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 — Core Sex Hormones (LC-MS/MS): Estradiol (E2), Progesterone, Testosterone.
3 markers — the essential female hormonal trio for assessing estrogenic status, progesterone balance, and androgen sufficiency across all life stages in a single at-home saliva kit.
Related Symptoms
Changes in menstrual-cycle regularity; premenstrual breast tenderness, bloating, irritability or mood changes; hot flushes, night sweats or vaginal dryness; reduced sexual desire; and persistent acne, oily skin or increased facial or body hair.
How Your Results Can Help Guide Symptom Management
This panel measures estradiol, progesterone and testosterone in saliva. Reviewed alongside your symptoms, menstrual-cycle timing and treatment history, the results provide additional hormone information to help your healthcare professional plan appropriate next steps.
Changes in Menstrual-Cycle Regularity
Related hormones: Estradiol and progesterone
These hormones participate in regulating the menstrual cycle. Your measurements can add information when reviewing changes in period frequency or cycle length.
How to use your results: Bring your report and a record of your periods to your appointment. Your clinician can consider whether further hormone tests, an ovulation assessment or a gynaecological review would help explain the changes and guide treatment.
Premenstrual Breast Tenderness, Bloating or Mood Changes
Related hormones: Estradiol and progesterone
Premenstrual symptoms can be associated with sensitivity to normal hormonal fluctuations, as well as changes in hormone production. Results collected at the appropriate cycle stage provide context for reviewing your symptoms.
How to use your results: Track symptoms across at least two cycles and review them with your report. This helps your clinician discuss suitable symptom management, including regular exercise, sleep habits, dietary adjustments and treatment for persistent or disruptive PMS.
Hot Flushes, Night Sweats or Vaginal Dryness
Related hormone: Estradiol
Changes in oestrogen during perimenopause and menopause are associated with these symptoms. Your estradiol measurement adds hormone information to a review of your age, menstrual history and symptoms.
How to use your results: Discuss options for relief with your clinician, including hormonal or non-hormonal treatments where appropriate. Practical measures include keeping your bedroom cool, identifying personal hot-flush triggers, and using vaginal moisturisers or lubricants for dryness.
Reduced Sexual Desire
Related hormones: Testosterone and estradiol
Testosterone participates in sexual desire, while oestrogen supports vaginal tissue health and comfort. Your results contribute to a broader review of sexual wellbeing, including discomfort, sleep, stress and medication.
How to use your results: Explain whether the main concern is reduced desire, dryness or pain during sex. This helps your clinician focus on appropriate care, such as treating vaginal discomfort, reviewing medicines or considering specialist assessment. Testosterone treatment decisions require a clinical assessment and appropriate blood testing.
Persistent Acne, Oily Skin or Increased Facial or Body Hair
Related hormone: Testosterone
These symptoms can be associated with increased androgen activity. Your testosterone measurement provides additional information for your clinician to consider.
How to use your results: Record when symptoms began and whether your periods have also changed. Your clinician may recommend blood androgen tests or an assessment for PCOS, then discuss suitable skin, hair or hormonal treatments.
Turn Your Report Into a Practical Plan
Your laboratory results, reference ranges and accompanying comments give you information to discuss with your healthcare professional. Together, you can identify what needs further investigation, agree suitable symptom-management steps and track improvements in your daily wellbeing.
Did You Know?
During perimenopause, ovulation becomes less regular, which can reduce progesterone production, while estrogen levels may fluctuate. These changes can occur alongside menstrual changes, hot flushes, night sweats and premenstrual symptoms.
Testosterone also plays a role in women’s sexual wellbeing, and excess levels can be associated with acne or increased facial and body hair.
This saliva panel measures estradiol, progesterone and testosterone using LC-MS/MS. Reviewing the results alongside your symptoms, cycle timing and treatment history provides additional hormone information to discuss with your healthcare professional.
Who Should Consider This Test?
Women whose healthcare professional has recommended measuring estradiol, progesterone and testosterone as additional information when reviewing:
- Menstrual changes — irregular cycles or changes in period frequency.
- Recurring premenstrual symptoms — breast tenderness, bloating, irritability or mood changes occurring before a period.
- Symptoms associated with menopausal hormonal changes — hot flushes, night sweats or vaginal dryness.
- Reduced sexual desire — particularly when accompanied by other hormonal symptoms.
- Possible androgen excess — persistent acne, oily skin or increased facial or body hair.
Results should be reviewed alongside your symptoms, menstrual-cycle stage and any hormone treatments to guide appropriate further assessment.
Why This Test Is Particularly Important for Women
- Saliva LC-MS/MS measures free, bioavailable estradiol and testosterone — the fractions actually driving symptoms; standard blood immunoassay measures total hormone including the protein-bound inactive fraction, which frequently masks clinically significant imbalances in women on HRT or with elevated SHBG
- The progesterone-to-estradiol ratio is the most clinically meaningful number in this panel — oestrogen dominance (low progesterone relative to estradiol) is responsible for the majority of PMS, cycle irregularity, breast tenderness, and perimenopausal anxiety even when absolute estradiol is within the reference range
- Progesterone decline precedes estradiol decline by several years in perimenopause — making progesterone measurement essential for identifying the earliest hormonal shift that standard panels routinely miss
- Testosterone deficiency in women is systematically overlooked — low testosterone in women produces persistent fatigue, flat mood, reduced libido, and difficulty maintaining muscle tone; it becomes increasingly prevalent after age 35 and is rarely assessed by GP panels
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 at home following the detailed instructions — ideally on Day 19–21 of your cycle (7 days after ovulation) for optimal progesterone capture; guidance for postmenopausal and HRT users is included
- 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 female life-stage-specific reference ranges
- Visual charts for all three hormones
- Progesterone-to-estradiol ratio assessment and oestrogen dominance evaluation 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 female hormonal balance across all life stages.
When should I collect my sample during my menstrual cycle?
Day 19–21 of your cycle (approximately 7 days after ovulation) is optimal for capturing both estradiol and progesterone in context. Full timing guidance for irregular cycles, perimenopause, postmenopause, and HRT users is included in your kit.
Can I use this test if I am postmenopausal or on HRT?
Yes. This test is suitable for women at all life stages, including those on HRT, bioidentical hormones, or the contraceptive pill. It is particularly valuable for monitoring HRT response and identifying whether dosing is achieving the intended hormonal balance.
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 and responsible for symptoms. Standard blood tests measure total hormone including the protein-bound inactive fraction, which can mask clinically significant imbalances, particularly in women on HRT or with elevated SHBG.
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.
