What tests are included in a basic hormone panel for women?

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Basic Hormone Panel Tests for Women

A comprehensive hormone panel for women should include estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and prolactin as the core tests, with additional hormones assessed based on clinical presentation. 1

Core Hormone Tests

Reproductive Hormones

  • Estradiol (E2): Measures ovarian function and estrogen levels
  • Follicle-stimulating hormone (FSH): Evaluates ovarian function and menopausal status
  • Luteinizing hormone (LH): Assesses ovulation and ovarian function
  • Progesterone: Particularly important for assessing luteal phase function and ovulation

Thyroid Function

  • Thyroid-stimulating hormone (TSH): Screens for thyroid disorders
  • Free T4: Often included when TSH is abnormal

Other Essential Hormones

  • Prolactin: Evaluates pituitary function and can affect menstrual cycles

Additional Tests Based on Clinical Presentation

For Suspected PCOS

  • Total testosterone and free testosterone: Primary tests for hyperandrogenism 2
  • Free Androgen Index (FAI): 78% sensitivity, 85% specificity for PCOS 2
  • Androstenedione: 75% sensitivity, 71% specificity for PCOS 2
  • Dehydroepiandrosterone sulfate (DHEAS): Evaluates adrenal androgen production 2
  • 17-hydroxyprogesterone: To exclude congenital adrenal hyperplasia 2

For Menopausal Assessment

  • Anti-Müllerian hormone (AMH): Emerging marker for ovarian reserve assessment 1
  • Inhibin B: Additional marker for ovarian reserve 1

For Fertility Evaluation

  • Morning cortisol: When adrenal disorders are suspected 1
  • ACTH: For suspected pituitary dysfunction 1

Timing Considerations

  • Reproductive hormones should ideally be measured on specific days of the menstrual cycle:

    • FSH and estradiol: Best assessed on days 2-5 of the menstrual cycle (early follicular phase)
    • Progesterone: Best assessed 7 days after ovulation (mid-luteal phase, typically day 21 of a 28-day cycle)
    • LH: Can be measured throughout the cycle, but peaks at ovulation

  • Thyroid hormones show seasonal variation with:

    • TSH levels typically higher in winter and spring
    • TSH levels lower in summer and autumn 3

Clinical Context for Testing

  • Irregular menstrual cycles: FSH, LH, estradiol, progesterone, prolactin, TSH
  • Infertility workup: Complete panel including AMH and testosterone 1
  • Menopausal symptoms: FSH, estradiol (FSH may not be reliable in women with prior chemotherapy or on tamoxifen) 1
  • Suspected thyroid disorders: TSH, free T4, thyroid antibodies if autoimmune thyroid disease is suspected 4

Important Considerations

  • FSH is not a reliable marker of menopausal status in women with prior chemotherapy, pelvic radiation exposure, or those on tamoxifen 1
  • Hormone levels measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) may be lower than those measured by older immunoassay methods 5
  • Anti-Müllerian hormone (AMH) shows promise as a predictor of ovarian reserve and timing of menopause onset 1
  • Women with PCOS have higher rates of thyroid disorders, particularly Hashimoto's thyroiditis, suggesting the importance of thyroid testing in these patients 4

By understanding which hormone tests to include in a basic panel and when to add specialized tests, clinicians can more effectively evaluate women's hormonal health and address specific concerns related to fertility, menstrual irregularities, and menopausal symptoms.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

2
Guideline

Diagnosis and Management of Polycystic Ovary Syndrome (PCOS)

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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