of available antral follicles. Normal AMH values indicate adequate ovarian reserve, while low values suggest reduced follicle count, potentially leading to poor fertility treatment outcomes. Elevated AMH levels are frequently seen in women with PCOS, reflecting a higher follicle count but also an increased risk of ovarian hyperstimulation during treatment (22-24). 

AMH results have direct implications for fertility and reproductive treatment strategies. Low AMH may suggest difficulty conceiving naturally and a potentially weak response to ovarian stimulation during IVF or ovulation induction (22, 25). On the other hand, elevated levels, especially in PCOS, may require careful management to avoid complications during treatment (23). 

It is important to note that a single AMH measurement is not sufficient to fully determine ovarian reserve. Ideally, serial assessments (e.g., every 3 months) are recommended to detect significant declines over time. Moreover, results should be interpreted alongside other markers such as FSH, antral follicle count (AFC), and the patient’s age (22, 24, 26). 

Since ovarian reserve is multifactorial and influenced by various factors — such as previous surgeries, age, and gynecological conditions like endometriosis or cancer — no single marker can fully capture ovarian status. Therefore, integrating multiple test results is essential for a comprehensive and accurate evaluation (22, 24, 26, 27). 

When and Why to Perform Female Hormone Testing? 

Female hormone testing is recommended at different life stages, depending on clinical symptoms or specific goals such as conception or monitoring the transition to menopause. During reproductive years, hormonal testing of FSH, LH, estradiol, and progesterone helps investigate menstrual irregularities, ovulatory disorders, and infertility. 

AMH, in particular, can be tested at any point in the cycle and is widely used for reproductive planning and assisted reproduction treatments (22, 25, 26). 

Women suspected of having PCOS may also benefit from evaluating androgens like total testosterone and DHEA-S, and prolactin testing if clinical signs are present. 

In perimenopause and postmenopause, FSH and estradiol testing help characterize declining ovarian function and guide clinical decisions, especially for symptoms such as hot flashes, insomnia, and mood changes. 

At this stage, persistently high FSH and low estradiol levels are typical (28, 29). TSH testing is also important, as thyroid dysfunction can mimic or worsen climacteric symptoms. 

Regardless of life stage, female hormone testing should always be individualized and interpreted by a healthcare provider, considering clinical context, age, cycle timing, and health goals such as pregnancy planning, symptom monitoring, or preventive hormonal health assessment (26, 30). 

What Tests Does SYNLAB Offer for Female Hormonal Profile Assessment? 

SYNLAB offers a comprehensive portfolio for evaluating the female hormonal profile, essential at all stages of a woman’s life — from menstrual cycle tracking and reproductive disorder investigation to menopause monitoring. Key tests include:

• Follicle-Stimulating Hormone (FSH): Important for assessing ovarian function and follicular reserve, especially in women with irregular cycles or undergoing infertility workup;
• Anti-Müllerian Hormone (AMH): A sensitive ovarian reserve marker, useful in reproductive planning and assisted reproduction;
• 17-beta Estradiol (E2): The main reproductive estrogen; helps monitor the cycle, fertility, and menopause. Available in both serum and saliva samples;
• Luteinizing Hormone (LH): Works with FSH to regulate ovulatory cycles; useful in anovulation, PCOS, and infertility evaluation;
• Prolactin: Elevated levels may be linked to infertility, menstrual changes, and galactorrhea;
• Progesterone: Essential for assessing the luteal phase and confirming ovulation. Available in serum and saliva samples;
• Dehydroepiandrosterone (DHEA): An androgenic hormone that influences female hormonal balance, particularly in cases of chronic fatigue, aging, and sexual dysfunction. Available in serum and saliva samples.

Get to Know SYNLAB – A Leader in Medical Diagnostic Services! 

Accurate and up-to-date testing is essential for precise diagnoses and better treatment guidance. SYNLAB is here to help. 

We offer diagnostic solutions with rigorous quality control to the companies, patients, and healthcare providers we serve. Present in Brazil for over 10 years, we operate in 36 countries across three continents and are leaders in diagnostic services in Europe. 

Contact the SYNLAB team to learn about our available tests. 

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