DUTCH Hormone Testing

Hormone symptoms are common — but hormone testing is often misunderstood.

The DUTCH test (Dried Urine Test for Comprehensive Hormones) is one of the most informative tools we have for understanding how hormones are produced, processed, and cleared by the body. It’s not always the first test I use, but when hormone patterns are complex or persistent, it can provide clarity that other methods miss.

How DUTCH Compares to Other Hormone Tests

There are several ways to measure hormones. Each has value — and each has limitations. The reason I use DUTCH is because it fills in important gaps.

DUTCH vs. Saliva Testing
Saliva testing can show free cortisol patterns, which can be helpful for understanding daily stress rhythm. However, saliva testing does not measure cortisol metabolites — the byproducts created when cortisol is broken down and cleared.

This matters because cortisol levels can appear “normal” in saliva while the body is actually overproducing cortisol and clearing it too quickly, or underproducing cortisol but clearing it slowly. Without metabolite data, results can be misleading.

The same is true for sex hormones. DUTCH measures estrogen and androgen metabolites, which helps reveal how hormones are being processed — not just how much is present.

DUTCH vs. Blood (Serum) Testing
Blood testing is widely used and accessible, but it has limitations when it comes to hormones.

Cortisol cannot be accurately assessed throughout the day using blood. Diurnal (daily) cortisol rhythm is missed, and hormone metabolism — especially for cortisol and estrogens — is largely absent.

Blood tests provide a snapshot. DUTCH shows patterns.

DUTCH vs. 24-Hour Urine Testing
Traditional 24-hour urine testing does measure metabolites, but it comes with two major drawbacks.

Collection is cumbersome and error-prone, with a significant number of samples collected incorrectly. In addition, daily cortisol rhythm cannot be assessed from a single pooled sample.

Some providers combine urine with saliva to fill in the gaps. DUTCH was designed to eliminate the need for multiple tests by combining free and metabolized hormone data into one streamlined collection.

Why I Use DUTCH

DUTCH is very popular but I use it because it answers specific clinical questions.

DUTCH is especially helpful when:

-hormone symptoms persist despite “normal” labs

-stress, sleep, and hormone symptoms overlap

-detox sensitivity or estrogen issues are present

-hormone replacement therapy requires careful monitoring

Collection

DUTCH uses dried urine samples collected at specific times over a 24-hour period. The samples are easy to ship and far less disruptive than traditional urine testing.

Effective for Hormone Therapy Monitoring

DUTCH is particularly useful for monitoring hormone replacement therapies, including oral progesterone and vaginal hormones, using methods tailored to those delivery routes.

When Collection Takes Place (Men/Women)

Cycling Premenopausal Women
Collection typically occurs between days 19–22 of a 28-day cycle. Timing is adjusted for shorter or longer cycles.

If only adrenal or organic acids testing is ordered, collection timing is more flexible.

Irregular Cycles or Post-Surgical Cycles
Specific guidance is provided to determine the best timing.

Men and Postmenopausal Women
Collection can be done any day.

How the Test Is Collected

Each collection card is labeled with required information.
Urine is applied directly to the filter paper or via a clean cup.
Cards are left open to dry for at least 24 hours.
Once dry, the cards are sealed and returned with the completed requisition.

How DUTCH Fits Into My Process

DUTCH is not a first-line test for everyone. I use it when symptoms suggest that hormone processing, stress physiology, or metabolism may be contributing — and when the body is ready for deeper investigation.

Testing is always chosen intentionally, in sequence, and with a clear purpose.