Quick Facts
- Sample: Urine
- Fasting: Not required; first morning urine preferred for organic acids
- Turn-around: 7–21 business days from lab receipt. May take longer based on weather, holiday, or lab delays.
Benefits
- All-in-one assessment: Combines hormone production, estrogen metabolism, cortisol rhythm, and nutritional status in a single report
- At-home convenience: Non-invasive urine collection—no needles, blood draws, or office visits required
- More accurate than blood: Urinary testing normalizes hormonal pulsatility for a representative view of overall production (NIH 2019)
- Actionable insights: Color-coded Functional Imbalance Scores translate complex data into clear next steps
- Privacy guaranteed: Confidential results you can review with any healthcare provider
Who Is This Test For?
- Women experiencing irregular periods, mood swings, or unexplained fatigue
- Anyone navigating perimenopause or menopause transitions
- Those struggling with fertility concerns or suspected PCOS/endometriosis
- Women seeking to understand anxiety, depression, or brain fog root causes
- Health-conscious individuals establishing a preventive health baseline
- Anyone frustrated by "normal" blood work that doesn't explain symptoms
How It Works – Just 3 Steps
- Order online — Kit ships directly to your home with all supplies and prepaid return shipping
- Collect samples — Follow simple instructions to collect urine at designated times
- Review results — Receive a comprehensive report in 7–21 days to help guide your next steps
FAQ
What makes this test different from standard blood work? Women's Health+ measures hormone production, metabolism, and nutritional cofactors together—revealing root causes that fragmented testing misses. Urinary metabolite testing also provides a more stable hormone picture than single-point blood draws affected by daily fluctuations.
Can I take this test while on birth control or HRT? Genova's assays detect bio-identical hormones but not synthetic hormones from oral contraceptives or non-bioidentical HRT, which may produce unpredictable results. Discuss timing with your provider if using synthetic hormones.
Will this diagnose PCOS or endometriosis? The test doesn't diagnose conditions directly but reveals hormone imbalances—elevated testosterone, abnormal estrogen metabolism, low progesterone—and metabolic patterns commonly seen in these conditions, supporting clinical diagnosis when combined with imaging and symptom assessment (WHO 2025).
Do I need to fast before collecting samples? Fasting is not required. However, first morning urine is preferred for organic acid collection, and you should limit fluid intake to six 8-ounce glasses in the 24 hours before collection to prevent dilution.
How accurate is dried urine testing? Dried urine testing for comprehensive hormone metabolites achieves inter-assay coefficients of variation less than 10% and intraclass correlation coefficients exceeding 0.9 compared to serum methods, demonstrating high clinical reliability (NIH 2021).
When should cycling women collect samples? For evaluating ovulatory function, collect between cycle days 19–25 (luteal phase). For other assessments, any day is appropriate. Do not collect during menstruation.
More Details
What is the purpose of this test?
Women's Health+ provides a comprehensive 360° view of female biochemistry by measuring hormone production (estradiol, progesterone, testosterone, DHEA, cortisol), estrogen metabolism through liver detoxification pathways (2-OH, 4-OH, 16-OH), and over 70 organic acid markers reflecting nutritional status, energy production, neurotransmitter turnover, and gut health. This integrated assessment reveals root causes of hormonal imbalance, irregular cycles, fatigue, mood changes, and metabolic dysfunction that standard blood work often misses.
The test uses advanced gas and liquid chromatography with tandem mass spectrometry (GC-MS/MS or LC-MS/MS), offering exceptional sensitivity for detecting trace-level compounds. Results include clinician-ready Functional Imbalance Scores, hormone ratios, estrogen metabolite pathway charts, and built-in therapeutic considerations, making it an ideal starting point for identifying hormonal and metabolic imbalances.
Who would benefit from this test?
Women's Health+ addresses a significant gap in preventive women's health screening. An estimated 30% of reproductive-aged women and up to 80% of all women experience hormonal imbalances at some point, yet many remain undiagnosed (NIH 2022). This test is particularly valuable for:
Menstrual health: Women with irregular or absent periods, anovulation, luteal insufficiency, or suspected estrogen dominance benefit from mapping hormonal patterns across the cycle.
Reproductive health: Those struggling with infertility can evaluate hormonal sufficiency and metabolic factors affecting reproductive capacity. PCOS affects 6–13% of reproductive-aged women, with up to 70% of cases remaining undiagnosed (WHO 2025).
Menopausal transitions: Women navigating perimenopause or menopause can assess hormone transitions and metabolic changes during this critical life stage.
