Endocrinology

Hormone Panel: Understanding Your Hormonal Balance

Hormones are chemical messengers that regulate virtually every function in your body — from metabolism and mood to fertility and bone strength. A hormone panel blood test measures key reproductive and metabolic hormones to investigate symptoms like fatigue, weight changes, irregular periods, low libido, or difficulty conceiving. Understanding your hormone levels is the first step toward identifying imbalances and finding the right treatment.

Hormone Reference Ranges

Ranges shown are for adults. Female ranges marked with * vary significantly with menstrual cycle phase, pregnancy, and menopausal status. Values based on RCPA guidelines used in Australian pathology labs.

Timing matters: Testosterone should be measured between 8–10am when levels peak. Female reproductive hormones are cycle-dependent — your doctor will specify which day to test (commonly Day 3 for FSH/E2, Day 21 for progesterone).

Hormone	Male Range	Female Range	Unit	Role
Total Testosterone (TT)	8.0–30.0	0.5–2.6	nmol/L	Primary male sex hormone. Controls muscle mass, bone density, libido, mood, and red blood cell production in both sexes.
Free Testosterone (FT)	170–670	10–70	pmol/L	The biologically active fraction not bound to SHBG or albumin. More clinically relevant than total testosterone in many situations.
Oestradiol (Estradiol) (E2)	40–160	100–1500*	pmol/L	Primary female oestrogen. Drives the menstrual cycle, protects bones, and maintains cardiovascular health. *Varies dramatically with cycle phase.
Follicle-Stimulating Hormone (FSH)	1.5–12.4	1.7–21.5*	IU/L	Stimulates egg development in women and sperm production in men. Elevated FSH in women suggests declining ovarian reserve or menopause.
Luteinising Hormone (LH)	1.7–8.6	1.0–95.6*	IU/L	Triggers ovulation in women and testosterone production in men. The LH surge mid-cycle is the key ovulation signal.
Progesterone (P4)	0.7–4.3	0.6–89.0*	nmol/L	Prepares the uterus for pregnancy after ovulation. Day 21 progesterone confirms whether ovulation occurred.
Prolactin (PRL)	86–390	102–496	mIU/L	Stimulates breast milk production. Elevated levels can suppress FSH/LH and cause irregular periods, infertility, or low libido.
DHEA-Sulphate (DHEA-S)	2.2–15.2	1.8–13.0	µmol/L	Adrenal androgen precursor. Declines steadily with age. Used to assess adrenal function and PCOS.
Sex Hormone-Binding Globulin (SHBG)	15–55	30–120	nmol/L	Binds testosterone and oestradiol, making them inactive. High SHBG lowers free testosterone; low SHBG increases it.

Hormone Testing for Women

Female hormone levels change dramatically throughout life. The tests ordered and their interpretation depend entirely on your life stage, symptoms, and menstrual cycle day.

Reproductive Years

Ages 18–40

E2, FSH, LH, P4

Hormones cycle monthly. Day 3 FSH/E2 assess ovarian reserve. Day 21 progesterone confirms ovulation. Irregular cycles warrant a full panel.

Perimenopause

Ages 40–55

FSH, E2, AMH

FSH rises as ovarian function declines. Oestradiol fluctuates wildly. Periods become irregular. Symptoms include hot flushes, mood changes, and sleep disruption.

Post-Menopause

Ages 55+

FSH, E2

FSH consistently above 30 IU/L with low oestradiol confirms menopause. Bone density screening becomes important as oestrogen protection declines.

PCOS Assessment

Ages Any

TT, FT, DHEA-S, SHBG

Elevated androgens with low SHBG and LH:FSH ratio above 2:1 suggest polycystic ovary syndrome. Insulin resistance testing also recommended.

Hormone Testing for Men

Male hormones decline gradually with age rather than abruptly like menopause. Testing is indicated for symptoms of low testosterone, infertility, or suspected pituitary problems.

Young Adult

Ages 18–40

TT, FT, LH

Peak testosterone years. Low levels warrant investigation for pituitary problems, medications, or chronic illness.

