Walking into your OB/GYN’s office with a detailed symptom log feels like a brave step. You’ve been noted changes in your sleep patterns, mood swings, and irregular periods, while also facing the myriad of strange experiences that come with age. You’re eagerly seeking answers, convinced a full hormone panel is the key, yet you’re met with indifference and the ubiquitous buzzword: perimenopause.
The response often isn’t what you hope for. Tests? Bloodwork? Those aren’t part of the conversation. Instead, you receive a prescription for birth control, as if that’s the magic solution for every woman in her 40s.
This scenario played out for TikTok creator @imnotmessyimbusy. She bravely shared her experience, ultimately garnering 226,000 views on her video.
In her post, she opened up about how her doctor failed to address her concerning symptoms, and during a follow-up visit, she tried yet again to advocate for her health.
She expressed to the nurse practitioner, “I want my hormones checked before any treatment begins. How can you treat symptoms without conducting any tests?”
She recounted, “I was in tears. I felt so defeated. I told her, ‘If I go to Quest [Diagnostics], I can pay $500 for this test. So why can’t you write it for me?’ She replied, ‘Well, we are treating the symptoms.’ Really? That doesn’t feel right.”
“You wouldn’t see a cardiologist prescribing a statin without performing any tests or an EKG,” she pointed out. “But it seems that’s the norm for women. Why?”
“What does it take to get a comprehensive hormone panel without incurring huge out-of-pocket expenses or resorting to holistic practitioners?” she pleaded, her desperation evident.
Many women in the comments echoed her frustration.
“I’m 34. I told my gynecologist I suspected I was perimenopausal. I listed all those symptoms you mentioned and was laughed at. I even mentioned that my mom experienced full menopause at 42, and perimenopause starts ten years prior. Yet I was completely dismissed,” one user shared.
Another said, “You often have to frame it as family planning to get their attention. My OB-GYN was accommodating because I told her I wanted to check my hormones as part of my fertility assessment and she agreed to run the tests under that pretense. It’s disheartening, but sometimes that’s what works. It may even relate to insurance issues.”
One thoughtful commenter added, “Unfortunately, perimenopause isn’t diagnosed through lab tests but rather through symptoms. Hormone levels fluctuate throughout the month, and you can have a ‘normal’ lab result while still experiencing symptoms.”
Others mentioned a test known as the Dutch test.
“It’s best to visit a holistic or hormone therapy practice. The Dutch test costs around $300. Sadly, OBGYNs often brush aside our concerns and don’t administer this test,” one user explained.
“Working with a dietitian focusing on hormones could reduce the cost to $50! Plus, I can arrange for a DUTCH test with a provider discount,” another mentioned.
However, one lamented, “Getting a doctor to even order the Dutch test is a huge challenge.”
What is a DUTCH test?
Per Allara Health, DUTCH stands for Dried Urine Test for Comprehensive Hormones. The DUTCH Complete panel evaluates sex hormones like estrogen, progesterone, and testosterone, as well as adrenal hormones like cortisol and DHEA-S. It also analyzes hormone metabolites and additional markers related to nutrients and gut health.
How does a DUTCH test work?
The process is relatively straightforward. You provide four or five urine samples on filter paper over the course of 24 hours. There are no needles involved. Once dried, you mail it back. Results typically arrive within two to three weeks, during which a healthcare provider guides you through the findings.
How is a DUTCH test different from a regular blood draw?
According to the official DUTCH Test website, blood tests offer a limited glimpse of your hormone levels at one moment in time. In contrast, the DUTCH test evaluates urine samples collected throughout the day—allowing for a fuller picture of your hormonal fluctuations over time. For those interested in a comprehensive look, the DUTCH Cycle Mapping™ test provides an extensive graphical view of your menstrual cycle. This allows healthcare providers to effectively track ovulation, investigate mid-cycle spotting, and assess ovarian function.
Essentially, the DUTCH test illustrates how your body generates hormones, utilizes them, and processes them. It’s not just about measuring hormone levels; it’s about the entire journey of your hormones in the body.
How much does a DUTCH test cost?
The disappointment here lies in the fact that while the DUTCH test seems informative, it usually isn’t covered by insurance and is often overlooked by primary care doctors.
The baseline DUTCH Complete test comes in at around $500, with prices escalating thereafter.
In summary, the DUTCH test is not a one-stop solution, and its cost can be daunting. However, for women feeling dismissed, told their tests are “fine” while experiencing troubling symptoms, or handed prescriptions before their concerns are properly addressed, it may be the key to paving the way for answers. We deserve more than a mere prescription for birth control or the dismissive attitude of “Just deal with it— that’s life.”
