What’s Up With My Hormones? Why Choosing the Correct Testing Method is Crucial in Measuring Accurate Results


Men worried about hair loss, erectile dysfunction, or low testosterone. Women suffering menstrual pain, fluctuations in their cycle, or menopause-related problems. Couples experiencing infertility. Patients whose medical condition is affected by hormone levels. And countless men and women are concerned about changes in their stamina, energy, or libido.  In short, it’s a rare adult who hasn’t wondered: What’s up with my hormones? 

Finding answers should start with a complete hormone profile measuring sex and adrenal hormones. But choosing the right method – testing the right substance, with the right sample – makes the difference between important data and meaningless numbers. And a true hormone profile is a complex thing, not a quick test you can order online.

Hormones can be measured in saliva, blood, and urine, but only urine shows the body’s full daily production of hormones. Yet even a profile using urine fails if it’s based on “spot” samples taken at various times of day. 

“Spot tests’ don’t work because they don’t capture the body’s full 24-hour hormone production,” says Frank J. Nordt, Ph.D., of Rhein Consulting Laboratories in Portland, OR. 

“Using a ‘spot test’ is like watching 30 seconds of a movie and reviewing the whole film. What if the main character isn’t even in those 30 seconds?”

The only useful hormone measurement comes from a 24-hour urinary steroid hormone profile. Hormones aren’t only isolated substances, like estrogen or testosterone. They operate together in an integrated system, around the clock. That’s why measuring just one hormone tells you nothing. 

Some hormones are produced continuously during the 24-hour timespan. Others are produced intermittently, in a pulse-like fashion, and disappear quickly. Some combine to change their performance in the body, and some even mimic others. Only a 24-hour urine profile looks at that full system to provide meaningful information.

So meaningful, in fact, that the 24-hour urine profile is the only one that insurance providers routinely reimburse. “Spot tests” aren’t deemed scientifically reliable enough to qualify.

A 24-hour hormone profile provides crucial information on such a wide range of health conditions that well-informed patients sometimes request the profile before a health-care practitioner recommends it. 

Many are women in every stage of reproductive life, including the use of hormone-replacement therapy during and after menopause. (For menstruating women, the profile is done mid-cycle, between days 19 and 21.) For men, erectile dysfunction is a key indicator, as are some less-specific symptoms, such as low energy, weight gain, and depression.

The hormone profile can answer questions a health-care provider hasn’t even asked yet.  And for patients, the difference truly could be life or death.

Dr. Nordt recently raised a warning flag for a patient in her mid-30s whose hormone levels were suspiciously high for a woman of that age. 

“I was concerned,” Dr. Nordt says, “so I shared that perspective with her primary-care practitioner, who had prescribed the hormone profile. That’s when I learned that the patient had been treated for breast cancer and told that she was in the clear. But her hormone levels didn’t agree with that assessment.”

The patient returned to her oncologist, who told her she was okay. Her surgeon confirmed the oncologist’s judgment. But when the patient went home and did a breast self-exam, she found a new lump herself.

A “spot test” would not have included the crucial information revealed by a round-the-clock urinary profile. The 24-hour urinary hormone profile is the most accurate test for checking hormones.

Frank J. Nordt, Ph.D., Director and CEO of Rhein Consulting Laboratories, created the first accurate, reproducible, clinically relevant assay measuring sex and adrenal hormones – today, the gold standard in the field. With more than 35 years of experience in biochemistry, pharmacology, and endocrinology, Dr. Nordt continues to innovate as a thought leader worldwide, providing clear information and expert interpretation on hormone health for women and men of all ages.

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