Ulta Lab Tests

Hormone Replacement Therapy (HRT) For Women

Hormone Replacement Therapy (HRT) for women is most commonly used around perimenopause and menopause to ease symptoms like hot flashes, night sweats, sleep changes, mood shifts, brain fog, and vaginal dryness. Because these symptoms overlap with other conditions (thyroid disease, iron deficiency, depression, sleep apnea, pregnancy in perimenopause), lab testing is essential for a safe, personalized plan.

A practical approach sets baselines (safety and risk), checks for mimics of menopause symptoms, and—when helpful—assesses estradiol, progesterone, and pituitary signals (FSH/LH) to clarify ovarian status. After HRT starts, periodic labs help monitor safety (blood counts, liver enzymes, cardiometabolic markers) and fine-tune care. Labs inform decisions but do not replace a clinician’s evaluation, cancer screening, or imaging when indicated.

Signs, Symptoms & Related Situations

  • Vasomotor & sleep: hot flashes, night sweats, insomnia, daytime fatigue

  • Mood & cognition: anxiety, low mood, irritability, brain fog

  • Cycle & bleeding: irregular or heavier periods in perimenopause; postmenopausal bleeding needs clinician evaluation

  • Genitourinary: vaginal dryness, pain with sex, urinary urgency or recurrent UTIs

  • Metabolic & body composition: weight gain or central fat, rising LDL or triglycerides

  • Bone & muscle: joint aches, loss of height, low bone density history

  • When to seek urgent care: heavy bleeding with lightheadedness, chest pain, shortness of breath, one-sided weakness, severe headache, or vision loss

Symptoms and cycle changes always require clinician evaluation.

Why These Tests Matter

What testing can do

  • Clarify ovarian status in unclear cases (FSH/LH with estradiol; pregnancy test if cycles continue)

  • Identify mimics of menopause symptoms (TSH for thyroid, ferritin/iron and CBC for anemia, A1c/glucose for glycemic issues)

  • Set safety baselines and monitor HRT (CBC/hematocrit, liver enzymes, lipids, A1c, and others as indicated)

What testing cannot do

  • Choose an HRT type, route, or dose by numbers alone—clinical context matters

  • Replace routine cancer screening (mammogram, cervical screening) or pelvic imaging when indicated

  • Predict risk from a single value; trends and the whole picture are key

What These Tests Measure (at a glance)

  • Estradiol (E2): main estrogen; typically low after menopause. Useful to document baseline or investigate persistent symptoms on therapy. Assay method matters at low levels.

  • Progesterone (P4): reflects ovulation in cycling women; less central to routine HRT monitoring but may be checked for bleeding patterns or therapy context.

  • FSH & LH: often elevated after menopause; variable in perimenopause.

  • TSH (± Free T4): thyroid disorders can mimic hot flashes, fatigue, and weight change. High-dose biotin may interfere with some assays.

  • hCG (pregnancy test): consider in perimenopause if cycles or bleeding persist.

  • SHBG, Total & Free Testosterone, DHEA-S: androgen context for libido/energy or when using androgen therapy (clinician-directed).

  • CBC (Hemoglobin/Hematocrit): anemia or polycythemia check; baseline safety.

  • Comprehensive Metabolic Panel (AST/ALT, creatinine, electrolytes): liver and kidney context for medication safety.

  • Lipid Panel (± ApoB) & A1c/Glucose: cardiometabolic risk that can change with age, weight, or therapy.

  • Ferritin/Iron/TIBC: iron deficiency is a common, treatable cause of fatigue.

  • Vitamin D (25-OH) ± Calcium: bone health context, especially if fracture risk is a concern.

Quick Build Guide

Clinical question Start with Add if needed
Perimenopause symptoms, status unclear FSH/LH • Estradiol • TSH • CBC • Ferritin/Iron • A1c/Glucose hCG if cycles continue • Prolactin for galactorrhea/irregular cycles
Pre-HRT safety baseline CBC • CMP (AST/ALT) • Lipid Panel • A1c/Glucose • TSH Estradiol/Progesterone for context • Vitamin D
On-therapy monitoring CBC • CMP • Lipid Panel • A1c/Glucose(timing consistent by route) Estradiol if symptoms persist • SHBG/Free T if using androgens
Abnormal bleeding on HRT CBC • hCG • TSH Iron studies; clinician-directed imaging/evaluation
Low libido or fatigue on HRT TSH • CBC • Ferritin/Iron • A1c/Glucose Total/Free Testosterone • SHBG • DHEA-S (clinician-directed)

How the Testing Process Works

  1. Choose your starting panel based on goals: symptom clarification, pre-HRT baseline, or monitoring.

  2. Prepare for accuracy: follow any timing guidance (morning draw; cycle-timed tests if still menstruating). List all medications and supplements—biotin, thyroid meds, and hormones can affect results.

