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Abstract:  Estrogens, progesterone, testosterone, dehydroepiandosterone, and cortisol play vital roles in many aspects of a woman’s physiology and quality of life. A wide variety of symptoms and medical conditions are completely or partially due to elevations or deficiencies of sex hormones in women. Often a clinician suspects that a patient’s symptoms are related to hormone irregularities, but conventional diagnostic serum testing shows hormone levels in the normal ranges. Serum is only one reservoir or sex hormones in the body, and thus serum level does not accurately reflect sex hormone bioavailability. Salivary hormone analysis, on the other hand, offers accurate and comprehensive assessment of hormone bioavailability at the tissue level, from all reservoirs. Reference values for salivary hormone testing have been established for women. Saliva testing is more convenient for the patient and costs less than serum testing, yet it has not been accepted into mainstream medicine. Disadvantages of salivary hormone testing include poor correlation with serum results in women receiving hormone replacement therapy and the potential for contamination of samples. These disadvantages can be overcome with careful sample collection technique and adjusting for the patient’s hormone replacement therapy status. Salivary hormone assay can be adapted by primary care providers to assist in the diagnosis and treatment of conditions related to sex hormone imbalances in women.

Related Keywords: Kenna Stephenson, MD, FAAFP, saliva testing, hormone levels, hormone imbalance, menopause, perimenopause, hormone deficiency, signs and symptoms, women

Related Categories: HRT

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