Test ID: S-123 | Sample Type: Saliva | Technology: LC-MS/MS | Results Time: 3–5 Working Days After Laboratory Receives Sample | Laboratory: ZRT Laboratory – CLIA Certified | Hormone Specialist Doctor Interpretation: Included | Suitable For: Adults and Children | Collect Sample At Home: No Clinic Visit Required
What Does This Test Measure?
Saliva — Three Sex Hormones (LC-MS/MS): Estradiol (E2), Progesterone and Testosterone.
This at-home panel provides three salivary hormone measurements to review with your healthcare professional alongside your symptoms, medicines and treatment history.
Testosterone and estradiol have established roles in male sexual and physical health. Progesterone is also measured, although its usefulness for explaining common male symptoms is less established.
Related Symptoms
Reduced sexual desire; fewer spontaneous or morning erections; erectile difficulties; reduced muscle mass or strength; and breast tenderness or enlargement. Persistent tiredness or low mood may also warrant assessment, particularly when accompanied by sexual symptoms.
Did You Know?
Men need both testosterone and estradiol. Testosterone supports sexual desire, muscle mass and other physical functions, while estradiol contributes to bone health and sexual function.
A normal total testosterone blood result does not always settle the question of testosterone deficiency. When appropriate, clinicians can assess free testosterone using blood measurements of testosterone, SHBG and albumin, or a specialist laboratory method.
This saliva panel provides additional measurements; it does not replace the established blood tests used to diagnose testosterone deficiency or monitor TRT.
Who Should Consider This Test?
Men whose healthcare professional has recommended salivary hormone measurements as additional information when reviewing:
- Reduced sexual desire
- Fewer spontaneous or morning erections
- Erectile difficulties, especially alongside reduced libido
- Unexplained reductions in muscle mass or strength
- Breast tenderness or enlargement
- Persistent tiredness or low mood accompanied by other signs of possible testosterone deficiency
How Your Results Can Help Guide Your Next Steps
Reduced Sexual Desire or Changes in Erections
Related hormone: Testosterone
Low testosterone can contribute to reduced libido and fewer spontaneous erections. Erectile difficulties can also involve circulation, medication, stress and other factors.
How to use your results: Review the report with your clinician alongside when symptoms began and any medication changes. They can decide whether morning testosterone blood tests and other investigations are appropriate, then discuss treatment suited to the findings.
Reduced Muscle Mass or Strength
Related hormone: Testosterone
Testosterone contributes to maintaining muscle mass. A hormone measurement adds information to a review of changes in strength or physical performance.
How to use your results: Discuss your training, food intake, sleep and recovery alongside the report. Your clinician can consider further hormone assessment, while helping you plan appropriate resistance exercise, adequate nutrition and recovery.
Breast Tenderness or Enlargement
Related hormones: Estradiol and testosterone
Changes in oestrogen and androgen activity can contribute to breast-tissue enlargement. Breast symptoms do not automatically mean estradiol is high.
How to use your results: Arrange a clinical examination and bring your report and medication list. Your clinician may recommend blood estradiol, testosterone or other tests to investigate the cause and discuss suitable management.
Persistent Tiredness or Low Mood
Related hormone: Testosterone, particularly when sexual symptoms are also present
These symptoms can occur with testosterone deficiency, but they have many possible causes.
How to use your results: Your clinician can review the findings alongside sleep, stress, nutrition and sexual symptoms, then prioritise further checks such as testosterone, thyroid function or anaemia testing where appropriate.
What Does the Progesterone Result Add?
Progesterone contributes another measurement to the laboratory profile. There is no established symptom pattern that reliably identifies low progesterone in men, so it should not be presented as the hidden cause of excess oestrogen, low libido or poor muscle development.
The Practical Benefit of This Test
Convenient home collection provides a report you can bring to a focused clinical discussion. The results and accompanying laboratory comments can help you understand the measurements, identify questions for your practitioner and plan appropriate further assessment.
Your practitioner can then combine the findings with your symptoms and established clinical tests to guide lifestyle changes or treatment.