  3. Sample collection: blood draw at a nearby patient service center; urine for hCG when indicated.

  4. Secure results: view results online and review with your clinician to align labs with symptoms and preferences.

  5. Plan follow-up: repeat labs after changes (often 3–6 months), then annually once stable—timing individualized.

Interpreting Results (General Guidance)

  • High FSH with low estradiol supports menopause; fluctuating results are common in perimenopause.

  • TSH outside range may explain fatigue, mood, or weight change even without classic thyroid symptoms.

  • CBC and ferritin/iron help explain fatigue or bleeding-related anemia.

  • Lipids and A1c track cardiometabolic risk over time; look at trends, not single values.

  • Estradiol values do not always match symptom relief; clinical response guides care.
    Always interpret results with a qualified healthcare professional.

Choosing Panels vs. Individual Tests

  • Baseline, most women: CBC • CMP • Lipids • A1c/Glucose • TSH

  • Status clarification or persistent symptoms: add FSH/LH • Estradiol • hCG (if cycles continue) • Ferritin/Iron

  • On HRT: continue safety labs (CBC, CMP, Lipids, A1c) and add targeted hormones only if symptoms warrant

  • Androgen context (clinician-directed): Total/Free Testosterone • SHBG • DHEA-S

FAQs

Do I need labs to diagnose menopause?
Often no in women over 45 with typical symptoms and 12 months without periods. Labs help when younger, on certain contraceptives, or when symptoms are unclear.

Will estradiol levels tell me the “right dose”?
Not by themselves. Symptoms, safety labs, and preferences guide therapy more than a single estradiol value.

If I still have periods, should I test for pregnancy before HRT?
Yes—hCG may be appropriate in perimenopause if cycles continue or bleeding is irregular.

How often should I have labs on HRT?
Commonly at baseline, 3–6 months after starting or adjusting, then annually if stable—timing varies by your plan.

Can supplements or medications affect results?
Yes. Biotin can distort some tests; hormones and thyroid meds also matter. Follow your order’s instructions.

Does route of estrogen (patch vs pill) change labs?
It can affect SHBG and some liver-synthesized proteins. Your core safety labs (CBC, CMP, Lipids, A1c) are still important over time.

What if I have unexpected bleeding on HRT?
Check CBC, hCG, TSH and contact your clinician. Further evaluation or imaging may be needed.

Related Categories & Key Tests

  • Hormone Tests Hub

  • Endocrine Tests • Menopause & Perimenopause • Thyroid Testing • Women’s Health Panels • Bone & Osteoporosis • PCOS & Androgens

  • Key Tests: Estradiol (E2) • Progesterone (P4) • FSH/LH • TSH (± Free T4) • hCG • SHBG • Total & Free Testosterone • DHEA-S • CBC • Comprehensive Metabolic Panel (AST/ALT, electrolytes, creatinine)• Lipid Panel (± ApoB) • A1c/Glucose • Ferritin/Iron/TIBC • Vitamin D (25-OH)

References

  • North American Menopause Society — Position statements on menopausal hormone therapy and monitoring.
  • Endocrine Society — Clinical practice guidance on menopause, thyroid disease, and androgen evaluation in women.
  • American College of Obstetricians and Gynecologists — Practice bulletins on menopausal symptoms and abnormal uterine bleeding.
  • International Menopause Society — Recommendations on assessment during midlife.
  • Clinical reviews on estradiol assay methods and SHBG effects.
  • Laboratory best practices for biotin interference and hormone timing.

Available Tests & Panels

Your HRT for Women menu is pre-populated in the Ulta Lab Tests system. Start with baseline safety labs (CBC, CMP, Lipids, A1c, TSH), ad FSH/LH, estradiol, hCG, ferritin/iron to clarify symptoms or status, and include androgen markers (SHBG, total/free testosterone, DHEA-S) when appropriate. Follow timing instructions and review results with your clinician to personalize monitoring and next steps.

 

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The Fractionated Bilirubin Test separates total bilirubin into direct and indirect forms to assess liver and blood health. Elevated direct bilirubin may point to hepatitis, cirrhosis, or bile duct obstruction, while elevated indirect levels can signal hemolytic anemia or inherited disorders. Doctors order this test for jaundice, anemia, or suspected liver conditions. Results help guide diagnosis, treatment, and monitoring of liver and blood disorders.

