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The Best Blood Tests for your Period (& Fertility)

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March 27, 2018
period blood tests, toronto naturopath, naturopathic doctor toronto

Lately, I’ve been getting many women coming into my office trying to figure what’s going on with their periods. Some of them will come to me with half diagnoses of PCOS, some will come in with feelings of fatigue and heavy periods. I know and believe that there are so many ways to help with these conditions, but blood work will give us a better idea of what is going on, and how a treatment plan should begin. So today I wanted to talk about why you should have blood work done annually AND which tests you should consider having done if you suspect something is up with your period. 

Please keep in mind that for many of the situations listed below, lifestyle (aka. stress, estrogen detox) can also be a factor, but that cannot be quantified using blood work. Instead, you may way to look at salivary cortisol.  

Blood Test Basics

Much of our health can be determined through blood testing. Sometimes saliva or urine would be indicated when you are interested at looking at patterns (ie. cortisol), or determining how hormone like estrogen are metabolizing within the body. 

In Ontario, Medical Doctors will use their clinical judgement to requisition lab tests that they feel are appropriate for you. The costs of these tests are covered by OHIP. Naturopathic Doctors are also able to requisition most blood work to ensure that no stone is left unturned when trying to discover the root cause of your symptoms. While this testing is not covered by OHIP, you will have to pay out of pocket, but 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

  • HbA1c

  • 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!”

Taking a look at two key hormones are important. Unfortunately while endometriosis is a huge reason of painful periods, there aren’t any blood tests to diagnose it.  

  • Estrogen

  • Progesterone

“We’re trying to have baby, but nothing’s working!”

  • FSH

  • LH

  • Progesterone

  • Fasting Insulin

  • Total Testosterone

  • Free Testosterone

  • Sex Hormone Binding Globulin

  • DHEA-S

Final Thoughts

Blood test results gives us an idea of what may be going on inside the 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

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