Why We Prescribe Hormone Therapy without Blood Tests

Feb 22, 2022
Medically reviewed by: 
Leah Millheiser, MD

We’re frequently asked why we don’t require patients to have their hormone levels checked before prescribing and during treatment with hormones for menopausal symptoms.

The answer is simple: Hormone testing is unnecessary for individuals aiming to use hormones for symptom relief. This is because we are not treating hormone levels. We are treating the symptoms of menopause.

An “optimal” hormone level for menopausal individuals has not been defined. According to the North American Menopause Society, determining the dosages of menopausal hormone therapy based on blood or salivary hormone testing is meaningless for midlife individuals because these levels vary from day to day and even from hour to hour. Since hormones are prescribed to target symptoms, the efficacy of these treatments depends on communicating with your medical provider to find the right dosage.

Using the Menopause Rating Scale to address severe symptoms

At Evernow, we use the self-administered Menopause Rating Scale (MRS) to understand our patients’ experiences with their symptoms. The MRS is a scientifically-validated questionnaire that our clinicians use regularly with patients to assess the presence and severity of menopausal symptoms.

Hormone levels do not determine how mild or severe an individual’s menopausal symptoms will be. This experience varies from person to person. For example, you might have the same level of estrogen as your best friend, but they could be having bothersome hot flashes and night sweats while you may be sailing through, not bothered at all.

No messy tests, no labs

We know that some medical practices will continue ordering hormone testing as part of a menopause care assessment, and some patients will like that. At Evernow, we believe in science and we follow the standard of care when it comes to prescribing and adjusting menopausal hormone therapy. We know that sharing your symptoms and experiences with our medical team will get you the most effective treatment as quickly as possible—without putting expensive, unnecessary tests between you and symptom relief.