DUTCH Testing vs Serum Testing for Measuring Sex Hormones

Sex hormone testing is a hugely beneficial tool for both patients and practitioners, especially when it comes to identifying and understanding the root cause of hormone-related symptoms. From complex hormonal conditions such as polycystic ovary syndrome (PCOS) and endometriosis, to heavy menstrual bleeding and pelvic pain, sex hormone testing can help us determine whether your reproductive hormones are behind the symptoms or health concerns you’re experiencing. 

That being said, not all types of hormone testing are created equal. Functional hormone tests such as the DUTCH urine test from Precision Analytical are far more comprehensive than conventional blood, saliva, and urine tests. Conventional hormone testing is still an option, but these tests can’t tell us nearly as much as DUTCH tests can. The choice of test really depends on the specific situation and the hormone being tested. 

Sex hormones 101

Before we get into the pros and cons of urine, blood, and saliva hormone testing, let’s take a moment to discuss the benefits of measuring your sex hormones. For example, your main reproductive hormones like estrogen, progesterone, and testosterone. These hormones affect everything from fertility and libido to mood, muscle mass, bone density, sleep, and more!

Why test your sex hormones?

When we measure the level of hormones in your urine, saliva, or blood, we can assess whether your sex hormones — estrogen, progesterone, and testosterone — are within optimal ranges for your age, gender, and stage of life. For women, these life stages include pre-menopause (before menopause), perimenopause (during/around menopause), and post-menopause (after menopause). 

It’s normal for sex hormones to fluctuate throughout life, especially during puberty, pregnancy, and perimenopause. However, certain medical conditions, lifestyle factors, and metabolic issues can affect hormone levels and lead to hormonal imbalances that cause complex hormone-related symptoms (think fatigue, mood swings, hair loss, low libido, and brain fog). 

This is where sex hormone testing comes in! Hormone testing can measure sex hormone levels in the blood, saliva, or urine; identify imbalances in sex hormones; and in some cases, monitor hormone replacement therapy (HRT). 

The DUTCH urine test tells us even more

Some functional hormone tests — for example, the DUTCH urine test by Precision Analytical — can also clue us into why your hormone levels are above or below the reference ranges for your age, gender, and life stage. This is because DUTCH hormone testing measures more than sex hormone levels alone!

What is a DUTCH test?

Otherwise known as the Dried Urine Test for Comprehensive Hormones, DUTCH hormone testing is the only test that looks at how your body metabolizes and detoxifies excess hormones. This information is especially useful for preventing and managing hormone-related conditions like infertility, PCOS, endometriosis, male-pattern hair loss, prostate concerns, and certain types of cancer. 

Here’s why: if the body cannot effectively process (metabolize) and remove (detoxify) sex hormones once they’ve served their purpose, excess hormones build up in the body. This can result in estrogen excess and/or androgen excess. Numerous factors affect hormone metabolism and detoxification, including nutrient deficiencies, exposure to endocrine-disrupting chemicals (EDCs), and gut dysbiosis. 

DUTCH tests look at multiple hormone groups

High levels of sex hormones — in addition to causing symptoms of hormone excess — can also lead to a deficiency in other types of hormones. For example, estrogen excess can lead to low progesterone, low testosterone, and low DHEA levels. Hormone balance is key!

This is why DUTCH tests look at multiple hormone groups and their metabolites, as one type of hormone imbalance can lead to another. Tests such as the DUTCH Plus test and DUTCH Cycle Mapping Plus are the most comprehensive hormone panels, followed by the DUTCH Complete test and DUTCH Sex Hormone Metabolites. The first three tests measure sex hormones and cortisol levels, which can be helpful if you’re experiencing adrenal-related symptoms such as:

• Chronic fatigue.
• Depression or anxiety.
• Poor stress tolerance. 
• Insomnia. 

Conventional saliva and blood tests can also measure certain adrenal hormones, but only urine testing can measure free cortisol (the active form of cortisol). And remember: dried urine testing is the only test that looks at how hormones are metabolized and detoxified. Once we understand how the body breaks down and removes hormones, we can take steps to improve this process and keep our hormones balanced.  

Does DUTCH hormone testing cost more? 

While the DUTCH urine test is my preferred at-home hormone panel, there is a downside: it often costs more than conventional serum hormone testing and is rarely covered by insurance. Still, it’s a worthwhile financial investment if you’re experiencing complex hormone-related symptoms. 

A DUTCH test is also an invaluable tool if you are considering starting hormone therapy and would like to know about pre-existing risk factors associated with imbalances in hormone metabolism and how to mitigate these. For example, the DUTCH test can highlight excessive conversion of testosterone to metabolites causing acne and male pattern hair loss, or excessive conversion of estrogen to potentially carcinogenic metabolites – both mechanisms that can be managed with natural remedies used in conjunction with hormone replacement!

If DUTCH testing isn’t the right hormone panel for you, conventional blood testing can effectively measure estrogen, progesterone, DHEAs and testosterone levels as well. The advantage of blood tests for hormones is that they are widely available; however, common blood tests only measure a few of the hormones (much less than tested on the DUTCH test), only measure the amount of hormone currently available and do not provide any information on hormone metabolization (“breakdown”) – which is so important to mitigate risk!