Middle Age

Ages 40–60

TT, FT, SHBG

Testosterone declines 1–2% per year. SHBG rises with age, further reducing free testosterone. Symptoms may include fatigue, reduced libido, and increased body fat.

Late Andropause

Ages 60+

TT, FT, E2, LH

About 30% of men over 60 have clinically low testosterone. Low LH with low testosterone suggests pituitary cause; high LH suggests testicular cause.

Fertility Assessment

Ages Any

FSH, LH, TT, PRL

Elevated FSH in men indicates impaired sperm production. Prolactin elevation can suppress testosterone and cause erectile dysfunction.

Common Hormonal Imbalance Patterns

Low Testosterone + Low LH/FSH

Secondary Hypogonadism

The pituitary gland is not sending enough signal. Causes include pituitary tumours, obesity, opioid use, and chronic illness. Potentially reversible.

Low Testosterone + High LH/FSH

Primary Hypogonadism

The testes are not responding to pituitary signals. Causes include Klinefelter syndrome, testicular injury, chemotherapy, or ageing. May require testosterone replacement.

High Testosterone + Low SHBG (Female)

Possible PCOS

Excess androgens with low SHBG and insulin resistance is the classic PCOS pattern. Confirm with ultrasound and metabolic assessment.

High FSH + Low E2 (Female)

Menopause / Ovarian Insufficiency

The ovaries have stopped responding to FSH stimulation. If under 40, this is premature ovarian insufficiency requiring urgent specialist referral.

Elevated Prolactin

Hyperprolactinaemia

Can be caused by pituitary adenoma, medications (antipsychotics, SSRIs), hypothyroidism, or stress. Causes irregular periods in women and low testosterone in men.

Low DHEA-S for Age

Adrenal Insufficiency

DHEA-S is produced almost exclusively by the adrenal glands. Low levels may indicate adrenal fatigue or Addison’s disease. Always correlate with cortisol.

Factors That Affect Your Hormone Levels

Lifestyle Factors That Help

Resistance training and regular exercise boost testosterone naturally
Adequate sleep (7–9 hours) is essential for hormone production
Healthy body weight — excess fat converts testosterone to oestrogen
Stress management — cortisol directly suppresses reproductive hormones
Zinc and vitamin D support testosterone synthesis
Balanced diet with healthy fats (avocado, nuts, olive oil)

Factors That Disrupt Hormones

Chronic stress — elevated cortisol suppresses FSH, LH, and testosterone
Excess alcohol — directly toxic to testes and increases oestrogen
Obesity — aromatase in fat tissue converts testosterone to oestradiol
Opioid pain medications — strongly suppress testosterone production
Anabolic steroids — shut down natural production (can be permanent)
Endocrine disruptors (BPA, phthalates) in plastics and cosmetics

Related Blood Test Guides

Thyroid Function

Thyroid hormones interact closely with sex hormones and affect every cell in your body.

Glucose & Insulin

Insulin resistance is central to PCOS and affects testosterone in both sexes.

Bone Health

Oestrogen and testosterone are critical for maintaining bone density.

Hormones Overview

Broader guide to all hormone-related blood tests including thyroid and adrenal.

Women’s Health Tests

Complete guide to blood tests important for women at every life stage.

Men’s Health Tests

Complete guide to blood tests important for men including PSA and testosterone.

See your doctor or an endocrinologist if you experience:

• Absent or irregular periods for 3+ months (not related to contraception)
• Persistent fatigue, low mood, or loss of motivation despite adequate sleep
• Difficulty conceiving after 12 months of trying (6 months if over 35)
• Loss of libido, erectile dysfunction, or reduced muscle mass in men
• Unexplained weight gain concentrated around the abdomen
• Hot flushes, night sweats, or vaginal dryness before age 45
• Excessive facial or body hair growth in women (hirsutism)
• Male breast tissue enlargement (gynaecomastia)

Track Your Hormones Over Time

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Medical Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Hormone levels must be interpreted by a qualified healthcare professional in the context of your symptoms, age, sex, medications, and menstrual cycle phase. Never start or stop hormone therapy based on information found online.