Sex steroid hormones are chemical messengers that circulate throughout your body and tell your cells what to do. From the time you are born, these important hormones not only ensure that you will grow and develop, but they also help to protect you from disease. The texture and suppleness of your skin, the strength of your muscles and bones, the flexibility of your arteries and veins, your digestion and elimination, your sexuality, even your ability to cope with stress, are all impacted by your sex steroid hormones.

The estrogens (estradiol, estriol, and estrone), progesterone, testosterone, and DHEA are all sex steroid hormones. Each has specific jobs to do on their own, but they also work together as a team - intricately involved with each other in a kind of syncopated dance. The amount of each one of them you have in your system is important and so is the balance between them. When you don’t have enough of one, or if the ratio between them is out of kilter, your cells may not receive the messages they need to function optimally.

Your body regulates your sex steroid hormone levels in somewhat the same way that the thermostat on an air conditioner regulates the temperature in a room. If you set it for 70 degrees and the temperature in the room rises above that, the air conditioner will turn on. Once the room temperature drops to 70 degrees again, the air conditioner turns off. In your body the amount of hormone you have circulating is controlled by a ‘hormonal thermostat’. When you don’t have enough of a particular hormone, more is produced. When you have the right amount, production stops. A complex system of checks and balances keeps your hormone levels balanced.

Every woman’s hormonal thermostat works in a way that is unique to her. Therefore, hormone levels can differ substantially from woman to woman. That’s why, even though all women share the same basic hormonal cycles and transitions, their experience during these events varies widely. Some women have easy, regular monthly cycles, while others have difficult premenstrual syndrome (PMS) symptoms. And the same is true for menopause. Some women breeze through it, while others are challenged with discomforts. Some women experience menopause when they are in their forties, others not until after their fiftieth birthday. There are as many ways of going through hormonal transitions as there are women because women’s hormones fluctuate and decline at different rates and at different times. A woman’s hormonal profile is uniquely her own.

In the same way that there are healthy ranges for cholesterol, blood sugar, and blood pressure levels, there are optimum ranges for hormone levels. When a woman is still having menstrual cycles, her body is producing generous amounts of sex steroid hormones, and she is enjoying all the benefits of good health and disease protection they provide. The years known as perimenopause and menopause, however, mark the time in a woman’s life when her body’s production of sex steroid hormones is decreasing. The decline in these important hormones can begin as early as age 35 and can continue gradually until she is well into her sixties and seventies. Symptoms of hormone deficiency can range from hot flashes, night sweats and moodiness to the more serious signs of hormone decline, such as bone loss and impaired cardiovascular functioning. However, symptoms alone don’t determine whether or not a woman’s hormones are declining. Nearly half of all menopausal women have no outward signs of decreased hormone levels, and yet they are still at risk for heart disease and osteoporosis. So how do you know what’s going on with your hormones? You test your hormone levels.

Sex steroid hormones are complex. There are many aspects to them. A drop in the "free" fraction of sex steroid hormones specifically leads to perimenopause and menopause. Because this "free" fraction of hormone can easily pass from the blood into the salivary glands, it is now possible to determine precisely what your free hormone levels are with a simple saliva test you can do at home. When you take a saliva hormone test, you just chew a special piece of gum that is provided with the test, spit in a little tube, then send the tube to the lab for processing. Within a few days your test results are sent to you and your healthcare provider. This is called a baseline. Evaluating your baseline free sex steroid hormone levels is the first step in deciding if hormone replacement therapy (HRT) is right for you.

If you discover that your hormone levels have fallen below the premenopausal level, you may want to consider HRT to bring them back into the "protective" zone. Hormone replacement can restore your hormone levels to what they were when you were younger and in the peak of health.

When it comes to hormone replacement dosages, one size does not fit all. The way each woman responds to replacement hormones is uniquely her own. What works well for one woman may be too much, or too little, for another. If you do make the decision to begin hormone replacement, a saliva hormone test can be an important guide for determining how much hormone you should take because it can tell whether or not what you are taking is physiologically beneficial.

Finally, it is important to remember that your body’s production of hormones can continue to decline gradually for a number of years after menopause. The HRT dose you are taking might work just fine one year but not as well during the next. Therefore, the dosage of your hormone replacement may need to be reevaluated. Frequent monitoring of your hormone levels with a saliva test can tell you how well you are meeting your body’s ever-changing needs.