The Best Blood Tests for your Period (& Fertility)

Figuring out what's going on with your period doesn't need to be difficult.Whether you're convinced you might have PCOS, or you're emptying your cup every 3 hours, there's a simple way to get some answers.Blood work!Hear me out: I hate needles too, but the pain is worth the reward.Looking at your results will give me a better idea of what's going on, and how we should structure your treatment plan!So if you suspect something is up with your period, here are some tests that you should probably have done!Keep in mind that for many of the situations listed below, lifestyle (aka. stress, estrogen detox) can also be factors, but they cannot be quantified using blood work. Instead, you may way to look at salivary cortisol.

Blood Test Basics

We can figure out what's going on with your health through blood testing. Sometimes saliva or urine is indicated when you're hoping to look at a pattern (ex. cortisol), or trying to find out how estrogen is being metabolized in your body.In Ontario, Medical Doctors use their clinical judgement to requisition lab tests that they feel are appropriate for you. These tests are often covered by OHIP.Naturopathic Doctors can also requisition most tests to ensure that no stone is left unturned when trying to discover the root cause of your symptoms. Although it's not covered by OHIP and you'll have to pay out of pocket, some of this testing may be covered by insurance plans.

Best Blood Tests for Period Health

The Basics

• Complete Blood Count
• Cholesterol Panel
• Fasting Blood Sugar
• Fasting Insulin
• Vitamin B12
• Vitamin D
• Thyroid Panel
• Ferritin
• Zinc (plasma)

"Why am I changing my tampon all the time?" 

Typically, you shouldn't be losing more than 80mL of blood during your period. If you use a menstrual cup - you shouldn't be emptying a full cup 3+ times. A cup usually holds about 30mL, so emptying it 3 times at capacity puts you at 90mL of blood loss.Moreover, your flow shouldn't be longer than 7 days (with the first day of your period being a heavy day). If this happens, this means that you may not have ovulated.

• Progesterone
• Ferritin

If your periods are longer than 7 days, and day 1 is heavy bleeding; we want to rule out PCOS

• Free Testosterone
• Total Testosterone:
• Sex Hormone Binding Globulin
• DHEAS
• Fasting Insulin

"I hardly bleed during my period"

Anything less than 25mL of blood loss during a period (think less than 5 soaked tampons), would be considered a light period.This may be due to low estrogen within the body or PCOS.

• Estrogen
• Free Testosterone
• Total Testosterone
• SHBG
• DHEAS
• Fasting Insulin

"Why do I have facial hair?"

In the case of facial hair, and other non-traditional places in women (nipples, abdomen, upper arms and legs), we look to androgens and PCOS as a likely cause.

• Fasting Insulin
• Total Testosterone
• Free Testosterone
• Sex Hormone Binding Globulin
• DHEA-S

"Why isn't my period regular?"

Ideally your period should be happening every 21 to 35 days. If this isn't the case, you need to consider:

• Fasting Insulin
• Total Testosterone
• Free Testosterone
• Sex Hormone Binding Globulin
• DHEA-S
• Androstenedione
• 17-OH progesterone
• Progesterone
• Prolactin

"I used to have a period, and now I don't!"

Amenorrhea may be due to a few different causes like pregnancy, PCOS, and even female athlete triad.

• Pregnancy Test
• Prolactin
• Fasting Insulin
• Total Testosterone
• Free Testosterone
• Sex Hormone Binding Globulin
• DHEA-S

"I can't get out of bed, my periods are so painful!"

Unfortunately while endometriosis is a huge reason of painful periods, there aren't any blood tests to diagnose it.

"We're trying to have baby, but nothing's working!"

• FSH

• LH

• Estrogen

• Thyroid panel

• Fasting Insulin

• Total Testosterone

Final Thoughts

Blood test results gives us an idea of what may be going on inside your body and helps us to rule in OR out possible causes. If you're experiencing any of the above situations, getting more information will be helpful when it comes to treatment

Looking for a quick chart to refer to? You can download my healthy hormone guide here!