When to test your hormones as a woman

What counts as day 1 of your cycle?

Day 1 is the first day of proper bleeding. Not spotting, not the brown day before. If bleeding starts in the late afternoon or evening, count the following day as day 1.

This sounds like a technicality. It is the single most common reason a hormone panel comes back difficult to interpret. FSH, LH and oestradiol are read against a window that is only four days wide, and the numbers move fast inside it. Counting the spotting day as day 1 can push a day 3 draw to what is really day 5, and the picture changes.

If you cannot work out where you are in your cycle, that is a normal reason to test, not a reason to put it off. Irregular or absent cycles are one of the main things a hormone panel is for. Where there is no reliable day 1 to count from, the test is drawn on the day you come in and interpreted with that in mind.

Which day of your cycle should you test each hormone?

Only some hormones need cycle timing. FSH, LH and oestradiol are drawn on day 2 to 5. Progesterone is drawn about seven days before your period is due. Cortisol and testosterone are drawn in the morning. Thyroid markers, prolactin and DHEA-S can be drawn on any day.

What that looks like on a real report

Female hormones are not reported against one range. They are reported against four, one for each phase of the cycle, and the same number can be flagged high in one phase and be perfectly ordinary in another. Below is an anonymised extract from an Epicentre functional report, drawn during the luteal phase.

Look at the line under each bar. FSH at 10.1 is flagged high, and the same 10.1 would have been in range in either of the two phases before it. Oestradiol at 232.63 is the same story: high for the luteal phase, entirely ordinary for ovulation. Nothing about the blood changed. Only the day it was drawn.

Progesterone shows the other side of it. At 0.53 it is low for the luteal phase, and that is the point of drawing it there, because a luteal progesterone this low suggests ovulation did not happen that cycle. Drawn a fortnight earlier, in the follicular phase, 0.53 would have been unremarkable and the finding would have been missed entirely.

What are you actually trying to find out?

Women test their hormones for one of four reasons: an irregular or absent cycle, trying to conceive, symptoms of raised androgens such as acne or hair changes, or tiredness and brain fog that may not be hormonal at all. Working out which one you are asking is more useful than ordering the widest panel you can afford.

• Irregular or absent cycles. Unpredictable, very long, very short or missing. Day 2 to 5 timing matters most here, and prolactin and thyroid belong in the panel, because both can disrupt a cycle on their own.
• Trying to conceive. Progesterone seven days before your period is due tells you whether you ovulated. AMH speaks to ovarian reserve, though it predicts response to fertility treatment better than natural conception, and a low result is not a verdict.
• Acne, hair changes or weight that will not shift. Acne past your twenties, hair growth in a male pattern, or thinning on the scalp. This is the PMOS question, and it needs metabolic markers as much as hormones.
• Tired, flat or foggy. Often not a sex hormone problem at all, and that is worth knowing. Thyroid, iron and vitamin D explain a large share of exactly these symptoms, and none need cycle timing.

Each of those four is a tag on the panel cards further down, so once you know which one you are, you can go straight to it. If none of them quite fits, tell the team what you are noticing and they will point you at the right panel and the right day.

PCOS has a new name: PMOS

In May 2026 a global consensus published in The Lancet renamed polycystic ovary syndrome to polyendocrine metabolic ovarian syndrome, or PMOS. The condition, the diagnostic criteria and the tests are all unchanged. The name changed because the old one pointed at cysts that are not really cysts, and because the word "ovary" framed a whole-body metabolic condition as a gynaecological one.

Both names will be in use for a while: adoption is planned across about three years, so PCOS stays in test names, package names and medical aid codes. For testing, the practical points are that an adult diagnosis needs two of three features, that since 2023 an AMH result can stand in for an ultrasound, and that in adolescents neither ultrasound nor AMH should be used at all.

When will a hormone test not help you?

In three situations: when you are 45 or over and asking whether you are perimenopausal, when you plan to act on one result in isolation, and when you are unclear about what medication or contraception you are taking. A laboratory saying that out loud is unusual, so here it is plainly.

