In short: A hormone health check usually means a consultation plus targeted blood tests, chosen according to your symptoms, age and sex. Common tests include thyroid function, testosterone, and reproductive hormones such as FSH, LH, oestradiol and prolactin. Hormone levels vary through the day and the menstrual cycle, so timing matters and results need a clinician to interpret them. For many women over 45, perimenopause and menopause are diagnosed from symptoms without blood tests.

This guide, written by a Ready Health prescribing pharmacist and based on NICE and NHS guidance, explains which hormone tests are useful, when to have them and what the results can and cannot tell you.

What symptoms might suggest a hormone problem?

tiredness, low mood or poor concentration
changes in weight without an obvious cause
irregular, heavy or absent periods
hot flushes, night sweats or sleep problems
low sex drive or erectile difficulties
excess hair growth, acne or thinning hair
difficulty conceiving

These symptoms are common and have many possible causes, not only hormones. That is why testing works best after a consultation.

Which hormone tests are commonly used?

Concern	Typical tests	Notes on timing
Thyroid	TSH, free T4 (sometimes free T3, thyroid antibodies)	Any time of day
Low testosterone in men	Total testosterone, SHBG, LH, FSH, prolactin	Morning sample, ideally before 11am; an abnormal result is usually repeated
Perimenopause or menopause	Often none needed over 45; FSH in some younger women	Varies through the cycle; hormonal contraception can affect results
Irregular periods or PCOS	Testosterone, SHBG, LH, FSH, prolactin, thyroid; sometimes HbA1c or lipids	Often early in the cycle if periods occur
Ovulation check	Progesterone	About 7 days before the next expected period

Do you need a blood test to diagnose menopause?

Usually not if you are over 45. NICE guidance says perimenopause and menopause can be diagnosed in women over 45 based on symptoms and changes in periods. Hormone levels fluctuate a lot during perimenopause, so a single FSH result can be misleading.

Blood tests may be considered in women aged 40 to 45 with symptoms, and are important in women under 40, where premature ovarian insufficiency needs to be considered. Other tests, such as thyroid function, may help rule out conditions that cause similar symptoms.

How is low testosterone in men assessed?

Low testosterone (male hypogonadism) is diagnosed from a combination of symptoms and repeated morning blood tests, not a single result. Levels naturally peak in the morning and can be lowered temporarily by illness, poor sleep, heavy alcohol use, some medicines and being overweight. Additional tests help work out the cause and check suitability before any treatment is considered.

Testosterone treatment is a prescription-only medicine. It is not suitable for everyone and needs regular monitoring, including blood count and, where relevant, prostate checks. A prescriber decides whether it is appropriate after a full assessment.

Can hormone tests tell you about fertility?

Partly. Tests such as progesterone (to check ovulation), FSH, LH, prolactin and thyroid function can help identify some causes of fertility problems. Anti-Müllerian hormone (AMH) gives an estimate of ovarian reserve, but it does not reliably predict the chance of natural conception. If you have been trying to conceive for a year (or six months if you are 36 or over), see your GP, who can start NHS fertility investigations for you and your partner.

What happens if results are abnormal?

Depending on the result, next steps may include repeating the test, further investigations, lifestyle advice, treatment or a referral to a specialist such as an endocrinologist or gynaecologist. Hormone treatments, including hormone replacement therapy (HRT) and thyroid medicines, are prescription-only and only started after an individual assessment of benefits and risks.

Frequently asked questions

Should I fast before a hormone blood test?

Most hormone tests do not require fasting. Testosterone is best taken in the morning, and some guidance suggests a fasting sample. You will be told what to do when booking.

Can I test my hormones while on the pill or HRT?

Hormonal contraception and HRT affect many reproductive hormone results. Tell the clinician what you take so they can decide whether testing is useful.

Are home hormone test kits reliable?

Finger-prick kits can measure some hormones, but results depend on correct sampling and timing. Abnormal or borderline results usually need repeating and a clinician's review.

How often should hormone levels be checked?

There is no routine schedule for healthy people. Testing is guided by symptoms, existing conditions and any treatment that needs monitoring.

Key takeaways

Hormone tests are most useful when chosen to match your symptoms.
Timing matters: testosterone in the morning, progesterone in the second half of the cycle.
Most women over 45 do not need a blood test to diagnose perimenopause.
Any hormone treatment is prescription-only and decided by a prescriber after assessment.

Sources and further reading

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own clinician.

To talk through your symptoms and the right tests, you can book a private blood test consultation, a women's health and menopause appointment or a men's health assessment at Ready Health in Standish, Wigan.

Hormone Health Checks for Men and Women: Which Tests and When