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Also Known As: Fractionated Bilirubin Test
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The Ceruloplasmin Test measures levels of ceruloplasmin, a copper-carrying protein made in the liver, to evaluate copper metabolism and related disorders. Low levels may indicate Wilson’s disease, Menkes disease, or severe liver disease, while high levels may suggest inflammation or pregnancy. Doctors order this test for patients with liver problems, neurological symptoms, or abnormal copper levels. Results help diagnose metabolic disorders and guide treatment.

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Also Known As: Copper Oxide Test, Wilson’s Disease Test
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The Cinnamon f220 IgE Test measures IgE antibodies to cinnamon proteins. Elevated levels may indicate an allergic reaction, which can cause symptoms such as itching, hives, digestive discomfort, or respiratory issues after consuming cinnamon. The test helps identify cinnamon allergy and supports appropriate management and dietary guidance.

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Also Known As: Cinnamon IgE Test, Cinnamon f220 Test
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The DHEA Unconjugated Test measures levels of dehydroepiandrosterone, an adrenal hormone that serves as a precursor to testosterone and estrogen. Abnormal levels may indicate adrenal tumors, congenital adrenal hyperplasia, or hormone imbalance. Doctors order this test to evaluate infertility, irregular cycles, excess hair growth, or early puberty. Results provide insight into adrenal gland function, reproductive health, and endocrine disorders.

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Also Known As: Dehydroepiandrosterone Test
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The Estriol (E3) Test checks blood levels of estriol, an estrogen hormone important in pregnancy. It is commonly included in the second-trimester triple or quad screen to detect chromosomal disorders such as Down syndrome and assess placental function. Estriol testing helps monitor fetal growth and maternal hormone health. Low or abnormal levels may signal pregnancy complications, guiding further testing and prenatal care decisions.

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Also Known As: E3 Test, Estrogen 3 Test
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The Follicle-Stimulating Hormone (FSH) Test measures FSH levels to evaluate reproductive and endocrine health in both men and women. In women, it helps assess infertility, irregular periods, menopause, or ovarian function. In men, it is used to check sperm production and testicular function. Abnormal results may indicate PCOS, pituitary disorders, or hormonal imbalance. Doctors order this test to guide fertility treatment, hormone therapy, and overall reproductive care.

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Also Known As: Follicle Stimulating Hormone Test, Follitropin Test
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The Growth Hormone Test with 2 specimens measures growth hormone levels at two collection times to evaluate pituitary gland function and hormone regulation. Tracking these changes helps assess growth disorders, short stature, gigantism, or acromegaly, while providing insight into metabolic balance, bone development, and overall endocrine system health.

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The Growth Hormone Test with 3 specimens measures hormone levels at three collection times to evaluate pituitary gland function and overall hormone regulation. Tracking growth hormone across intervals provides insight into growth disorders, short stature, gigantism, and acromegaly, while supporting assessment of metabolism, bone development, tissue repair, and endocrine health.

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The Indican Urine Test measures indican, a byproduct of protein breakdown by intestinal bacteria. Elevated levels may indicate poor digestion, malabsorption, small intestinal bacterial overgrowth (SIBO), or gastrointestinal disorders. Doctors use this test to evaluate gut health, investigate symptoms like bloating, gas, or fatigue, and monitor treatment for digestive imbalances. It provides valuable insight into intestinal function, metabolism, and overall digestive health.

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The LH Test measures luteinizing hormone levels in blood to assess fertility, reproductive health, and endocrine function. Abnormal LH may indicate infertility, menstrual irregularities, menopause, or pituitary disorders in women, and low testosterone or testicular dysfunction in men. Doctors use this test to evaluate ovulation, investigate infertility, monitor puberty disorders, or guide hormone therapy. It provides key insight into reproductive and hormonal balance.

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Also Known As: Luteinizing Hormone Test, Lutropin Test, Interstitial Cell Stimulating Hormone Test, ICSH Test
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The Lipid Panel Test checks six key blood lipids: total cholesterol, HDL cholesterol, LDL cholesterol, non-HDL cholesterol, triglycerides, and the Chol/HDL ratio. This panel assesses risk for cardiovascular disease, heart attack, and stroke by evaluating cholesterol balance and fat levels in the blood. Doctors use lipid panel results for routine screening, treatment monitoring, and guiding lifestyle or medication adjustments.

Also Known As:  Lipid Profile Test, Cholesterol Panel Test, Lipids Blood Test 
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The Progesterone Ultrasensitive Test measures very low progesterone levels in blood with high accuracy to evaluate reproductive and endocrine health. Doctors use it to assess menstrual cycle function, confirm ovulation, investigate infertility, and monitor hormone therapy. It is also useful in pregnancy evaluation and detecting hormonal disorders. Results provide precise insight into progesterone balance, fertility, and overall reproductive health.

