If you’re a woman in or approaching your 30s (or beyond), you’re likely wondering if you missed the memo to monitor your hormonal health and plan for things like conception. We were taught so little about fertility and hormones at school, and it still remains a largely off-limits subject in many friendship circles. 

Some will sail through starting a family, and others will not. Some will go through menopause barely breaking a sweat, and others will need the support of HRT. So it’s understandable that women are turning to tech to try to fill in some of the gaps.

DIY wellness tests are a booming business. From DNA kits that can predict the likelihood of you developing certain diseases to ones that tell you where your ancestry lies, the global market for health self-monitoring technologies is predicted to grow from $48.7 billion (£42.8bn) in 2021 to $185.9 billion (£163.3bn) by 2026, according to research from BCC Research. And now, more and more women are using at-home hormone tests to predict everything from ovarian reserves to thyroid issues.

So, why are people taking at-home hormone tests?

Take fertility, for example. Stats suggest more women are now getting pregnant in their 30s than their 20s for the first time. And yet, in the UK, your GP is unlikely to even consider offering hormone tests related to fertility unless you’ve been trying with a partner for a baby for at least a year. 

That obviously leaves out same-sex couples and single women who are considering their options. It’s no wonder, then, that testing your fertility with a finger prick is a tempting concept; who doesn’t want to know what their reproductive health picture looks like? Whether or not you want kids, you’re probably at least a little intrigued as to how far off you might be from a permanent decision, as well as perimenopause symptoms and menopause.

Long NHS waiting lists

“Long waiting lists on the NHS, busy lifestyles and the high cost of going private are some of the most common reasons women are increasingly opting for DIY at-home testing,” says hormone specialist and nutritionist Kay Ali. “They are often cheaper, quick and convenient to organise.” 

But she warns that the downside of organising your own tests, without guidance from a doctor or specialist, is that you might not be testing for the most helpful things or getting the full picture of your hormonal health. “Understanding your hormones and how to navigate them is vast and complex, never mind the complexities of certain hormonal issues like infertility,” she says. 

“Assuming a decent home test is available and taken at the right time in your cycle, most kits will only offer insight into hormone levels. What a finger-prick blood test won’t answer is how these hormones are metabolised or detoxified. This is really important as some hormonal issues are due to poor signalling or detoxification.” For this reason, she says she’s sceptical of “cleverly marketed finger-prick tests that typically assess a very narrow panel”.  

They’re much cheaper than in-clinic checks

At-home fertility ‘MOTs’, as they are crassly dubbed, are often a fraction of the cost of seeing a specialist in-clinic, but Dr Dimitrios Mavrelos, consultant obstetrician and gynaecologist at University College London Hospital, urges caution when it comes to these kinds of tests. “You have to see it in the context of what these tests were developed for in the first place and how we use them in the clinic. 

“When I see a couple that has been trying to conceive or a woman who’s thinking about freezing her eggs, we have a discussion about her history and expectations before we do these tests and then we meet again to interpret the results.”

While Dr Mavrelos says he understands the appeal of a number “that’s either high, low or medium”, he warns that if those numbers are not interpreted with care, they may create “more anxiety and distress than there needs to be”. 

He points to the example of the AMH test. Anti-müllerian hormone (AMH) is produced by cells in ovarian follicles and is used as a marker to give an idea of the state of a woman’s ovarian reserve. “But AMH is not a test of fertility. It does not tell you that a woman at 30 who has a lower AMH is less fertile than a woman at 30 who has high AMH,” he says. 

“What it tells you is if I was going to attempt to collect your eggs for IVF, would I need to give you a high dose? Would you be at risk of using too many eggs? Or would you be someone who is not going to respond to that treatment?” He is concerned that “unexpectedly low” results from these kinds of tests could cause unnecessary anxiety about something that may never have been an issue in the first place. “You may have tried with a partner and fallen pregnant and never known about the low AMH.”

Too much knowledge isn’t always empowering

Obviously, the other side of the argument is that arming yourself with as much knowledge as possible about your hormones and potential fertility allows you to do something about it. So, isn’t that empowering? 

“Yes, and no,” Dr Mavrelos says. “Because what can you do about it? You can make choices that perhaps you wouldn’t have made, and making these consequential life choices – like who you’re going to start a family with – on the basis of a blood test that you may have misinterpreted concerns me.” 

You don’t always have the money to act on findings

And, of course, not everyone has the privilege of being able to take immediate action – whether that’s having the budget for egg-freezing or having a partner to discuss starting or at least trying for a child.

Dr Sohère Roked, a GP, integrative medicine specialist and host of the It’s Your Hormones! podcast, will often agree to her clients testing their hormones through external companies as it can be more economical, but she echoes this concern about interpreting results without proper support. 

We often don’t know how to interpret data

“The problem is that most people don’t know what they’re asking for when they ask for a hormone test. There’s no point having loads of data if you don’t know how to interpret it.” Hormones such as oestradiol, progesterone and testosterone are often very important, she says: “Quite often, progesterone is something that’s missed out on hormone tests.” 

Even when testing in-clinic, the picture is complex. Hormones do fluctuate, of course, so most need to be done on certain days of the cycle, but if you’re having an irregular cycle, Roked suggests that “complicate” things.

Her job is often to connect the dots, and hormone tests are only one piece of the puzzle, Roked adds. “If someone’s symptoms aren’t correlating, then it gives me an indication to look a bit further or to trial some treatment regardless, but tests are useless without understanding a person’s history.” 

Additionally, many people might be taking hormone tests because they’re experiencing certain symptoms, but receive ‘normal’ test results. “Where does that leave you? The person still feels terrible, so it’s really important for me to look at these results with that context and make sure the person is doing them at the right time of the cycle for them.”

So, other than expensive testing, how else can you keep an eye on things? According to Dr Mavrelos, simply analysing your menstrual cycle – which many of us already do – gives you a good indication of your ovarian reserve. 

“The cycle itself gives you a whole wealth of information because there’s no other mechanism in the body that gives a regular cycle apart from regular ovulation,” he says. “The natural history of periods is that they start, they’re irregular and all over the place, then (hopefully) they settle into a pattern, then cycles become shorter in the late 30s, early 40s. Then cycles become longer, women start missing periods, and then they stop.”

If you have a regular-ish cycle of between 28 and 35 days, your reserve is “probably fine”, he says. If the cycle is longer than 28 days, then chances are your reserve is high, but if your cycle is less than 28 days, around 24 or 26 days, then that could be a sign that reserve is declining, he adds. Meanwhile, if your cycle is longer than 35 days, it could mean that you’re not ovulating. 

But don’t lifestyle factors like stress affect the length of cycles month to month? “Stress, also thyroid function, definitely affects periods,” he concedes, so look for patterns. “Everyone has an app these days they use to track their cycle; this is really valuable information.”

Of course, there’s nothing wrong with taking an at-home hormone test, as long as the results are seen for what they are – one piece of a very complex puzzle that often specialists struggle to navigate or explain. If you’re thinking of taking one, it’s worth thinking about next steps beforehand and planning what you’re going to do with that information, particularly if your results are not what you were expecting. And if you do take one, whether it’s a test related to fertility, perimenopause or thyroid function, the next port of call should always be making an appointment with your GP.

Images: Getty