Female Hormone Panel (FHP™) by
Diagnos Tech is a dynamic mapping (See
Figure 1) of the bioactive levels of
Estradiol and Progesterone throughout
one cycle. The panel also includes
a cycle average value for Free Testosterone
and DHEA. The extended panel includes
an additional 4 or 5 FSH & LH measurements.
The panel uses 11 saliva samples collected
during specified time slots* throughout
the menstrual cycle (1, 2, 3).
*A time slot is a window of 2-3 days.
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This panel requires 11 saliva samples that are collected at the
patient's convenience. Patient samples are collected and mailed
to the laboratory without involving clinic staff and with no biohazard
risks; no blood, no mess. The test also avoids the inconvenience
of women performing a 24 hour urine collection in a gallon sized
This eleven sample profile of estradiol and progesterone plus cycle
averages of testosterone and DHEA costs less than 2 estradiol and
progesterone blood tests, or a single steroid urine analysis.
Scientific Advantages:Correlation with Free Bioactive
Fraction in Blood. The general consensus is that the unbound or
free fraction of steroid hormones exerts the biological influence
on tissue. The bioactive fraction accounts for most of the extra vascular
hormones in the tissue space (4). Recent work indicates that salivary
estradiol, progesterone, DHEA and testosterone levels correlate
well with their respective serum free fractions (5, 6, 16, 17).
to Serum Progesterone & Body Temperature Records
In a study comparing saliva progesterone values to body temperature
records and serum progesterone over 3 consecutive menstrual cycles
in 41 women, the conclusion was: "Basal body temperature records
or mid luteal serum progesterone measurements were less satisfactory
indices of luteal function than a salivary progesterone profile."
Finn, M.M., et al. Gynecol. Endocrinology 3:297-308 (1989).
Output & Reserve Estimation
Since the output of both progesterone and estrogens varies with
the day of the cycle, the single serum or urine samples preclude
the ability to estimate ovarian cycle output and reserves. The FHP™
hormone mapping includes ovarian output and reserve estimates.
The FHP™ has broad clinical applications that include:
Phase Defects (LPD) & PMS
The term LPD describes abnormalities in the luteal phase of the
female cycle which includes defects in hormone concentrations and
balance. Luteal phase defects are common and affect between 8% (7)
and 35% (8) of patients, depending on the sub-population studied.
Luteal phase defects show abnormalities in progesterone output and
can be classified into 3 subclasses: LPD-I, LPD-II, LPD-III.
LPD-I: The luteal defect related to shortening or lengthening of
the luteal phase. The normal luteal phase length is 12-18 days.
Clinically, LPD-I is associated with inability to conceive, scant/heavy
menstrual flow, increased risk of proliferating diseases, insomnia
and various emotional problems.
LPD-II: The luteal defect related to reduction in overall progesterone
output due to an underdeveloped corpus luteum or sub optimal pituitary
stimulation (weak LH pulse). Clinically, LPD-II is associated with
water retention, breast tenderness, spotting, increased irritability,
headaches, insomnia and a constellation of cognitive and emotional
LPD-III: The luteal defect related to uneven distribution of progesterone
throughout the luteal phase. Women with this defect usually show
low progesterone in the last 5-7 days before menstrual flow. Clinically,
in LPD-III the symptoms (same as LPD-II) are often confined to the
last 5-7 days before menstrual flow.
Our FHP™ report will make the distinction and suggest guidelines
for therapy in all LPD subclasses.
and serum hormone concentration in mid-luteal phase are practically
useless in LPD detection. The inadequacy has been worded as follows:
"We reject the notion that a single mid-luteal phase progesterone
assay is sufficient to make the diagnosis of luteal phase defect
(7)." The mid-luteal phase progesterone assay "is of little
or no assistance in establishing a diagnosis" of luteal phase
deficit [Wentz, A.C. Clinical Obstet. Gynecol. 22:169 (1979)].
summary, mid-luteal testing is a technique shown to have poor or
minimal correlation with luteal insufficiency on a patient-by-patient
The salivary FHP™ can be used to detect anovulatory cycles
(6) which may occur in about 22% of young women age 20-31 years
(12). This is a common cause of in- fertility and may result from
excessive and chronic stress. We have verified this notion over
the years through the use of the salivary Adrenal Stress Index™
performed at our laboratory.
