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Why You Need to Do a DUTCH Test in Perimenopause and Menopause


Reviewed by Traci Eliszewski, NP of Forum Health Madison

Navigating the journey into perimenopause and through to menopause can be challenging to say the least. Hormonal imbalances during this time can lead to a wide range of symptoms, from mood swings and hot flashes to disrupted sleep and weight gain.  


But you don’t have to go into perimenopause and menopause blind! Having a comprehensive understanding of your hormonal profile can empower you for the changes to come and help you take steps to manage your health as your hormones change.  

The DUTCH (Dried Urine Test for Comprehensive Hormones) test is a powerful tool that our functional medicine providers recommend for all women entering perimenopause and menopause.

The DUTCH test is a revolutionary advancement in hormone testing because it provides a comprehensive and accurate assessment of hormonal levels. It measures hormone metabolites over a 24-hour period through dried urine samples, which allows for a more in-depth analysis of hormonal imbalances and provides insights into the specific pathways that may be contributing to perimenopausal and menopausal symptoms. 

Hormone testing itself is not standard of care, and The Menopause Society does not include testing in their normal protocols for prescribing hormone therapy. However, for a personalized dose that is right for you, hormone testing can reveal how much hormone your body is still producing via the adrenal gland. The DUTCH test is instrumental in assessing how well your body processes estrogen, as well as a comprehensive check on cortisol. For some, estrogen metabolism is sluggish and leads to accumulation of estrogen which can increase the risk of hormonally driven cancers. We can improve estrogen detoxification with dietary suggestions and supplements.

Using the DUTCH Test to Understand Hormonal Changes During Perimenopause and Beyond

Perimenopause, the transitional phase leading up to menopause, is characterized by fluctuating hormone levels, particularly estrogen and progesterone. As you progress into menopause, the ovaries gradually cease hormone production, resulting in lower levels of estrogen and progesterone. 


DUTCH testing provides a detailed hormonal profile, highlighting not only the levels of estrogen and progesterone but also their metabolites. This nuanced information allows for a more targeted approach to hormonal balance.  


DUTCH test results help our providers identify specific hormonal imbalances and their potential underlying causes.  


For instance, elevated levels of cortisol metabolites may indicate chronic stress, leading to adrenal fatigue. In such cases, stress reduction techniques, lifestyle modifications, and targeted supplements may be recommended to support adrenal function and alleviate related symptoms. 


And elevated levels of certain estrogen metabolites may indicate an increased risk for estrogen-related cancers, while imbalances in cortisol metabolites may shed light on adrenal dysfunction contributing to symptoms like fatigue and stress. 

The Functional Medicine Approach to Advanced Testing for Perimenopause and Menopause

Our functional medicine providers are uniquely equipped to not only interpret DUTCH test results but help develop a plan using the information to optimize your overall health and lifestyle. They consider the interplay between hormones, nutrition, stress, and environmental factors, offering a holistic approach to hormone management.   

"I recommend all hormone patients utilize the DUTCH test once a year."
Traci Eliszewski, NP
Forum Health Madison

DUTCH testing together with the expertise of our functional medicine providers, empowers you to take control of your hormonal health during perimenopause and menopause. You can not only alleviate discomfort but also foster overall well-being and vitality during this transformative phase of your life. Remember, every woman’s journey through perimenopause and menopause is unique, and with the right support, it can be a time of empowerment and renewed vitality!