Hormone Panel for Women Explained: Estradiol, Progesterone, FSH, LH, and DHEA-S

Women's hormones don't just affect periods and fertility — they influence energy, mood, sleep, weight, skin, hair, bone density, and cognitive function. When hormones shift, the effects ripple through your entire body. Yet many women go years with symptoms that are dismissed or misattributed because their doctors never checked the full picture.

A comprehensive female hormone panel looks beyond just one or two values. Here's what each test measures, what normal looks like at different life stages, and what your results might mean.

Estradiol (E2)

What it is: Estradiol is the primary and most potent form of estrogen. It's produced mainly by the ovaries during reproductive years, with smaller amounts made by fat tissue and the adrenal glands.

What it does: Estradiol regulates the menstrual cycle, supports bone density, protects cardiovascular health, maintains vaginal and skin health, and plays a role in mood regulation and cognitive function. It's the hormone most responsible for the physical characteristics that develop during puberty.

Normal ranges vary dramatically by cycle phase:

• Follicular phase (days 1-13): 30-120 pg/mL
• Ovulatory peak (around day 14): 100-400 pg/mL
• Luteal phase (days 15-28): 60-150 pg/mL
• Postmenopause: Below 30 pg/mL (often below 10)

What low estradiol means:

• In premenopausal women: possible ovarian insufficiency, excessive exercise, low body weight, or pituitary problems
• In perimenopausal women: expected transition toward menopause
• Symptoms of low estradiol: hot flashes, night sweats, vaginal dryness, mood changes, difficulty sleeping, joint pain, brain fog

What high estradiol means:

• Could indicate estrogen dominance (high estrogen relative to progesterone)
• Obesity (fat tissue produces estrogen)
• Certain ovarian cysts or tumors
• Symptoms: heavy periods, breast tenderness, bloating, mood swings, weight gain

Timing matters: Estradiol should be drawn at a specific point in your cycle depending on what your doctor is evaluating. For general assessment, day 3 of your cycle is standard. For fertility evaluation, multiple draws throughout the cycle may be needed.

Progesterone

What it is: Progesterone is produced by the corpus luteum — the structure left behind after an egg is released from the ovary. It's the hormone of the second half of your cycle.

What it does: Progesterone prepares the uterine lining for potential pregnancy, supports early pregnancy, balances the effects of estrogen, promotes sleep, has calming effects on the nervous system, and supports thyroid function.

Normal ranges by phase:

• Follicular phase: Below 1 ng/mL
• Luteal phase (day 21): 5-20 ng/mL (confirms ovulation occurred)
• Pregnancy first trimester: 11-44 ng/mL
• Postmenopause: Below 0.5 ng/mL

What low progesterone means:

• Anovulation (no egg released — so no corpus luteum to make progesterone)
• Luteal phase defect (ovulation occurred but progesterone production is inadequate)
• Symptoms: irregular periods, PMS, anxiety, insomnia, spotting before periods, difficulty maintaining pregnancy

The estrogen-progesterone balance: Many symptoms attributed to "estrogen dominance" are actually about the ratio between estrogen and progesterone. You can have normal estrogen levels but still experience estrogen-dominant symptoms if your progesterone is too low to balance it.

FSH (Follicle-Stimulating Hormone)

What it is: FSH is produced by the pituitary gland in your brain. It tells your ovaries to develop follicles (which contain eggs) and stimulates estrogen production.

What it does: FSH is part of the feedback loop between your brain and ovaries. When estrogen is low, FSH rises — the brain is shouting at the ovaries to produce more. When estrogen is adequate, FSH drops.

