Test ID: SB-643F | Saliva 4-Point Cortisol + Blood Spot LCMS Hormones 7 with SHBG
The Female Hormone Health Test is one of the most comprehensive at-home hormone profiles available for women, measuring 15 key hormones and markers via a combination of saliva 4-point cortisol and blood spot LCMS testing. It is designed to provide a clinically complete picture of sex hormone balance, adrenal stress response, and the binding protein that controls how much of your hormones are actually available to your body.
What distinguishes this test is the inclusion of SHBG (Sex Hormone Binding Globulin) alongside the full sex hormone panel. SHBG determines the proportion of testosterone and oestradiol that is free and active versus bound and unavailable — meaning two women with identical total hormone levels can have very different symptoms depending on their SHBG. This test measures both total and free hormone availability, providing a level of clinical detail that standard hormone blood tests do not offer.
Test from home with confidence — no clinic visit required. Results within 3–5 working days.
Why This Test Is Uniquely Suited to Women
Female hormonal health cannot be understood by measuring one or two hormones in isolation. This test assesses the full integrated network:
- SHBG is the key to understanding free hormone availability in women — high SHBG (driven by oestrogen, the contraceptive pill, or liver stress) binds testosterone and oestradiol, leaving insufficient free hormone for energy, libido, and mood; low SHBG (driven by insulin resistance, PCOS, or high androgens) releases excess free testosterone, driving acne, hair loss, and cycle irregularities; without measuring SHBG, total hormone levels are clinically incomplete
- All three oestrogens reveal oestrogen metabolism, not just oestrogen levels — oestradiol (E2) is the dominant premenopausal oestrogen; oestrone (E1) becomes the dominant postmenopausal oestrogen via adipose conversion; oestriol (E3) reflects oestrogen metabolic activity; together they reveal dominance patterns, conversion imbalances, and metabolic oestrogen risk that E2 alone cannot show
- Progesterone-to-oestrogen ratio determines hormonal balance — oestrogen dominance — caused by low progesterone relative to oestrogen — is one of the most common hormonal patterns in women and drives PMS, heavy periods, breast tenderness, anxiety, insomnia, and weight gain; this ratio can only be assessed when both markers are measured simultaneously
- Testosterone and DHEAS together reveal the full androgenic picture — testosterone drives libido, energy, and muscle tone in women; DHEAS is its adrenal precursor and declines from the mid-30s; together they reveal whether androgen excess (PCOS), androgen deficiency (fatigue, low libido), or adrenal androgen depletion is driving symptoms
- Cortisol connects the entire hormonal system — chronic cortisol elevation suppresses progesterone, depletes DHEAS, drives oestrogen dominance, impairs T3 thyroid conversion, and raises SHBG; the 4-point profile captures the full daily adrenal rhythm and shows whether the HPA axis is overactivated, exhausted, or dysrhythmic
What This Test Measures
Saliva — 4-Point Cortisol
- Cortisol (C) — Morning: The Cortisol Awakening Response — the critical morning surge that sets energy, blood sugar, progesterone balance, and immune function for the day. A blunted morning response signals HPA burnout; an exaggerated response indicates high stress reactivity and progesterone suppression.
- Cortisol (C) — Noon: Elevated noon cortisol in women drives blood sugar instability, afternoon energy crashes, sugar cravings, and worsens the oestrogen dominance pattern by suppressing progesterone and increasing aromatase activity.
- Cortisol (C) — Evening: Should be declining significantly to allow progesterone and melatonin to rise, supporting hormonal restoration and sleep onset. Elevated evening cortisol disrupts the hormonal shift that women depend on for quality sleep and overnight recovery.
- Cortisol (C) — Night: Elevated night cortisol is a primary cause of insomnia, night sweats, and overnight blood sugar dysregulation in women — particularly during perimenopause and menopause when progesterone is no longer available to buffer cortisol during sleep.
