Shouldn't Saliva/Blood Hormone Tests Be Done As a Matter of Course?

I couldn't believe that my doctor didn't test my hormone levels after my hysterectomy. (I'm 9 weeks post-op.) Is this usual?

Testing hormone levels seemed like common sense to me, and I mistakenly assumed at my 6-week check-up that it would be the first thing he did.

How can a doctor know which hormones to replace and the appropriate dosages without testing? Is it just me, or does it seem like a "crapshoot" to just presribe a standard dose of Premarin or some such form of estrogen?

When I asked him about such testing, he replied that no, his office has never done that and has no plans to.

Think I should search for a doctor who does such testing, and is it true that saliva testing is more accurate than blood serum testing?

Thanks for any words of wisdom you may have! :-))

Hi Sherrie It's not routine for DRs to test hormone levels at any particular interval post op. Some women never need to have them checked... it tends to be done more as a last ditch effort when attempts at finding the right HRT have not been successful. Most DRs prefer to prescribe by symptoms, and by trial and error, since there is a very wide range in what is "normal" in terms of hormone levels. For example, one woman might feel great with an estrogen level of, say, 120, while another feels much better at 200 and a third at 60.

One exception to the prescribing by symptoms policy has to do with prescribing testosterone. Most DRs won't prescribe testosterone until they've tested the woman's serum level of free testosterone and found it to be low. This is because supplementing with testosterone when the level is not low can lead to rather unpleasant symptoms of too much testosterone which can be hard to get rid of. Testosterone also shouldn't be prescribed without first evaluating the woman's lipid profile... testosterone can tend to adversely affect cholesterol so it's not for women with trouble in that department.

There is some controversy over which is better, blood or saliva testing. I have had both done. I didn't find either one all that enlightening. With testosterone, the blood test was more representative of the situation, and I believe it's more commonly done. There is a problem with using saliva tests for progesterone testing if you're using progesterone creams, which is that the creams can lead to false very high (like thousands of times too high) results on the test. This is a known problem with saliva tests for progesterone but I have not seen a good explanation of why it occurs. And with estrogen, in my experience neither type of test was particularly useful since the range of 'normal' values is so broad.

So.... I would concentrate on treating your symptoms and finding an HRT or combination of HRT's that make you feel like yourself again... and reserve the hormone testing for if and when you get stuck along the way and need a hint. Just my

s,
-Linda

Once again, surferbabe, thank you. Your responses always remind me of how much I have yet to learn about the Hormone Jungle.

I really appreciate your sharing your knowledge with me :-)