Why Functional Hormone Testing Still Matters
If you’re already on HRT (Hormone Replacement Therapy), you might be wondering if it’s still worth testing your hormones. After all, isn’t that what the HRT is supposed to fix?
This is something we’re asked all the time in clinic, and the answer is a firm yes, it’s not only still relevant… it’s especially helpful.
“I’ve Tried Everything and I’m Still Not Feeling Right”
We hear this every week from women in their 40s and 50s. You’ve followed the advice, gone back and forth with your GP, tried the oestrogel, the patches, maybe a coil. It helped a bit — maybe you sleep better, maybe your hot flushes eased — but other symptoms haven’t shifted at all. In some cases, they’ve even got worse.
Your libido is still gone. Your anxiety feels through the roof. You’ve put on weight around your middle and can’t shift it. Your energy is on the floor. You feel emotionally flat, or on edge, or just… not you anymore.
And yet the only option you’re offered is more oestrogen.
HRT Is Not One-Size-Fits-All
HRT can offer powerful relief for many women, particularly in perimenopause and menopause. It helps to replace declining oestrogen and progesterone levels, often improving symptoms like hot flushes, sleep issues and vaginal dryness.
But here’s the problem: simply adding in hormones doesn’t guarantee your body is using them in the right way.
You might still be struggling with:
- Low mood, anxiety or irritability
- Weight gain, especially around the middle
- Worsening PMS or breast tenderness
- Poor sleep, fatigue or brain fog
- Skin breakouts or hair loss
- Low libido
That’s where functional hormone testing becomes so valuable.
What the DUTCH Test Can Tell You (That Blood Tests Can’t)
The DUTCH test (Dried Urine Test for Comprehensive Hormones) gives us a much deeper view than a standard blood test. Instead of a one-off snapshot, it shows:
- How your body is metabolising oestrogen, progesterone and testosterone
- Whether you’re clearing hormones safely or pushing them down inflammatory pathways
- Your daily cortisol rhythm and adrenal function (are you wired, tired or both?)
- Clues about your liver detox pathways, nutrient methylation, and stress load
For women on HRT, this is especially useful, because it can help us understand:
- Why you’re still feeling anxious, low or tired despite being “on the right dose”
- Whether you’re oestrogen dominant (yes, even with the coil)
- How your HRT is being processed, is it supporting you, or causing more imbalance?
- If other systems (like the thyroid or gut) need attention too
Hormones Are Just One Piece of the Puzzle
We believe the best care doesn’t just look at your age or your cycle changes, it looks at the whole picture.
That includes:
- How you’re sleeping
- What your stress load is like
- What you’re eating (and absorbing)
- How your liver and gut are functioning
- Whether you’re getting the right nutrients to clear hormones properly
At PCH, we support women with a truly personalised approach, whether you’re on HRT, thinking about starting it, or coming off.
Case Study Example: Why This Matters
We recently worked with a woman in her late 40s who was using the Mirena coil and Oestrogel. Her GP told her hormone levels were “fine” based on a basic blood test, but she was still struggling with weight gain, anxiety and restless sleep.
Her DUTCH test revealed:
- Poor oestrogen clearance down the 4-OH pathway (not ideal)
- Low methylation activity (linked to a need for B6, B12, and magnesium)
- A flat cortisol curve, suggesting adrenal fatigue from long-term stress
- Low overall progesterone (explaining her persistent anxiety)
With this information, we were able to adjust her supplement plan, support her detox pathways, and work with her to tweak her HRT, leading to significant improvement in symptoms.
What About If You’re Considering Coming Off HRT? Can You Test?
If you’re thinking of transitioning off HRT (either now or in the future), the DUTCH test is a brilliant way to see what your baseline hormone function is like and help you build a natural, supportive plan. You don’t want to come off blindly and find your symptoms come flooding back so work with our PCH practitioner on this. You can explain that you’d like to come off in your first 30 minute consultation before testing. Your practitioner can then explain how long to wait before testing so that your HRT is out of your system.
What About When to Test?
If you’re already on a steady dose of HRT, we typically recommend doing the DUTCH test after you’ve been on your current regime for at least 6–8 weeks, so we can assess how your body is processing it.
Supporting Your Body While on HRT
Remember: HRT is only one piece of the puzzle. At PCH, we support the whole body, particularly your detox pathways, gut, adrenals and blood sugar balance to help you feel your best both on and off HRT.
Some helpful supplements to support your body while on HRT include:
- PCH Magnesium Complex – supports nervous system calm, sleep quality, and the methylation process (key for clearing oestrogen safely).
- PCH B Complex and PCH B12 – crucial for hormone detox, energy, and mood support, especially for women on synthetic or bioidentical hormone therapies.
- PCH Detox – supports liver function and phase 1 and 2 detox pathways, which are essential for clearing both your own hormones and any HRT you’re taking. It’s especially helpful if you’re experiencing symptoms of hormone build-up like breast tenderness, bloating, or irritability.
- PCH Gut Repair – designed to strengthen and soothe the gut lining, which is vital for hormone balance, nutrient absorption, and reducing inflammation — especially if you’ve struggled with bloating, sluggish bowels or long-term stress.
- PCH Repopulate Probiotic – a high-potency, broad-spectrum probiotic delivering 50 billion CFUs of 12 clinically researched strains — including DDS®-1, shown to support healthy digestion, improve stool consistency, ease lactose intolerance, and reduce gut discomfort linked to travel or everyday imbalances.
To Conclude
If you’re already using HRT and not feeling quite right, or you’re curious about how your body is responding, the DUTCH -test can give you the clarity and control you deserve. From 19th – 21st May 2026 you can get £100 off Dutch hormones testing with code DUTCHMAY. For more information and to book a Dutch test click here.