Metabolic concerns: Those experiencing unexplained fatigue, brain fog, or weight issues can detect energy production problems, nutrient deficiencies, and metabolic inefficiencies.
Mental wellness: Women with anxiety, depression, or mood dysregulation can identify neurotransmitter imbalances and metabolic factors linked to mental health.
Preventive screening: Health-conscious women can establish a baseline before symptoms worsen, enabling early intervention.
When should I order Women's Health+?
Order this test when experiencing hormonal or metabolic symptoms that standard blood work doesn't explain, before starting hormone therapies to establish a baseline, during major life transitions (perimenopause, career stress, postpartum), or as part of proactive preventive health screening. For cycling women assessing ovulatory function, collect specimens between cycle days 19–25 (luteal phase). For other assessments, any day is appropriate unless your provider specifies timing for menstrual cycle phase evaluation.
How do I interpret the results?
Results are organized into several integrated sections providing a complete picture of your hormonal and metabolic health:
Functional Imbalance Scores: Color-coded indicators (green, yellow, red) show whether hormone or metabolic markers are optimal, moderately imbalanced, or significantly abnormal for easy identification of priorities.
Hormone Ratios: Key ratios like progesterone/estradiol and anabolic/catabolic balance assess hormonal equilibrium and stress response.
Estrogen Metabolite Pathways: Bar charts display the distribution of estrogen metabolites along detoxification pathways (2-OH protective, 4-OH potentially harmful, 16-OH proliferative), revealing metabolism efficiency.
Organic Acid Interpretation: Elevated or depressed organic acids link to specific nutritional deficiencies (B12, folate, B6, carnitine), mitochondrial dysfunction, dysbiosis patterns, or detoxification capacity issues.
Nutrient Need Overview: The report maps organic-acid patterns to practical B-vitamin, mineral, antioxidant, probiotic, and GI support recommendations.
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
`Timing: If evaluating ovulatory function, collect specimens between cycle days 19–25 (luteal phase). For other assessments, any day is appropriate.
Hormone therapy: Do not take bio-identical hormones immediately before collection; wait until after collection (8–12 hours post-dose is often optimal). Avoid skin-to-skin contact with others using hormone creams to prevent unintentional exposure.
Fluid intake: In the 24 hours before collection, consume no more than six 8-ounce glasses of fluid to prevent over-dilution of organic acids and hormonal markers.
Avoid confounding factors: Do not collect urine during menstruation (including menstrual blood). Blood contains hormones that falsely elevate urinary hormone results. Avoid diuretics unless approved by your provider.
Medications: Continue all medically necessary medications. High-dose biotin (above 30 mcg RDI) may interfere with certain assays—the American Thyroid Association recommends holding biotin for at least 2 days before testing. Discuss any concerns with your provider.
How often should I get tested?
- Establishing baseline (no symptoms): Every 12–24 months
- Active symptoms or imbalances: Every 3–6 months to track intervention progress
- Starting new hormone therapy or supplements: Baseline before starting; retest 3–6 months after
- Major life transitions (perimenopause, postpartum): Every 6–12 months
- History of PCOS, endometriosis, or hormone-sensitive conditions: Every 6–12 months or as symptoms change
Repeat testing allows tracking whether dietary, supplement, or lifestyle changes are improving biochemistry. Discuss timing with your healthcare provider.
Why early detection matters
Early identification of hormonal and metabolic imbalances enables timely intervention before symptoms worsen. Urinary hormone testing normalizes hormonal pulsatility and diurnal variation, providing a more representative picture of hormone production compared to single-point-in-time blood tests (Nature 2023).
Monitoring estrogen metabolite ratios via urine enables targeted interventions for detoxification and hormone balance. Organic acid analysis highlights nutritional deficiencies that underlie fatigue, cognitive dysfunction, mood disorders, and metabolic inefficiency. Correcting these deficiencies—B vitamins, mitochondrial cofactors, antioxidants—can improve quality of life and prevent progression to chronic conditions.
Related tests you may consider
Comprehensive Metabolic Panel (CMP) — Kidney and liver health, blood glucose, electrolytes; complements Women's Health+ by providing a broader snapshot of physical health.
Thyroid #3 Extreme Blood Test Panel— Ensures hormone imbalance isn’t primarily driven by thyroid dysfunction.
Organic Acids Test - Mosaic Diagnostics Test Kit — Provides detailed analysis of over 70 organic acids for nutritional deficiencies, mitochondrial function, detoxification capacity, and neurotransmitter status.