Blood Spot — Full Sex Hormone Panel with SHBG (LCMS)
- Oestradiol (E2): The primary and most potent oestrogen in premenopausal women — driving reproductive health, bone density, cardiovascular protection, skin integrity, and mood stability. Declining E2 in perimenopause drives hot flushes, night sweats, vaginal dryness, and accelerated bone loss.
- Oestriol (E3): Reflects oestrogen conversion pathways and metabolic activity. E3 is produced from oestradiol and oestrone metabolism; low E3 relative to the other oestrogens can indicate suboptimal oestrogen conversion and reduced oestrogenic tissue protection.
- Oestrone (E1): The dominant postmenopausal oestrogen, produced by androgen conversion in adipose tissue. Elevated E1 in women with higher body fat or on HRT can drive oestrogen-dominant symptoms — breast tenderness, bloating, and increased cancer risk — if not appropriately balanced by progesterone.
- Progesterone (Pg): The essential counterbalance to oestrogen. Progesterone supports sleep quality, mood stability, bone health, uterine lining integrity, and thyroid function; it is a natural anti-anxiety hormone and cortisol inhibitor. Low progesterone — from anovulation, chronic stress, luteal phase deficiency, or perimenopause — is one of the most common and most undertreated causes of female hormonal symptoms.
- Testosterone (T): Essential in women for libido, energy, muscle tone, motivation, and cognitive clarity. Low testosterone in women causes persistent fatigue, low libido, poor exercise response, and low mood. Elevated testosterone — as in PCOS — drives acne, facial hair growth, scalp hair loss, and cycle irregularities. SHBG determines how much of this testosterone is actually free and available.
- DHEAS (DS): The primary adrenal androgen precursor in women, declining from the mid-30s and depleted rapidly under chronic stress. Low DHEAS is associated with persistent fatigue, reduced libido, poor stress resilience, worsening perimenopausal symptoms, and reduced testosterone precursor availability. Elevated DHEAS — from adrenal overactivity or PCOS — drives androgen excess symptoms.
- Cortisol (C) — Blood Spot: Provides the absolute cortisol value that anchors the 4-point saliva cortisol profile, confirming adrenal output at the time of blood spot collection.
- SHBG (Sex Hormone Binding Globulin): The transport protein that binds testosterone and oestradiol, determining how much free (active) hormone is available to tissues. High SHBG reduces free testosterone and oestradiol availability even when total levels appear normal — producing symptoms of hormone deficiency despite adequate production. Low SHBG releases excess free testosterone and oestradiol, driving androgen-excess and oestrogen-dominant symptoms. SHBG is directly affected by insulin resistance, the contraceptive pill, liver health, thyroid function, and oestrogen levels — making it a critical interpretive marker for the entire panel.
Who Should Consider This Test?
This test is particularly relevant for women who experience:
- Persistent fatigue or exhaustion that does not improve with sleep or rest
- PMS, heavy, irregular, painful, or absent periods
- Breast tenderness, bloating, or mood changes in the second half of the cycle
- Perimenopausal or menopausal symptoms: hot flushes, night sweats, low mood, vaginal dryness
- Low libido or reduced sexual interest
- Unexplained weight gain, particularly around the abdomen and hips
- Sugar cravings, energy crashes, or afternoon dips
- Brain fog, poor concentration, or memory issues
- Anxiety, irritability, or emotional volatility
- Insomnia, night waking, or unrefreshing sleep
- Acne, oily skin, excess facial hair, or scalp hair thinning
- Hair thinning, dry skin, or brittle nails
- Fertility difficulties or recurrent miscarriage
- Diagnosed or suspected PCOS or oestrogen dominance
- Currently on HRT or the contraceptive pill (which directly affects SHBG, oestradiol, and testosterone availability)
- Chronic stress or burnout
- Women over 35 wanting a comprehensive hormonal health baseline
Key Features
- 15-marker combined saliva cortisol and blood spot LCMS hormone panel
- SHBG included — the only way to assess free hormone availability alongside total levels
- All three oestrogens (E1, E2, E3) measured for complete oestrogen metabolism assessment
- 4-point cortisol profile revealing the full daily adrenal rhythm
- Results within 3–5 working days after lab receipt
- Expert analysis by a Hormone Specialist PhD Doctor
- Clear graphical and numerical results with personalised commentary
- All-inclusive price — laboratory fees included, no hidden costs
- Valid for 12 months from purchase
How It Works
- Order the kit online — delivered directly to your door.