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Also Known As: Ultrasensitive PGSN, Progesterone LCMS Test
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The PTH Intact Test measures intact parathyroid hormone (PTH) levels in blood to evaluate parathyroid gland function and calcium balance. Abnormal PTH may indicate hyperparathyroidism, hypoparathyroidism, kidney disease, or vitamin D imbalance. Doctors use this test to investigate osteoporosis, kidney stones, or unexplained calcium abnormalities. Results provide vital insight into endocrine function, bone metabolism, and overall calcium regulation.

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Also Known As: Parathyroid Hormone Intact test, Intact PTH test, Parathormone Test
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The T3 Total Test measures total triiodothyronine (T3), a combination of both bound and unbound (free) T3, to assess thyroid function. Abnormal levels may indicate hyperthyroidism, hypothyroidism, goiter, or pituitary disorders. Doctors use this test to evaluate symptoms like fatigue, weight changes, anxiety, or irregular heartbeat and to monitor thyroid treatment. The T3 Total Test provides essential insight into metabolism, energy regulation, and overall endocrine health.

Also Known As: Total T3 Test, Total Triiodothyronine Test, T3 Test, Bound and Unbound T3
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The T4 Total Test measures total thyroxine (T4) in blood, a combination of both bound and unbound (free) T4, to assess thyroid function. Abnormal levels may indicate hypothyroidism, hyperthyroidism, goiter, or pituitary disorders. Doctors use this test to evaluate symptoms like fatigue, weight changes, hair loss, or irregular heart rate and to monitor thyroid replacement or antithyroid therapy. The T4 Total Test provides key insight into metabolic, hormonal, and endocrine health.

Also Known As: Total T4 Test, Total Thyroxine Test, T4 Test, Bound and Unbound T4 Test
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Everyting About Hormone Replacement Therapy (HRT) Lab Tests for Women

Forty-four percent of woman that have gone through menopause have admitted to seeking hormone replacement therapy (HRT) as a means of helping reduce the symptoms they get from menopause. If you're thinking about undergoing HRT, you'll be happy to know there are HRT lab tests for women that will help determine if it's the right treatment for you.

Before we jump into everything you need to know about lab tests for HRT, we're going to educate you about the symptoms of menopause and how they can affect your long-term health.

Symptoms of Menopause

The paragraph above noted the transition to education on the symptoms of menopause. Some of the symptoms include hot flashes that seemingly come out of nowhere.

Menopause also causes women to experience mood changes and increased irritability no matter the situation. These frequent changes can also lead to depression and increased anxiety.

Some other symptoms include, but aren't limited to:

  • Irregular menstrual period
  • Issues with the sleep cycle
  • Sweating at night
  • Urinary tract issues
  • Problems concentrating 
  • Changes to the skin
  • Increased heart rate

Menopause has also been known to cause issues in the sexual department because it can cause a woman to experience discomfort or vaginal dryness.

What is HRT?

HRT, otherwise known as hormone replacement therapy, is a form of therapy that uses medication to adjust hormone levels and treat symptoms associated with menopause. When a woman goes through menopause, there is a drop in their estrogen levels.

HRT medication is used to replace these levels and can help to reduce and control symptoms that come with menopause. There are several types of hormone therapy that a woman might undergo, including:

- Low-does vaginal
- Systemic hormone therapies

Low-dose vaginal medications are typically creams or tablets that lower the amount of estrogen the body absorbs. This form of treatment is commonly used to treat symptoms caused by menopause that influence things like vaginal dryness and urinary tract symptoms.

Systemic hormone therapy is a type of treatment that comes in various forms, including pills and sprays. This form of treatment can help with several of the symptoms caused by menopause.

Risk Factors for Women's HRT

While there are several benefits of undergoing hormone replacement therapy, there are also some important risks to know about. For every 1,000 women over 50 that used HRT, approximately 83 got breast cancer.

Breast cancer is one of the risks of HRT; although researchers are still studying it, there is little known about how it causes breast cancer. It's believed that the estrogen in the body stimulates the growth of certain types of cancer cells.

Other risks for women that are using HRT to treat menopausal symptoms include:

- Increase in blood clots
- Heart disease
- Potential stroke

Some risks are higher for some and lower for others because of several variants, including a woman's age, past health history, and type of HRT treatment.

Side Effects of HRT in Women

One side effect that you might experience when getting hormone replacement therapy is tenderness around your breast. This is usually because of the increase in hormones flowing through your body, much like what happens when you're on your period.

