Female hormone blood test

The female hormone blood test is a ten-marker panel covering the hormones behind your cycle, skin, energy and mood. It costs $139 with your own doctor's signed request, or $219 with a KnowLuna women's health doctor who requests the panel and explains your results in a 20-minute video consult. Collect at an accredited Australian centre, or choose a home kit or a nurse visit at checkout (options below).

What it measures

• FSH: the pituitary signal that recruits an egg each cycle. Read early in the cycle, it shows how hard the brain is working to run your ovaries.
• LH: triggers ovulation mid-cycle. A persistently high LH to FSH ratio is one pattern seen in PCOS.
• Oestradiol: the main oestrogen of your reproductive years (also searched as estrogen). It builds the uterine lining and shifts across the cycle.
• Progesterone: rises after ovulation. A day 21 level is the standard way to confirm you ovulated.
• Testosterone: women make it in small amounts. Raised levels can show as acne, excess hair growth or scalp thinning.
• SHBG: the protein that carries testosterone. High SHBG means less active hormone; low SHBG means more.
• Free androgen index: total testosterone divided by SHBG, times 100. A better guide to active androgen than testosterone alone.
• Prolactin: the milk hormone. Raised outside pregnancy and breastfeeding, it can suppress ovulation.
• DHEA-S: an androgen from the adrenal glands, which helps separate adrenal from ovarian sources of excess androgen.
• Cortisol: the adrenal hormone that peaks in the morning, so it is measured before 10am. A single morning level is a screen, mainly for a clearly low result, not a measure of stress or burnout.

Which symptoms point to which hormones?

Hormone symptoms overlap, which is why doctors read these markers as a set.

Symptom	Markers read first	Why
Irregular, late or missing periods	FSH, LH, oestradiol, prolactin, testosterone	Is brain-ovary signalling running, is prolactin interfering, are androgens high?
Heavy or painful periods	Full blood count and ferritin first, thyroid function if indicated, clotting studies if bleeding has been heavy since your teens	Hormone levels rarely explain heavy or painful bleeding. A pelvic ultrasound through your GP looks for structural causes; the hormone panel helps only when cycles are also irregular.
Adult acne or excess facial hair	Testosterone, SHBG, free androgen index, DHEA-S	Androgens drive oil and hair growth; the index shows how much is active.
Weight that will not shift	Testosterone, SHBG, cortisol	Low SHBG often travels with insulin resistance; cortisol affects appetite and fat distribution.
Low energy, flat mood, poor sleep	Cortisol, oestradiol, progesterone, prolactin	These shift with stress and across the cycle.
Low libido	Testosterone, free androgen index, oestradiol	Active androgen and oestrogen both contribute.

Who it's for

Anyone with irregular, absent or changing cycles, or with fatigue, mood changes, acne, hair changes or low libido, who wants to understand what their hormones are doing. If your main concern is heavy or painful bleeding, hormone levels rarely explain it: a full blood count and ferritin, thyroid function if indicated, clotting studies if bleeding has been heavy since your teens, and a pelvic ultrasound are the usual first steps through your GP. Adults aged 18 and over. If thyroid symptoms are also in the picture, the hormone and thyroid panel adds a full thyroid check.

What you'll learn, and what you won't

You'll see each marker against your laboratory's range, with a plain-English explanation of what it does and how it relates to the others. A doctor explains the pattern in the context of your cycle day, symptoms and contraception, and suggests next steps: a repeat on another cycle day, a related test such as the PCOS panel, or a referral letter.

What a single panel cannot do is tell the whole story. Hormones fluctuate by the hour and across the cycle, so one collection is a snapshot. A blood test is one input to a doctor's assessment, not a diagnosis on its own.

Reference ranges and what they mean

Typical adult ranges for women in their reproductive years. Several change with cycle day, so the collection day is printed beside your result.