Why This Test Is Particularly Important for Men
- Saliva LC-MS/MS measures free, bioavailable testosterone — the fraction actually reaching cells and driving libido, muscle, and mood; a man with high SHBG can have normal total blood testosterone but critically low free testosterone with full androgenic deficiency symptoms
- Estradiol must be measured alongside testosterone in men — excess estradiol from aromatase-driven testosterone conversion suppresses HPG-axis testosterone production, causes gynaecomastia, drives water retention, and impairs sexual function; the testosterone-to-estradiol ratio is the most clinically actionable number in this panel
- Progesterone is the natural regulator of male estradiol balance — acting as a direct aromatase inhibitor, low progesterone allows unchecked testosterone-to-estradiol conversion and is frequently the hidden driver of oestrogen dominance symptoms in men with plausible testosterone values
- This is the most appropriate starting panel for men with suspected androgen deficiency, early andropause, or TRT-related estradiol monitoring needs — capturing the three markers that must be interpreted together
Not Sure Which Test Is Right for You?
Email us at info@hormonelab.co.uk with your gender, age, symptoms, medications, and any current treatments. We will forward your enquiry to our doctors and respond within 24 hours.
How It Works
- Order your kit — delivered directly to your door
- Collect your saliva sample in the morning (ideally 7–9am), when testosterone is naturally at its peak, before eating, drinking, or brushing your teeth
- Post your sample to ZRT Laboratory using the return instructions provided
- Receive your full report by email within 3–5 working days
What You Receive
- Estradiol (E2), Progesterone, and Testosterone results with male-specific reference ranges
- Visual charts for all three hormones
- Testosterone-to-estradiol ratio interpretation and progesterone–estradiol balance assessment by a Hormone Specialist PhD Doctor
- Personalised next-step recommendations
- Laboratory fee included — no hidden charges
Why We Use ZRT Laboratory
All testing is performed by ZRT Laboratory — a globally recognised, CLIA-certified diagnostic laboratory founded in 1998 by Dr. David Zava, PhD. ZRT has performed over 11 million tests and is trusted by healthcare professionals in 96+ countries.
- Pioneers of at-home dried blood spot (DBS) and saliva hormone testing
- Advanced LC-MS/MS technology for clinical-grade accuracy
- Qualified for the CDC Hormone Standardization (HoSt) Program
- Personalised reference ranges based on age and sex
Through our partnership with ZRT Laboratory, Hormone Lab UK delivers internationally recognised, research-backed hormone testing to people across the UK and Europe — from the comfort of home.
Frequently Asked Questions
What hormones does this test measure?
Estradiol (E2), Progesterone, and Testosterone — the three core sex hormone markers for assessing androgenic balance and estradiol regulation in men.
When should I collect my sample?
Collect in the morning, ideally between 7–9am, when testosterone is naturally at its daily peak. Full collection instructions are included in your kit.
Can I use this test if I am on TRT?
Yes. This test is particularly valuable for men on TRT wanting to monitor estradiol conversion and progesterone balance alongside their testosterone levels.
Why is saliva better than blood for these hormones?
Saliva LC-MS/MS measures free, bioavailable hormone — the fraction actually active at the cellular level. Standard blood tests measure total hormone including the protein-bound, inactive fraction, which can mask clinically significant imbalances.
Does the price include the laboratory fee?
Yes. The full laboratory analysis fee is included. There are no additional charges. You are only responsible for posting your sample to the laboratory.
How long is the kit valid for?
The kit must be used within 12 months of the purchase date.
Saliva Sample Collection Instructions
Collect your saliva samples at home using the materials supplied with your kit. Check your Test Requisition Form and kit instructions to confirm whether you need one, two or four samples. You may not need every tube supplied.
Read all instructions before collection, including the Hormone Users section if you take hormone treatment.
1. Confirm Your Collection Times
| Number of samples required | Collection times |
|---|---|
| One | Morning |
| Two | Morning and before bed |
| Four | Morning, before lunch, before dinner and before bed |
Use the large 10 mL tube for your morning sample and the smaller 5 mL tubes for later samples.
2. Choose Your Collection Day
Choose your collection day and mark it on your calendar. Record all current medicines on your Test Requisition Form.
Men, children and women who do not menstruate: Collect on any day of the month, following the hormone-treatment instructions below where applicable.
