You have your blood test results in front of you, and behind every line sits an abbreviation: E2, FSH, LH, TSH. What do those numbers actually mean, and which ones belong in a thorough hormone panel for women anyway? This article walks through them one by one, so you can read your own results with more confidence.
My take up front: a single isolated hormone value tells you almost nothing. The value of a hormone test lies in the combination and in the moment you draw blood.
What does a hormonal blood test measure?
A small amount of blood is drawn and analysed in the lab for specific hormones. The result is not a diagnosis but a snapshot of your hormonal status. According to Thuisarts.nl, a value that sits just outside the reference range need not be a problem at all: the context of your symptoms and cycle phase weighs more heavily than a single number.
Which values are measured and what do they mean?
The table below shows, per hormone, what it measures, a rough reference value and the best moment in your cycle to test. Reference ranges differ per laboratory, so always follow the values printed on your own result.
| Hormone | What it tells you | Rough reference | Best moment |
|---|---|---|---|
| Estradiol (E2) | Main oestrogen; cycle, bones, mood | Highly variable: 45-850 pmol/L by phase | Day 2-5 (baseline) |
| Progesterone | Confirms whether you ovulated | > 30 nmol/L suggests ovulation | Day 19-22 |
| FSH | Egg reserve and menopause | Elevated (above ~25 IU/L) can suggest menopause | Day 2-5 |
| LH | Triggers ovulation; LH/FSH ratio in PCOS | Varies sharply around ovulation | Day 2-5 |
| Testosterone | Elevated can fit PCOS (acne, hair growth) | Low in women; lab-dependent | Morning, day 2-5 |
| TSH | Screens the thyroid | 0.4-4.0 mU/L | Morning, any time |
| Cortisol | Stress hormone that affects others | Highest in early morning | Before 9:00 |
Female sex hormones
The values of estradiol (E2) and progesterone fluctuate strongly across your cycle. A progesterone measurement on day 19-22 can confirm whether you actually ovulated, which is useful with a wish to conceive or an irregular cycle.
Regulating hormones
FSH stimulates egg maturation and LH triggers ovulation. An elevated FSH can point to a reduced egg reserve or to menopause. The NVOG (the Dutch society of gynaecologists) stresses that diagnosing menopause rests mainly on your symptom pattern and age, not on a single FSH value, because that one jumps from month to month in perimenopause.
Androgens, thyroid and stress
A high testosterone can fit PCOS. TSH is the first screening value for your thyroid: an abnormal result is reason for further testing of free T4. Cortisol is best measured in the early morning.
GP or arrange it yourself?
Through your GP the test is requested based on your symptoms, and costs are often reimbursed. The downside is that not every hormone is always included. According to NHG guidelines, a GP requests specifically what fits your story, not a broad panel by default. If you arrange it yourself, you choose which hormones to measure. The blood is drawn and analysed the same way; the difference is who places the request.
Why the ratio matters, not one number
Hormones do not work in isolation. FSH and LH drive your ovaries, which in turn make estradiol and progesterone; cortisol from your adrenals can slow that whole system down. An estradiol of exactly the same number can be normal in one woman and too low in another, depending on her age, cycle phase and the other values around it. That is why a doctor looks at the whole: an elevated FSH with low estradiol tells a different story than an elevated FSH with normal estradiol. So do not be alarmed by one line on your result that turns red; the pattern is what counts.
How do you prepare?
- Draw blood in the morning (before 10:00) for more stable cortisol and TSH values.
- Note which cycle day you test on.
- Mention any medication and supplements you use.
- Fasting is usually not needed for hormone tests.
Which test suits you?
Want a broad picture in one go? A panel like our hormones for women test measures the core hormones together. Also read our pillar on hormone testing for women: which tests and when, and if you mainly want to know which hormones to measure, hormone test for women: which hormones to test helps further.
Frequently asked questions
Which blood test is most complete?
A panel measuring estradiol, progesterone, FSH, LH, testosterone, TSH and cortisol gives the broadest picture. What is useful for you depends on your symptoms and life stage and is best discussed with a doctor.
Can my GP test additional hormones?
Yes. If a first test shows abnormalities, your GP can add free T4, prolactin or SHBG.
How do I read my result?
Your result shows your measured values next to the lab reference ranges. A value outside that range is a reason to discuss it with a healthcare provider, not an automatic diagnosis.
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