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Testing & Diagnosis Guide

Know what tests to request, when to get them, and how to interpret the results. This guide helps you advocate for appropriate testing and understand what your numbers actually mean for conditions like PCOS, thyroid issues, perimenopause, and more.

Before You Test: Key Principles

Testing Should Match Symptoms
Don't test randomly. Your symptoms guide which tests are appropriate. If you have irregular cycles and acne, PCOS testing makes sense. If you have fatigue and hair loss, thyroid testing is warranted.
Timing Matters
Many hormones fluctuate throughout your cycle. Testing at the wrong time can give misleading results. See the timing guide below to know when each test should be done.
'Normal' Isn't Always Optimal
Lab reference ranges are broad. You can be in the 'normal' range but still symptomatic. Ask where you fall within the range, and know that optimal levels are often narrower than the reference range.

Tests by Condition

Use this section to understand which tests are relevant for your symptoms. Bring this information to your appointment to advocate for appropriate testing.

PCOS
8 Tests
Common symptoms: Irregular cycles, acne, excess hair growth, weight gain

Thyroid Issues
5 Tests
Common symptoms: Fatigue, weight changes, hair loss, irregular cycles, mood changes

Perimenopause
3 Tests
Common symptoms: Irregular cycles, hot flashes, mood changes, sleep issues

Endometriosis
3 Tests
Common symptoms: Severe period pain, pain with sex, heavy bleeding, infertility

PMDD
2 Tests
Common symptoms: Severe mood symptoms in luteal phase (week before period)

General Screening Tests

These tests aren't condition-specific but are helpful for ruling out common issues that cause similar symptoms. Consider requesting these alongside condition-specific testing.

Basic Metabolic Panel

Complete Blood Count (CBC)

Screens for anemia (common with heavy periods), infection, and blood disorders

Comprehensive Metabolic Panel (CMP)

Checks kidney and liver function, electrolytes, blood sugar

Vitamin D

Deficiency common and affects mood, bone health, immune function

Vitamin B12

Deficiency causes fatigue, mood changes, neurological symptoms

Iron Panel (Ferritin, TIBC, Serum Iron)

Low iron causes fatigue, hair loss, and can worsen other symptoms

When to Test: Cycle Timing Guide

Hormones fluctuate throughout your menstrual cycle. Testing at the right time ensures accurate, interpretable results. If you have irregular or absent cycles, discuss timing with your provider.

Follicular Phase (Days 1-14)
Best time: Days 3-5 ideal for baseline hormones

Tests to do:

FSH, LH, Estradiol, Testosterone, Prolactin

Why:

Hormone levels are more stable and consistent in early follicular phase

Mid-Cycle (Day 14)
Best time: Around ovulation

Tests to do:

Progesterone (if checking for ovulation)

Why:

Progesterone should be low before ovulation, high after

Luteal Phase (Days 15-28)
Best time: About 7 days after ovulation (Day 21 in 28-day cycle)

Tests to do:

Progesterone (to confirm ovulation)

Why:

Progesterone peaks in mid-luteal phase if ovulation occurred

Any Time
Best time: Doesn't matter for these

Tests to do:

Thyroid panel, metabolic tests, vitamin levels, DHEA-S

Why:

These don't fluctuate significantly with menstrual cycle

How to Request Testing

What to Say

"Based on my symptoms of [list symptoms], I'd like to test for [condition]. Can we order [list specific tests]?"

Be specific about which tests you want and why. Reference your symptoms to justify the request.

If Testing Is Refused

"Can you explain why you don't think this testing is necessary? I'd like to understand what we're ruling out and what the next steps are if symptoms persist."

If they still refuse without good reason, consider getting a second opinion or finding a new provider.

After Testing: Getting Your Results

Request a copy of your actual results, not just "everything's normal." You have a right to see the numbers.

Ask where you fall within the range and whether your provider considers it optimal or just acceptable.

If results are "borderline," ask whether treatment or monitoring is appropriate rather than just waiting.

Keep copies of all results in case you change providers or want a second opinion.

Related Resources

Medical Advocacy
Scripts for requesting tests and being taken seriously
Condition Guides
Deep dives into PCOS, endometriosis, PMDD, and more
Track Symptoms
Document patterns to strengthen your case for testing