Are Saliva Tests Worthwhile?

My doctor is recommending having saliva testing done for hormone replacement instead of the standard blood test. Do you think it is more accurate?

– October 12, 2007

No. Saliva testing is not a reliable method of assessing levels of any hormone. If you’re approaching or believe you have reached menopause and want to know what your hormones indicate, ask your doctor for a blood test to measure levels of your serum follicle stimulating hormone (FSH). During childbearing years, the pituitary gland secretes FSH, which stimulates follicles in the ovaries to mature and release eggs. At menopause, the ovaries stop functioning, and FSH levels rise higher than they do at any time during the menstrual cycle. This is most accurately measured by testing a blood sample.

If you want a home test, you can get an FDA-approved urine test kit that can tell you whether your FSH levels have increased to levels indicating menopause. This is more reliable than any saliva test, but it isn’t foolproof: according to the FDA, the urine test accurately measures FSH levels nine times out of 10. (Incidentally, if you use any FDA-approved home test and have any problems with it, report it to the FDA’s Medwatch at

I’m aware that saliva tests are widely promoted on the Internet to check levels of estrogen, cortisol, progesterone, testosterone, melatonin or DHEA (dehydroepiandrosterone). Results supposedly determine your need for various anti-aging supplements, often sold on the same Web sites that promote the saliva tests.

Bottom line: If you think you’re approaching menopause, request a blood test for serum FSH to find out for sure.

Andrew Weil, M.D.

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