Quick Facts
- Sample: Saliva
- Fasting: No fasting required
- Turn-around: 5–7 business days after lab receipt. May take longer based on weather, holiday, or lab delays.
Benefits
- No needles required — painless saliva collection you complete at home
- High-precision LC-MS/MS technology — accurate measurement even at very low hormone levels
- Personalized reference ranges — results adjusted for your age, sex, and hormone use
- Convenient testing — collect sample in the morning when hormone levels naturally peak
- Direct access — order online, get results securely without an office visit
- Supports informed care — share results with your provider to guide treatment decisions
Who Is This Test For?
- Women experiencing hot flashes, night sweats, or irregular menstrual cycles
- Men with symptoms of low testosterone like fatigue, low libido, or mood changes
- Adults monitoring menopausal hormone therapy or testosterone replacement
- Individuals with suspected hormone imbalances affecting energy, mood, or sexual function
- Those seeking baseline hormone assessment for preventive health planning
How It Works – Just 3 Steps
- Collect at home — gather a morning saliva sample using the provided kit
- Ship to the lab — use the prepaid mailer to send your sample
- Get your results — review secure online results within 5–7 business days
FAQ
What hormones does this test measure? This test measures estradiol (E2), progesterone (Pg), and testosterone (T) in saliva using advanced LC-MS/MS technology for high accuracy.
Is saliva testing as reliable as blood testing? Yes. ZRT's LC-MS/MS saliva assays demonstrate high specificity and accuracy comparable to blood tests for sex hormone measurement (ZRT Laboratory).
Do I need to stop my hormone therapy before testing? No. Reference ranges are adjusted for hormone supplementation, so you typically continue your therapy; coordinate timing with your clinician (Endocrine Society 2018).
When should I collect my sample? Collect in the early morning shortly after waking when hormone levels peak; premenopausal women may need specific cycle-day timing (ZRT Laboratory).
How do I know if my results are abnormal? Your results include personalized reference ranges; values outside these ranges combined with symptoms warrant discussion with a healthcare provider (NAMS 2022).
Can this test diagnose menopause or low testosterone? It provides hormone levels that help identify imbalances; diagnosis requires clinical evaluation of both symptoms and laboratory results together (Endocrine Society 2015).
More Details
What is the purpose of this test?
This test measures three key sex hormones—estradiol, progesterone, and testosterone—in saliva using liquid chromatography-tandem mass spectrometry (LC-MS/MS). This advanced technology provides highly accurate detection even at low concentrations, avoiding the cross-reactivity issues that can affect some traditional immunoassays (ZRT Laboratory).
The test helps identify hormone imbalances that may explain symptoms like hot flashes, irregular cycles, low libido, fatigue, mood changes, or sleep disturbances. Accurate hormone measurement supports informed conversations with your healthcare provider about menopausal symptoms, andropause, fertility concerns, or hormone therapy monitoring (Endocrine Society 2018).
Who would benefit from this test?
This test is valuable for adults experiencing symptoms that suggest sex hormone imbalance. Perimenopausal or postmenopausal women with vasomotor symptoms—up to 80% experience hot flashes or night sweats during the menopausal transition—may use this test to assess estrogen and progesterone levels (Journal of Women's Health 2025).
Men aged 40-70 may benefit, as approximately 24–39% in this age group have testosterone deficiency, with 6–12% experiencing symptomatic hypogonadism requiring evaluation (JAMA Network Open 2023; PMC 2016). The test also supports monitoring for patients already on hormone therapy, those with suspected polycystic ovary syndrome, or individuals pursuing functional medicine approaches to bone health and quality of life in midlife.
When should I order Saliva LCMS Hormones 3?
Order this test when new symptoms arise such as hot flashes, night sweats, low libido, mood changes, or irregular menstrual patterns. It's also appropriate when adjusting hormone therapy doses or for periodic monitoring of ongoing treatment (NAMS 2022).
Timing matters: premenopausal women should coordinate testing with specific menstrual cycle days as directed by their clinician. If you use oral, transdermal, or topical hormones, consistent timing relative to your dosing schedule improves monitoring accuracy. Early morning collection captures peak hormone production for most sex steroids (ZRT Laboratory).
