Saliva or blood test to check hormone levels?

I’m in my late 40s and experiencing symptoms of perimenopause, so I would like my hormone levels tested. I’ve heard that saliva tests are more accurate than blood tests. Is this true? —Donna Minton, via email

Accuracy among saliva hormone levels and serum (blood) hormone levels is similar, so there’s no need for both tests. That said, a growing number of physicians feel salivary testing, which evaluates cyclical hormone levels, is superior to serum testing because saliva reflects which hormone actually gets into the tissue. Serum testing, on the other hand, measures only the level of hormones circulating in the bloodstream.

Saliva tests are painless, easy to perform, and let you collect samples at home without multiple, costly visits to blood-drawing facilities. To administer, take samples on 11 different days during your menstrual cycle. Basically, you spit into a tube and stick it in the freezer; once you’ve collected all 11, you mail them to the lab. Taking multiple samples from various points in time is key: The range illustrates hormone cycles completely, which allows doctors to determine “normal” levels and pinpoint abnormalities.

Saliva testing does have its disadvantages, though. Since conventional medicine considers serum testing the standard of care, many physicians are reluctant to order saliva tests and, as a result, few insurance plans reimburse for them. Talk with your doctor to determine which test best suits you.
—Kimberly Wilson, NMD, a naturopathic doctor in Plano, Texas