Can You Test My Hormones? – A Clinician's Guide to a Tricky Question

"Can you test my hormone levels?"

If you work in primary care, you’ve likely heard this question from patients in their late 30s to early 50s. The request often comes wrapped in frustration, fatigue, and TikTok-fueled anxiety, but rarely with clear symptoms. As a clinician, it can be a tricky line to walk—you want to acknowledge your patient’s concerns without diving headfirst into expensive and unhelpful lab panels.

So how do we answer this question with compassion, clarity, and evidence?

Where Is This Coming From?

In today’s digital age, hormone levels testing is big business. Hormone testing “at home” kits, social media influencers, and "hormone clinics" promise balance and vitality. It’s no wonder patients are curious, especially when they're feeling tired, moody, or not quite themselves. The cultural message is loud and clear: if you feel off, your hormones are probably to blame.

And they indeed might not be wrong—just misinformed on how to find the answer.

When Is Hormone Level Testing Appropriate?

Hormone testing should be driven by clinical symptoms and diagnostic suspicion. Here are just a few scenarios where targeted hormone testing may be appropriate:

• ▪️ Thyroid dysfunction: fatigue, cold intolerance, weight gain, menstrual irregularities
• ▪️Polycystic ovarian syndrome: irregular cycles, hirsutism, infertility
• ▪️Premature ovarian insufficiency: amenorrhea and vasomotor symptoms before age 40

Aside from these concrete instances, there’s no guideline that supports routine hormone testing for wellness or "balance" purposes.

Talking With Patients About Hormones

Rather than dismiss a patient’s request, validate their experience. Try phrases like:

• ▪️ "When you say 'check your hormones,' can you tell me more about what you're feeling?"
• ▪️ "Hormone levels vary based on age, cycle, and more—so broad testing usually isn't helpful. Let's focus on your symptoms to guide what we test."
• ▪️"There are tests that can help us rule out certain conditions. If they’re normal, we’ll still work on ways to help you feel better."

Meeting them where they are with a more structured approach not only helps guide evidence-based care but also builds trust.

Final Thoughts

When patients ask for hormone testing, what they often mean is, "I feel off, and I need help making sense of it."

Use that as your cue to dig deeper, rule out true endocrine dysfunction, and validate their concerns. Hormone panels aren’t the answer to every midlife symptom, but thoughtful, empathetic primary care just might be.

Want to walk through some real world cases with primary care clinicians? Check out our Primary Care Reviews and Perspectives (RAP) *** episode if you’re a subscriber, or subscribe to Primary Care RAP to hear Micaela and Ashley work through their approach.