DUTCH Hormone Test
Hormones are one of those subjects that get flattened horribly online. A few symptoms get bundled together, cortisol gets blamed for everything, and suddenly everyone is convinced they need a hormone test, six supplements and a morning routine involving sunrise and raw carrot salad.
Sometimes testing is useful. Sometimes it’s a distraction.
The DUTCH test, which stands for Dried Urine Test for Comprehensive Hormones, is one of the more detailed functional hormone tests available. It looks not only at hormone levels, but also at how your body is breaking hormones down and clearing them. That makes it particularly interesting when symptoms don’t fit neatly into one box, or when standard blood tests have come back normal but you still feel like something is off. Depending on the panel used, a DUTCH test can give insight into:
cortisol output across the day, including whether it rises and falls in a healthy pattern
cortisone and cortisol metabolites, which help show how stress hormones are being processed
oestrogen and its metabolites
progesterone markers
androgens such as DHEA and testosterone
melatonin on some panels, plus a few related markers depending on the version of the test.
You complete it at home over the course of a day, collecting urine onto special paper strips at specific times. Once dry, the strips are posted to the lab and analysed. It’s a practical alternative to doing repeated saliva samples or a full 24‑hour urine collection, and dried urine testing has been shown to correlate well with liquid urine methods.
When is a DUTCH hormone test useful?
Where this can be genuinely helpful is in women whose symptoms span stress, sleep, cycle changes, mood, energy and skin all at once. Think: feeling wired at night but knackered in the morning, PMS that has become less predictable, heavy or painful periods, hormonal acne, low mood, poor resilience, broken sleep, or that sense that perimenopause has hijacked your nervous system... and your patience.
A single NHS blood test can absolutely be the right tool for some questions. If we need to know whether your thyroid is underactive, whether you’re in menopause, or whether something more serious like Addison’s disease is on the radar, GP testing is the appropriate first line. But bloods are often snapshots. The DUTCH test is more like a day‑in‑the‑life view of hormone rhythm and metabolism, which is why it can add context in more complex symptom pictures.
That said, it is not a diagnostic crystal ball.
A DUTCH test can suggest patterns such as low overall cortisol output, elevated evening cortisol, a flattened daily rhythm, low progesterone relative to oestrogen, or shifts in androgen metabolism that might line up with acne, hair changes or mood changes. Useful? Yes. Definitive? No. These patterns need to be interpreted alongside your symptoms, cycle history, contraception, medications, stress levels, sleep, diet and any blood results you already have.
That’s also why I’m not interested in using a hormone test as an excuse to throw you onto a punishing hormone balancing protocol. If the test is worth doing, it should lead to grounded, practical changes. That might mean improving blood sugar balance, supporting sleep, looking at alcohol and caffeine habits, paying attention to bowel regularity and fibre if oestrogen clearance looks sluggish, or considering whether a more targeted supplement makes sense. Sometimes it also helps you decide whether a conversation with your GP, contraception review or HRT discussion needs to happen.
For women with hormonal acne in particular, this kind of testing can help us understand whether the picture looks more stress‑led, androgen‑led, ovulation‑related, or a bit of all three. That can be useful when you’re trying to support skin without creating a whole new layer of food rules and supplement clutter.
Of course, not every hormone symptom means you need a DUTCH test. Sometimes the basics are the work: eating enough, eating regularly, sleeping more consistently, drinking less, managing training load, reducing chronic stress where possible, and getting the right standard blood work done first. The boring stuff that's actually very effective.
If you’re wondering whether a DUTCH test would offer clarity for your cycle, skin, stress or perimenopause symptoms, you can book a free introductory call with me.