- Collect your saliva samples at four time points (morning, noon, evening, night) and your blood spot sample via a simple finger-prick, following the detailed instructions provided. Guidance on optimal cycle timing is included.
- Post your samples to the lab using the return instructions included in your kit.
- Receive your results within 3–5 working days, with specialist commentary and clear next-step guidance.
What Your Report Includes
- All 15 marker results with female-specific reference ranges
- Visual charts for your 4-point cortisol daily curve and full sex hormone panel including SHBG
- Clinical interpretation of your free versus bound hormone availability based on your SHBG result
- Analysis of your oestrogen-progesterone ratio and dominance pattern
- Specialist commentary by a Hormone Specialist PhD Doctor
- Personalised next-step recommendations
Frequently Asked Questions
What does this test measure?
4-point Cortisol (saliva: morning, noon, evening, night) plus Oestradiol (E2), Oestriol (E3), Oestrone (E1), Progesterone, Testosterone, DHEAS, Cortisol, and SHBG (blood spot LCMS) — 15 markers in total.
Why is SHBG important for women?
SHBG determines how much of your testosterone and oestradiol is free and active versus bound and unavailable. Two women with identical total testosterone levels can have very different symptoms depending on their SHBG — one with high SHBG may have symptoms of testosterone deficiency despite adequate production; one with low SHBG (common in PCOS and insulin resistance) may have androgen excess symptoms despite total testosterone appearing normal. Without SHBG, total hormone results are clinically incomplete.
When in my cycle should I collect?
Guidance on optimal cycle timing is included in the kit. For most women, collection in the luteal phase (days 19–21 of a 28-day cycle) provides the most clinically meaningful progesterone and oestrogen values.
Can I use this test if I am on HRT or the contraceptive pill?
Yes. Both HRT and the pill significantly affect SHBG, oestradiol, and progesterone levels — which is precisely why a comprehensive panel including SHBG is more informative than standard blood tests for women on hormonal treatment. Follow the timing guidance in your kit.
Why measure cortisol at four time points?
A single cortisol measurement cannot distinguish between burnout (low flat curve), high reactivity (elevated peak), evening elevation (sleep disruption), or night-time excess (overnight blood sugar and progesterone dysregulation). The 4-point profile captures the full adrenal daily rhythm and reveals the specific pattern affecting your hormonal balance.
When will I get my results?
Within 3–5 working days after your samples reach the laboratory.
Are there hidden costs?
No. Laboratory analysis and specialist review are fully included. You are responsible for postage to the lab.
How long is the kit valid?
12 months from purchase.
Why We Partner with ZRT Laboratory
At Hormone Lab UK, every home test kit is analysed by ZRT Laboratory, a globally recognised, CLIA-certified diagnostic and research laboratory specialising in hormone testing, thyroid testing, fertility testing, adrenal function, neurotransmitter analysis, cardiometabolic health, heavy metals, and wellness testing. Founded in 1998 by renowned biochemist and breast cancer researcher Dr. David Zava, PhD, ZRT has become one of the world’s leading laboratories for advanced functional health testing.
With more than 11 million laboratory tests performed and healthcare professionals in over 96 countries relying on its expertise, ZRT is recognised for scientific excellence, analytical accuracy, and continuous innovation. The laboratory pioneered at-home saliva hormone testing, introduced the first commercially available dried blood spot (DBS) hormone tests, and developed Dried Urine Testing (DUTS), helping make advanced laboratory diagnostics more accessible and clinically meaningful.
Every sample is analysed using state-of-the-art LC-MS/MS and ICP-MS technology under rigorous quality control standards. ZRT collaborates with the CDC, NIH, and leading universities, supporting ongoing research and advances in laboratory medicine.
