By Nastya Yeska

Women are affected by the ever-changing levels of their female sex hormones throughout all stages of their lives. These fluctuations may be normal or abnormal and may affect the development of a young woman’s secondary sexual characteristics, menstrual cycling and associated disorders, pregnancy and infertility issues, cardiovascular and bone health, and perimenopausal and menopausal symptoms. Saliva hormone testing is easy to do and is often the first step in diagnosing and better understanding the cause of a variety of women’s health problems. Saliva testing is a simple and noninvasive method of measuring female hormones that offers advantages over traditional blood testing as a female hormone imbalance test.

Tecan womens health saliva hormone testing

Saliva testing is a simple, needle-free method to measure women’s sex hormones for diagnosing a hormonal imbalance at any stage of a woman’s life.


A lifetime of hormonal changes

Hormones are chemicals secreted by glands. They travel through the bloodstream to act on various organs throughout the body. Women’s sex hormones can have a wide range of effects, including on energy levels, mood, weight, sexuality, reproduction, and more. Too much or too little of any one hormone can cause a hormonal imbalance, resulting in a variety of symptoms.

If symptoms suggestive of hormonal imbalance are present at any stage of a woman’s life, the first most practical step could be hormone testing. It is easy to measure the levels of the main female hormones and to determine if they fall within what is called the “normal range.” Testing should also determine whether the hormones exist in the proper ratios to each other.

Hormone imbalance testing is useful to diagnose developmental problems and for mapping a woman’s menstrual cycle. It can help detect the cause of infertility. It can also help determine whether a woman is in perimenopause or menopause and whether her symptoms might benefit from hormone replacement therapy (HRT) or an adjustment to ongoing HRT. Hormone testing should include the determination of levels of the main female sex hormones: estradiol, estriol, estrone, and progesterone. The laboratory conducting the test will provide the level of each hormone and a normal range for each hormone tested.

What hormones should be tested?

1. Estrogen: The ovaries produce most of a woman’s estrogen. This hormone is responsible for the physical changes that occur at puberty, including the start of menstruation. Estrogen also helps regulate the menstrual cycle, is important for fertility, helps control cholesterol, protects bone health, and affects the brain, heart, and other tissues. The body may make too much or too little estrogen, and women may take in estrogen through birth control pills or HRT. 

The body makes three main types of estrogen:

A: Estradiol– This hormone plays an important role in female reproduction. During menstruation, estradiol levels increase, causing the maturation and release of an egg and the thickening of the uterine lining in preparation for implantation of the fertilized egg. Estradiol levels decrease as women age and especially during menopause.

B: Estriol – A positive, mild-acting form of estrogen that is measured to aid control of hormone replacement therapy in menopausal women.

C. Estrone – Is a type of estrogen produced by the ovaries, and its role is less well understood. It is found in higher levels in postmenopausal women. It is possible that low estrone levels may be linked to the development of osteoporosis and menopausal symptoms, as these are associated with too little estrogen hormone.

2. Progesterone: During the second half of the menstrual cycle, after ovulation, a woman’s body produces a temporary gland called the corpus luteum. This gland secretes progesterone, which prepares the uterine lining for the possibility of pregnancy. It causes the lining to thicken and it prevents muscle contractions. In the event of pregnancy, progesterone continues to support the blood supply to the uterus. Women who have low levels of progesterone may have abnormal menstrual cycles, difficulty conceiving, or be at increased risk for miscarriage or pre-term delivery.

Advantages of saliva hormone testing

Women’s hormones are present in saliva, so diagnostics using an immunoassay-based saliva test kit offer a valuable needle-free alternative for hormone testing. Saliva testing with ready-to-go immunoassays that measure the levels of hormones in saliva is not only painless, but minimally invasive for the patient compared to more traditional testing approaches that require a blood draw. Conventional hormonal testing for menstrual cycle mapping or for infertility, for example, often require blood samples to be collected repeatedly over time, which can cause distress and require multiple patient visits to a clinic or physician’s office. By contrast, saliva sample collection can be performed discreetly and painlessly at the patient’s convenience—either in the clinic, or at home using a saliva hormone test ordered online.  At-home sample collection is safe and easy to perform. Once sample is collected, the patient simply mails the sample to the lab for processing.

Saliva testing has another important advantage over blood-based testing. Women’s hormones are steroids and they typically travel in the bloodstream bound to carrier proteins, making them metabolically inactive and unavailable to cells. Only a small amount of free, unbound, bioactive hormone is present in the blood and able to enter cells and affect their function. Unlike standard blood tests, saliva tests measure the levels of unbound biologically active hormones. 

Immunoassays for measuring hormones in saliva are highly sensitive and able to detect the very low levels of bioactive hormones present in saliva. Saliva collection devices have been optimized to collect an appropriate sample. Once received by the diagnostic lab, saliva samples can be quickly processed either manually or using automated instrumentation, which can further reduce turnaround times and improve reliability of the results. Patients receive their test results together with a report indicating the normal range for each hormone, as established by the specific laboratory.

The availability of more convenient and sensitive immunoassays and sample collection methods to enable saliva testing for hormone imbalance is a big step forward for women’s healthcare. Download our free resource “A female hormone testing guide” for key points on testing women’s hormones.



About the author

Nastya Yeska

Nastya Yeska

Nastya Yeska joined Tecan in 2017 as a product manager responsible for the Complementary medicine product portfolio, including Food intolerance and Saliva diagnostics. Nastya is part of Global Reagent Marketing & Support Department responsible for delivering ELISA solutions. In 2021, she changed her role to Integrated Marketing Manager.