Edmonton 13137-156ST NW, Edmonton, AB, T5V 1V2
Alberta Thermography Clinic

Month Long Assessment

Salivary Analysis of Hormones

Numerous studies support the use of salivary hormone analysis to map out menstrual cycle hormone profiles.  A study by Gandara measured estradiol and progesterone in serum and saliva and rated menstrual cycles as normal or abnormal according to the results.  There was good agreement between serum and saliva, with both sample types finding normal or near normal cycles in 78% of women studied.  The author concluded that  “whole saliva samples … provide a noninvasive, feasible method of  determining menstrual cycle profiles.”

The month-long assessment requires the collection of eleven saliva samples over 33 days.  Progesterone and estradiol are reported for all 11 samples, and an average testosterone is reported.     Women with erratic bleeding, amenorrhea, fertility issues or cycle-specific symptoms such as migraine headaches, hot flushes, and mood disturbances may benefit from a month-long assessment.


Month-Long Hormone Assessment

Women are asked to report significant symptoms that arise on sample days.  By correlating the patient’s self-reported symptoms with hormone levels throughout the menstrual cycle, it is often possible to find a hormone imbalance underlying a symptom or issue.  Cases presented on page 3 illustrate the benefit of knowing when symptoms appear relative to hormone levels throughout the cycle.


Fertility Issues

  • inadequate, early, or late progesterone surges in the luteal phase can affect ability to conceive.
  • menstrual cycle length may affect fertility.  For example, a woman whose progesterone peaks on day 14 will have difficulty conceiving if she assumes she is ovulating at that time.


Erractic bleeding

  • heavy bleeding is usually associated with high estradiol levels, but may also occur as a result of low estradiol, a relative imbalance of estrogen and progesterone, anovulation or androgen excess. The month-long hormone assessment helps identify many of the causes of erratic bleeding.



  • month-long assessment shows if amenorrhea is due to high androgen and/or anovulation.
  • the month-long assessment illustrates the effect of oral contraceptives on hormone production.


Mood Swings

  • by tracking mood-related symptoms with hormone levels, underlying hormone imbalances may be identified.


Cycle specific symptoms

  • certain symptoms may occur at specific times in the menstrual cycle.  For example: hot flushes may occur late in the luteal phase when Pg is falling and E2 rises unexpectedly.


Clinical utility and ease of sample collection makes salivary hormone analysis ideal for a month-long assessment. Samples can be kept in the freezer as collections proceed, and all eleven samples mailed in pre-paid mailer together when collection is complete.


  • High estradiol levels may impair thyroid function, and/or contribute to erratic bleeding.
  • Low estradiol levels may contribute to erratic bleeding and difficulty conceiving.


  • Insufficient progesterone relative to estradiol can result in estrogen dominant symptoms like weight gain at hip, breast tenderness, anxiety, fluid retention and fibrocystic breasts.


  • High testosterone correlates with insulin resistance and metabolic syndrome.  Low testosterone may be responsible for symptoms like low sex drive, vaginal dryness and bone loss.


What if I have a shorter than average menstrual cycle length?

If for example, you have a 25 day cycle; you can collect every third day in the first half of your cycle, then every other day in the latter half of the cycle. In other words, you will collect as follows: Day 1 (first day of bleeding), Day 4, Day 7, Day 10, Day 13, Day 16, Day 17, Day 19, Day 21, Day 23, Day 25.


Is testing useful if I am using progesterone cream?

If you are using progesterone cream, the results will reflect progesterone cream levels, not the endogenous progesterone level.  Therefore, the progesterone levels reported will provide no useful information regarding ovarian production of progesterone.


Is the month-long assessment useful if I am post-menopausal?

At this time, we have no data to suggest that the month-long assessment is clinically useful for postmenopausal women.



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