Women who menstruate: If testing estradiol, progesterone or testosterone, follow this schedule:
| Your usual menstrual-cycle length | When to collect |
|---|---|
| 23–26 days | Day 17, 18 or 19 |
| 27–30 days | Day 21, 22 or 23 |
| 31–34 days | Day 25, 26 or 27 |
| Shorter or longer regular cycles | 5–7 days before your next expected period |
| Infrequent or unpredictable cycles | Any non-bleeding day |
Day 1 is the first day of menstrual flow, not spotting. Ovulation timing varies with cycle length.
3. Hormone Users
Skip this section if you do not use hormones.
List all hormone treatments on your requisition form. This information helps the laboratory select appropriate reference ranges and provide relevant comments.
Continue prescribed hormone treatment. If the collection instructions require a change to your usual dosing time, confirm the timing with your prescriber.
Topical and Oral Hormones
- Continue your prescribed hormones on the day before testing.
- The laboratory specifies at least 12 hours between an evening dose and morning collection. For example, an 8 am collection requires the previous evening’s dose by 8 pm.
- Oral progesterone is an exception: it may be taken immediately before bed.
- For at least two days before collection, use gloves or an applicator when applying topical hormones rather than bare hands.
- Avoid applying hormones to the face, lips or neck.
Troches or Under-the-Tongue Hormones
These treatments are not recommended for saliva hormone testing because they can contaminate samples. Discuss an alternative, such as blood spot testing, with your healthcare professional. Samples may be fully or partially rejected.
Patches, Vaginal Rings, Pellets or Injections
The laboratory advises testing halfway between doses. Examples include approximately three days after a once-weekly patch or two weeks after a once-monthly injection.
Confirm the appropriate timing for your particular treatment with your prescriber.
Steroid Medicines
If you use glucocorticoids, including hydrocortisone or prednisone, ask your healthcare professional about collection timing.
Prevent Hormone Contamination
- Change your sheets, pillowcases and towels the night before collection.
- Avoid touching bathroom surfaces that may contain hormone residue.
- Dry your washed hands with a clean towel.
4. Prepare for Collection
Three days before collection
Avoid anti-ageing or anti-wrinkle facial creams and biotin/vitamin B7 supplements, including hair and nail formulas.
The night before collection
Stay normally hydrated without drinking excessive amounts. Both dehydration and overhydration can affect salivary hormone measurements.
Before your morning sample
Do not eat, drink anything except water, or brush your teeth.
Before any later samples
Do not eat, drink anything except water, or brush your teeth for at least two hours before collection.
5. Collect Your Samples
- Wash your hands with soap and water, then dry them with a clean towel.
- Rinse your mouth with water and wait five minutes.
- Begin your morning collection within 30 minutes of waking, using the large tube.
- Allow saliva to pool naturally in your mouth, then transfer it into the tube.
- Fill the tube at least halfway, excluding bubbles. Collection usually takes 15–30 minutes, depending on saliva flow.
- Screw the cap on securely.
- Label the tube with your name, collection date and collection time, then return it to its bag.
- Repeat these steps at any later required collection times, using the smaller tubes.
To encourage saliva flow: Try yawning, smelling food without eating it, or pressing the tip of your tongue against your teeth. Gently tap the tube on a hard surface to help remove bubbles.
6. Complete Your Paperwork and Return Your Samples
- Complete your requisition form fully, including your symptoms, medical history, medicines and hormone treatments.
- Place your labelled samples, requisition form and any additional paperwork inside the plastic test kit box.
- Include payment only if applicable under your kit’s arrangements.
- Snap the box lid shut and place the entire box inside the return packaging.
- Attach a prepaid label if supplied and applicable, or arrange the required postage.
- Return the package using the carrier specified in your kit instructions.
7. Storage and Collection Mistakes
Freeze any samples that will not be shipped within 24 hours. The laboratory states that samples remain stable under average shipping conditions, including weekends and holidays.
If you make a collection mistake, rinse the affected tube with hot water only—no soap. Shake out the remaining water, allow it to air-dry and restart collection at the appropriate time.
Before packing, check that every sample tube is at least halfway full of liquid saliva, excluding bubbles.