Normal ranges:

• Follicular phase: 3.5-12.5 mIU/mL
• Ovulatory peak: 4.7-21.5 mIU/mL
• Luteal phase: 1.7-7.7 mIU/mL
• Postmenopause: 25.8-134.8 mIU/mL

What high FSH means:

• In reproductive-age women: The ovaries aren't responding well to stimulation, so the brain is sending more FSH. This can indicate diminished ovarian reserve (fewer remaining eggs) or premature ovarian insufficiency.
• In women over 40: Rising FSH is one of the earliest lab markers of perimenopause. An FSH above 25-30 on day 3 of the cycle suggests declining ovarian function.
• Consistently above 40: Generally indicates menopause.

What low FSH means:

• Possible pituitary dysfunction
• Hypothalamic amenorrhea (from stress, low weight, or excessive exercise)
• Polycystic ovary syndrome (PCOS) — FSH is often low-normal while LH is elevated

Clinical pearl: A single FSH level doesn't definitively diagnose menopause. FSH fluctuates significantly during perimenopause — it can be elevated one month and normal the next. Trending multiple values over time is more reliable.

LH (Luteinizing Hormone)

What it is: LH is also produced by the pituitary gland. Its main job is to trigger ovulation — the LH surge causes the dominant follicle to release an egg.

Normal ranges:

• Follicular phase: 2.4-12.6 mIU/mL
• Ovulatory surge: 14-95.6 mIU/mL
• Luteal phase: 1.0-11.4 mIU/mL
• Postmenopause: 7.7-58.5 mIU/mL

The LH/FSH ratio: In healthy cycling women, the LH-to-FSH ratio is approximately 1:1. In women with PCOS, the LH-to-FSH ratio is often 2:1 or higher. This reversed ratio is one of the hormonal hallmarks of PCOS, though not all women with PCOS show this pattern.

What high LH means:

• Mid-cycle surge: normal ovulation
• Consistently elevated: possible PCOS, menopause, or primary ovarian insufficiency
• With low estrogen: suggests the ovaries aren't responding

DHEA-S (Dehydroepiandrosterone Sulfate)

What it is: DHEA-S is an androgen (male-type hormone) produced mainly by the adrenal glands. In women, it serves as a precursor to both testosterone and estrogen.

Normal range for women: Approximately 35-430 mcg/dL (varies significantly by age — levels peak in the 20s and decline steadily)

What DHEA-S tells us:

• High DHEA-S: Can indicate adrenal androgen excess — a common finding in PCOS. It can also suggest adrenal hyperplasia or, rarely, adrenal tumors. Symptoms include acne, excess body/facial hair (hirsutism), and hair thinning.
• Low DHEA-S: Associated with adrenal insufficiency, aging, and chronic stress. Low DHEA-S can contribute to fatigue, decreased libido, and reduced sense of wellbeing.

DHEA-S is useful for distinguishing between ovarian and adrenal sources of excess androgens. If testosterone is high and DHEA-S is normal, the excess androgen is likely ovarian. If DHEA-S is high, the adrenal glands are contributing.

When to Test and Timing Matters

Hormone levels in cycling women change dramatically throughout the month. Testing at the wrong time can give misleading results:

• Day 3 of your cycle (counting from the first day of your period): Best time for FSH, LH, and estradiol to assess baseline ovarian function
• Day 21 (or 7 days after ovulation): Best time for progesterone to confirm ovulation
• DHEA-S: Can be drawn any time — it doesn't fluctuate with the menstrual cycle
• Postmenopausal women: Can be drawn any time since there's no cycling

If your periods are irregular and you don't know what cycle day you're on, tell your doctor. They may need to draw labs regardless of timing or use other methods to interpret the results.

How Coral Approaches Female Hormone Testing

At Coral, we don't check one hormone and call it a day. We look at the full panel — estradiol, progesterone, FSH, LH, and DHEA-S — along with thyroid function and other metabolic markers to understand the complete hormonal picture.

Whether you're dealing with irregular periods, perimenopausal symptoms, fatigue, mood changes, or hair loss, your hormones are part of the equation. Understanding them is the first step toward feeling like yourself again.

Ready to get your hormones checked? Start your visit with Coral.

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