Irregular Cycles: Best Practices for Salivary Specimen Collection Timing

Laura Neville, ND | April 13, 2021

At Labrix by Doctor’s Data, sex hormone reference ranges for premenopausal females are based on the luteal phase of the menstrual cycle. This is specifically meant to capture the progesterone surge occurring after ovulation in order to assess not only progesterone levels, but the balance of progesterone to estrogen. The collection recommendation for a 28-day cycle is anytime from day 19 to 23 of the mid-luteal phase. 

However, it can be challenging to time this collection in perimenopausal patients or patients with irregular cycles that do not follow the typical 28-day pattern. The good news is that there are other means by which patients can be instructed to time collection, ensuring the information obtained remains clinically relevant.  

  • Patients who have regular cycles that are longer than 28 days should collect on a day that is 7-9 days prior to the usual end of the cycle; day 19 would be the minimum.   
  • Perimenopausal patients who know when ovulation is occurring should collect 7 days after ovulation. Patients without a sense of ovulation should collect samples after day 14 but prior to day 1 of the following cycle.  
  • Patients with cycles shorter than 14 days should collect between days 7 and 9.  
  • Patients without a point of cycle reference (for example – cycles that are 60 or more days in length) should collect samples and then freeze. If they do not begin menstruating within 2 days, they can proceed by mailing in the samples. If they begin menstruating within 2 days after collection, hormones levels will be at the nadir of the cycle and they will need to recollect. 
  • Men and postmenopausal women can collect samples at any time.  

Click here to view the Testing Schedule document, which provides a simple at-a-glance view of these recommendations.  

  • If patients are using HRT or BHRT, they will need to follow the appropriate dosage intervals based on the route of delivery being used. Click here to view additional details.

Understanding and adhering to these collection timing recommendations is important for providers and patients. For additional questions about collection, please call Customer Service.

Beyond Adrenal Fatigue: Reframing our Understanding of Stress and the HPA Axis

Tom Guilliams, PhD

April 21, 2021 | 12-1 PM Pacific

For too long, complex stress-related changes to HPA axis function have been labeled as "adrenal fatigue." This outdated and incorrect nomenclature has often prevented clinicians from properly understanding how the HPA axis adapts to stressors and why simplistic solutions (i.e., adrenal support) are inadequate for most patients. Our knowledge of the stress response system, HPA axis maladaptation, and the factors that influence glucocorticoid signaling have greatly advanced in just the past decade, though much of this knowledge is not well leveraged in most clinical practices. This webinar will reframe our orientation of stress in a way that focuses on the brain (rather than the adrenal gland), and shows that the stress response is not as linear as it is often perceived. While navigating through one of the premier resources to help clinicians understand the functional medicine approach to stress and the HPA axis, this lecture will also help re-frame the stress response within the larger (non-stress) functions performed by the HPA axis.

Wellness Wednesday Webinar

Comprehensive Hormone Health for Men

Laura Neville, ND

May 5, 2021 at 9:30 AM and 12 PM Pacific

Each session is approximately 60 minutes with Q&A

  1. Understand the role of testosterone in men's health
  2. Understand andropause and the health impacts of "Low T"
  3. Review the roles of estrogen and progesterone in men's health
  4. Review the research on prostate cancer and cardiovascular health in regards to testosterone replacement
  5. Explore therapies to address hormonal changes in men
  6. Discuss risks and benefits of testosterone replacement therapy (TRT)

Disclaimer: All information given about health conditions, treatment, products, and dosages are for educational purposes only and do not constitute medical advice.



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