Perimenopause, if you are 45 or over

Current NICE guidance is that perimenopause and menopause should be identified without laboratory tests in otherwise healthy people aged 45 and over. It names the tests not to use: FSH, AMH, oestradiol, inhibin A and inhibin B. The reason is not cost. It is that hormone levels swing dramatically during perimenopause, sometimes day to day, so a single reading can read entirely normal in someone who is clearly perimenopausal. Knowing the number does not change what happens next.

FSH is worth considering between 40 and 45 where there are menopausal symptoms alongside a change in cycle, and under 40 where early menopause is suspected. It should not be used to identify menopause in anyone on combined hormonal contraception or high-dose progestogen, because the contraception sets the number.

A single result you plan to act on alone

One number on one morning is a snapshot. Hormones move across the cycle, across the day and across the month, and the useful signal is usually a pattern across several markers, or the same marker over time.

While you are unclear on what you are taking

Hormonal contraception, hormone therapy and some supplements change these results. That does not make testing pointless, but it does mean the result describes you-on-that-treatment rather than your own baseline. Write down what you are taking and hand it over with the results.

Getting hormones tested in South Africa

You do not need a doctor's referral to have your hormones tested if you are paying cash. Epicentre is a walk-in laboratory with branches in Cape Town, Johannesburg and Durban, and you book your own panel. Results are emailed, encrypted, in 2 to 5 working days.

The referral question confuses almost everyone, so: a referral is about payment, not access. Cash patients need none, for any test. If you intend to claim from a medical scheme you will generally need one, with an ICD-10 code from your doctor, or the claim is rejected and you pay cash anyway.

That gap matters more here than it might elsewhere, and it is the reason walk-in testing exists. Most women paying for a hormone panel in South Africa are paying out of pocket. The route that runs GP consultation, then referral, then laboratory account adds both cost and weeks. Meanwhile the shelves are full of hormone balance supplements sold on the basis of symptoms nobody has measured. Testing first is cheaper than a year of guessing, and it is the only way to find out whether the problem is a sex hormone at all.

PMOS is a good example of why that matters locally. Among women referred to a Cape Town teaching hospital with the condition, unfavourable lipid results were common, with raised LDL cholesterol in over 40% of a cohort of more than 1,700. That is the metabolic side the old name hid, and it is measurable in a routine blood test long before anything is felt.

Closed weekends and public holidays. Payments over R1,200 can be split into four interest-free instalments over six weeks. Students with a Varsity Vibe ID and pensioners get 10% off. You can also book a slot online if you would rather not wait.

Which panel fits your question

Listed cheapest first. Every panel is drawn at the branch and emailed to you, encrypted, in 2 to 5 working days.

Anti-ageing, stress and cortisol, full-spectrum ODx and men's hormone panels are on the packages page, and every individual test is on the full test list. Prices are 2026 cash rates including VAT and may change; in-store pricing applies.

Frequently asked questions

What these terms mean

Day 1

The first day of proper menstrual bleeding, not spotting. Every cycle-timed hormone test is counted from this day. If bleeding starts in the late afternoon or evening, the next day is counted as day 1.

Follicular phase

The first half of the cycle, from day 1 until ovulation. Days 2 to 5 sit at the start of it, which is where FSH, LH and oestradiol are drawn.

Luteal phase

The second half of the cycle, from ovulation until your period starts. Progesterone peaks about seven days into it, which is when it is drawn to confirm ovulation.

Anti-Mullerian hormone (AMH)

A hormone produced by developing follicles, used as a measure of ovarian reserve. It is stable across the cycle, so it can be drawn on any day. Since 2023 it can also be used in place of an ultrasound when assessing PMOS in adults.

Hyperandrogenism

Raised male-type hormones such as testosterone, either measured on a blood test or visible as acne, hair growth in a male pattern or scalp hair thinning. One of the three diagnostic criteria for PMOS.

PMOS

Polyendocrine metabolic ovarian syndrome, the name adopted in May 2026 for the condition previously called polycystic ovary syndrome (PCOS). A multisystem endocrine and metabolic condition, not a purely gynaecological one.

Ovarian reserve

The number of eggs remaining in the ovaries. AMH and antral follicle count estimate it. It predicts response to fertility treatment better than it predicts natural conception.

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