Marker	Typical adult range	What it usually means
FSH (day 2 to 5)	About 3 to 10 IU/L	Higher suggests the ovaries need more stimulation, as in lower reserve or perimenopause.
LH (day 2 to 5)	About 2 to 10 IU/L	Usually close to FSH early in the cycle. Higher than FSH can be a PCOS feature.
Oestradiol (day 2 to 5)	Typically under about 200 to 300 pmol/L early in the cycle	Rises towards ovulation. Very low with high FSH suggests reduced ovarian activity.
Progesterone (day 21)	Above about 30 nmol/L mid-luteal is consistent with ovulation; 15 to 30 nmol/L is a borderline band	Low on day 21 can mean no ovulation this cycle, or that timing was off.
Total testosterone	Laboratory-specific; typically under about 2 nmol/L in women	Above range points to androgen excess, common in PCOS.
SHBG	Laboratory-specific, wide range	Low SHBG frees more testosterone and often travels with insulin resistance. Combined hormonal contraception raises it two- to four-fold.
Free androgen index	Laboratory-specific; low single digits typical	A raised index is the most useful biochemical sign of androgen excess.
Prolactin	Under about 500 mIU/L outside pregnancy and breastfeeding	Mildly raised results are often repeated. Persistently high levels can stop ovulation.
DHEA-S	Age-dependent; falls from the twenties onwards	Raised levels point to an adrenal source of androgen.
Cortisol (morning)	Roughly 100 to 550 nmol/L before 10am; reads high on combined hormonal contraception	Very high or very low morning levels prompt further testing. Mild variation is normal.

Ranges vary by laboratory; your report shows the range your lab uses. Typical ranges on this page are drawn from Pathology Tests Explained (RCPA) and the sources listed below.

When to do this test

Day 2 to 5 is the standard window for FSH, LH and oestradiol, with day 1 the first day of full bleeding. Testosterone, SHBG, DHEA-S and prolactin can be collected the same day. If your cycles are irregular or absent, collect any day and tell us the date of your last period. No fasting is needed.

Day 21 is for progesterone. It is most informative about seven days after ovulation, which is around day 21 in a 28-day cycle. Your doctor may suggest a separate collection, or you can add the ovulation check. We help you time it if your cycle is longer or shorter.

Cortisol needs a morning sample. It peaks soon after waking and falls through the day, so book before 10am. An afternoon cortisol reads low and tells the doctor very little. Avoid testing while unwell.

On the pill or an IUD?

Combined hormonal contraception (the pill, ring or patch) suppresses FSH, LH, oestradiol and progesterone, raises SHBG two- to four-fold and lowers total and free testosterone, so those results reflect the contraception rather than your own cycle. Total cortisol reads high on oestrogen-containing methods, because the protein that carries it rises, and DHEA-S reads low, so your doctor discounts those two or suggests retesting off the pill. Prolactin is usually still informative, although it can be mildly raised. A hormonal IUD has a much smaller effect. Androgens are best checked after about three months off a combined method, with other contraception in place. Tell us what you use. More in contraception and hormone tests.

How it works

• Order online. Either upload the request your own doctor has signed, or a KnowLuna women's health doctor reviews your short questionnaire and requests the panel for you.
• Collect at an accredited centre near you, or choose a home kit or a nurse visit (options below). We'll guide you on the best cycle day and the morning cortisol.
• Results are usually ready within a few business days, explained in your account, with a doctor to talk them through.

Choose how you collect

Every option is the same accredited test and the same report. Pick what suits you at checkout; the fee, if any, is added to either pathway price.

Common questions

Sources and further reading

• Pathology Tests Explained (RCPA): follicle stimulating hormone (FSH)
• Pathology Tests Explained (RCPA): luteinising hormone (LH)
• Pathology Tests Explained (RCPA): oestradiol
• Pathology Tests Explained (RCPA): prolactin
• Pathology Tests Explained (RCPA): testosterone
• Pathology Tests Explained (RCPA): sex hormone binding globulin (SHBG)
• Healthdirect: hormones

General information only, not medical advice. A test result is one input to a doctor's assessment, not a diagnosis on its own, and every abnormal result is followed up by a KnowLuna doctor. If your symptoms are severe or sudden, see a doctor promptly. Read our medical disclaimer.

Related

• All cycle and hormone tests
• Female hormone and thyroid panel
• PCOS blood test panel
• Female hormone imbalance: symptoms and the tests that check them
• Testosterone, SHBG and DHEA-S in women