How do I interpret the results?
Your results display numeric levels for estradiol, progesterone, and testosterone alongside reference ranges stratified by age, sex, menstrual status, and reported hormone use. Values within range suggest normal hormone levels for your demographic, while results above or below range may correlate with your symptoms.
- Within reference range: Hormone level is appropriate for age and clinical status; continue monitoring if symptoms persist and discuss with your provider
- Below reference range: May indicate hormone deficiency; evaluate symptoms and consider hormone therapy if clinically appropriate
- Above reference range: May indicate excess hormone production or over-supplementation; review dosing and investigate other potential causes with your provider
Important: Treatment decisions should be based on both your symptoms and hormone levels together, not laboratory results alone, following Endocrine Society and NAMS clinical practice guidelines (Endocrine Society 2018).
Disclaimer: Reference ranges may vary by laboratory. Listed ranges are general guidelines and may differ from those used by the performing lab. Always consult your healthcare provider for interpretation.
Pre-test preparation
Collect your saliva sample in the early morning, typically within 30 minutes of waking, when hormone levels naturally peak. Avoid eating, drinking anything except plain water, brushing your teeth, or smoking for at least 30 minutes before collection to prevent contamination (ZRT Laboratory).
Use the collection tube provided in your kit. Let saliva pool naturally in your mouth without stimulation, then gently drool into the tube until you reach the indicated fill line. Cap the tube securely, label it with your information and exact collection time, and complete the requisition form. Place everything in the provided mailer and ship using the prepaid label. The stabilized saliva sample remains viable during standard shipping when you follow these instructions.
How often should I get tested?
Testing frequency depends on your clinical situation and treatment status. Work with your healthcare provider to determine the right schedule for your needs.
- Initial symptom assessment (no therapy): Once, then retest if symptoms change
- Starting or adjusting hormone therapy: Retest 2–3 months after change, then as directed
- Stable on hormone therapy: Every 6–12 months for ongoing monitoring
- New or worsening symptoms on therapy: Test promptly to assess current hormone levels
The Endocrine Society recommends monitoring testosterone levels in men on replacement therapy to ensure values remain in the therapeutic range while avoiding adverse effects. For women on menopausal hormone therapy, periodic monitoring helps confirm that hormone levels support symptom control without excess (Endocrine Society 2018).
Why early detection matters
Identifying and addressing sex hormone imbalances early can significantly improve quality of life and may prevent long-term health consequences. For women, untreated menopausal symptoms affect daily functioning, sleep, mood, and relationships—yet approximately 34% of U.S. women with moderate to severe vasomotor symptoms remain untreated (PMC 2024).
Menopausal hormone therapy remains the most effective treatment for vasomotor symptoms and genitourinary syndrome of menopause. When started in appropriate candidates within 10 years of menopause or before age 60, it also helps prevent bone loss and fractures (NAMS 2022). For men with confirmed symptomatic testosterone deficiency, replacement therapy can improve energy, sexual function, mood, and bone density when appropriately managed (Endocrine Society 2018).
Early, accurate hormone measurement supports timely, personalized treatment decisions. Complementary lifestyle measures—weight management, regular exercise, stress reduction, adequate sleep, smoking cessation, and moderate alcohol intake—enhance overall endocrine health alongside any medical therapy (Endocrine Society 2015).
Related tests you may consider
Saliva 4-Point Cortisol — measures cortisol at four times throughout the day to evaluate your HPA-axis and adrenal function, which often interacts with sex hormone balance and contributes to fatigue, insomnia, and mood symptoms.
LCMS Hormones 5 (Saliva) — adds DHEA-S and cortisol to estradiol, progesterone, and testosterone for a comprehensive view of both adrenal and gonadal steroids, refining treatment decisions in complex hormone cases.
Thyroid #3 Extreme Blood Test Panel — thyroid disorders can mimic or worsen sex hormone-related symptoms like fatigue, weight changes, and menstrual irregularity; assessing thyroid alongside sex hormones provides a broader endocrine evaluation.