The FHP™ can be successfully used in investigating the following
problems: Ovulation problems, sexual differentiation problems, estrogen-progesterone
imbalance, pituitary-ovarian axis dysregulation, functional infertility
and miscarriage, polycystic ovarian disease, recurring headaches
and hot flashes, libido problems and hirsutism.
Presently, hormone therapy is very empirical and a one-size-fits-all
approach is applied to most women. Due to variability among women,
a more customized and scientific approach is required. The FHP™
panel report analyzes hormone production trends and functional inter-relationships
which facilitates customized treatments. Then, hormone replacement
therapy can go beyond package insert protocols. For example, the
optimal treatment plan for a 25 year old is not likely the best
therapy for a 48 year old approaching menopause.
assessment of Breast and Uterine diseases
The relation of estrogen dominance to increased risk of proliferating
diseases in breast & endometrial tissue is universally accepted.
The FHP™ & e-FHP™ report includes the Follicular
Estrogen Priming Index (E fi) that quantifies the impact of excess
estradiol in menstruating women. Patient-specific recommendations
are routinely included in the report. Please note that certain estrogen
metabolites are falsely promoted as markers for breast cancer risk.
A recent study which compared 2/16 Hydroxyestrone ratio in women
with breast cancer to a control group of cancer-free women, concludes
that there is no support for the hypothesis that the ratio of 2/16
hydroxyestrone is an important risk factor for breast cancer (J
Nat'l Cancer Inst 1999 Jun 16:91(12):1067-72).
FHP™ allows an in-depth functional analysis of hormone relationships
that affect long-term health.
FSH & LH
The Expanded Female Hormone Panel™ includes 4 or 5 FSH &
LH measurements. The salivary FSH & LH constitutes a measurement
of tissue concentration of the bioactive hormone. Ovarian estrogen
production is dependent on presence and rhythmicity of FSH. Ovulation
and progesterone production are dependent on the mid cycle LH surge.
By coupling FSH with estrogen and LH with progesterone (Fig. 2 &
3), we have a powerful diagnostic tool to differentiate ovarian-based
from pituitary (brain)-based cycle irregularities. This is highly
relevant in PMS, infertility and early menopause-like symptoms.
Elevated FSH does not always imply low estrogen, it may indicate
a desensitized axis from previous use of birth control pills. FSH
& LH can be ordered as individual tests.
& DHEA in Women
In women, the effects of testosterone on certain target tissues
counteract those of estrogen. Increased testosterone in women is
associated with increased libido, enhanced spatial, mathematical,
artistic and musical abilities. Increased testosterone levels have
a nonlinear correlation with performance (18, 19, 20).
testosterone production in women is a good indicator of ovarian
cysts. Many of these women show abnormally rapid rates in converting
androstenedione to testosterone (21). The efficacy of anti androgen
treatment in women with excessive testosterone can be effectively
monitored by salivary testosterone (22).
the other hand, women with low testosterone may show a catabolic
tendency and reduced libido, and may require low dose augmentation
with testosterone. Salivary testosterone is well suited for initial
and post therapy follow-up evaluations. The panel also includes
a measurement of the cycle average of DHEA free fraction. DHEA is
the molecular precursor of the androgenic and estrogenic hormones.
Often, low DHEA is the cause of insufficient testosterone and estrogen
women become increasingly aware of the role that hormones play in
their health throughout their entire lives, they are realizing the
urgent need for reliable, clinically relevant assessment of hormone
activity. The Female Hormone Profile is a safe, non-invasive saliva
assay that analyzes levels of progesterone, testosterone and ß-estradiol
over 28 days. Because these hormones shape the course of a woman's
menstruation cycle, imbalances can produce disruptions in mood,
sleep patterns, appetite, sexual drive and PMS symptoms.
Female Hormone Panel provides clinical direction for successful
treatment of women with menstrual irregularities, difficulties with
ovulation, functional infertility, pre-menstrual syndrome, menopause,
osteoporosis, and other hormone related disorders. Once abnormal
patterns are accurately detected, an effective, customized treatment
plan can be developed to restore a patient's natural hormonal rhythms.
lab tests can be done through the mail in the privacy of your own
home, except blood tests, we send you to a lab to have your blood
drawn for these. After you pay for the test we mail you the kit,
the results take two weeks, the test results will be mailed to us
and we will call you to go over the results, its that easy! All
tests include the consultation for the report of findings.
Click on test of interest on the right for more information
Call our office for details.
800-956-7083 OR 818-707-3126