Another side effect you might experience is feeling sick, which can also be chalked up to the increase in your hormone levels. Eventually, the side effects you feel will begin to go away, but if they don't, you must speak with your doctor about what you're going through.

We do have some tips that can help to ease your side effects. Before you take your HRT dose, it's best if you don't take it on an empty stomach. Eating before taking your medication will help to reduce indigestion and the likelihood of becoming sick.

If you're having cramps, you could reduce them by engaging in regular activity. These are the side effects of estrogen, which are mostly the same that would be experienced when taking progesterone.

When taking progesterone, you might experience issues with acne and mood swings.

HRT Lab Tests for Women

As mentioned before, there are HRT tests for women that have proven to be beneficial. These tests are useful because they help you monitor your health and identify risk factors or other pertinent information that could change the course of the treatment you're receiving.

23 Key lab tests to monitor your health when on Hormone Replacement Therapy (HRT):

  • DHEA Sulfate, Immunoassay
  • Estradiol
  • Estrogen, Total, Serum
  • Estrone, LC/MS/MS
  • FSH and LH
  • IGF-I, LC/MS
  • Pregnenolone, LC/MS/MS
  • Progesterone, Immunoassay
  • Prolactin
  • Testosterone, Total And Free And Sex Hormone Binding Globulin
  • CBC (includes Differential and Platelets)
  • Comprehensive Metabolic Panel (CMP)
  • Hemoglobin A1c with eAG
  • Homocysteine
  • hs-CRP
  • IGF-I, LC/MS
  • Insulin
  • Lipid Panel with Ratios
  • QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS
  • T3, Free
  • T4, Free
  • Thyroglobulin Antibodies (TgAb)
  • TSH

These key lab tests can be used to monitor the impact of HRT on your health so that you and your doctor can take the right steps and implement the proper changes in your life. Selecting Ulta Lab Tests to get tested will provide you with quick and private access to your results.

Not to mention it allows you to play an active role in your health and the care you receive. Another reason you should seek lab testing from Ulta Lab Tests is that you don't need clearance from your insurance company or obtain a referral to have the testing completed.

What We Offer

We offer women the following four Hormone Health panels to make it easier and quicker to select and order lab tests needed to monitor their health while on HRT:

  • The Hormone Health, Women - Basic panel contains 5 tests with 7 biomarkers
  • The Hormone Health, Women - Basic Plus panel contains 9 tests with 14 biomarkers
  • The Hormone Health, Women - Advanced panel contains 11 tests with 18 biomarkers
  • The Hormone Health, Women - Comprehensive panel contains 18 tests with 28 biomarkers

We ensure that our customers have options they need to ensure they get the right type of test.

Frequently Asked Questions About Women's HRT

Now that you've got the information you need, we're sure there are several questions you might have. Below you can find the answers to the most asked questions.

By having these answers, you'll have what you need to move forward with getting the testing you need to help you decide whether hormone replacement therapy is right for you.

Who Shouldn't Have HRT?

If you've had a medical history of blood clots seeking HRT might not be the best form of treatment for you. Another reason that HRT won't work for some women is if they're not experiencing menopausal symptoms.

Also, if you've had a history of breast cancer, it would be more useful to speak with your primary care physician about other ways to treat it.

What if HRT Isn't an Option?

In some cases, HRT won't be the right option for all women. However, even if it's not something that will work for you, it doesn't mean you've got to continue having issues with the menopause symptoms you're experiencing.

Your doctor can recommend changes you can make in your lifestyle that can help to improve your overall symptoms.

Are There Benefits of HRT?

Yes, there are several benefits for women that undergo HRT, with the main benefit being relief from menopausal symptoms. HRT can help prevent bone loss, which can lead to several injuries related to Osteoporosis.

HRT can also make painful intercourse more enjoyable because one of the symptoms of menopause is vaginal dryness.

Order your Women's HRT Test with Confidence Today from Ulta Lab Tests

Ulta Lab Tests offers highly accurate and reliable tests so you can make informed decisions about your health.

  • Secure and confidential results
  • No insurance referral is needed
  • Affordable pricing
  • 100% satisfaction guarantee

You can take charge of your health by understanding your own body's needs.

Women undergoing hormone replacement therapy can see many benefits, but they must first know what is needed. Getting accurate lab results and frequent testing, and tracking your biomarkers are vital steps in successful HRT.

Order your women's hormone replacement lab tests today, and your results will be provided to you securely and confidentially online in 24 to 48 hours for most tests.

Take control of your health today with Ulta Lab Tests.