Women's Health+ Hormone Test
Your labs came back fine, but you don't feel fine? One at-home test checks your hormones, your stress hormone pattern, how you break down estrogen, and key nutrient needs.
This test may help if you:
- Feel tired, foggy or moody, and standard labs look normal
- Are thinking about starting hormone therapy, or are already on it
- Have heavy or painful periods, PMS, fibroids or endometriosis
- Are in perimenopause or menopause
- Have trouble sleeping or feel wired and tired
- Have a family history of breast cancer
What the test measures
- Sex hormones (saliva): estradiol, estrone, progesterone, testosterone and DHEA
- Cortisol (saliva): your stress hormone from morning to night
- Estrogen breakdown (urine): the 2-OH, 4-OH and 16-OH paths, and how well your body clears them
- Organic acids (urine): signs of low B vitamins, minerals and antioxidants, plus gut and energy markers
What you get
- A test kit mailed to your home
- The order through Evexia's partner physician
- A 45-minute results visit with Paul Milani, PharmD
- A written plan with your next steps
Price
| Women's Health+ test |
|
| 45-minute consult and interpretation | $100 |
| Total | $749 |
Available to adults who live in Washington, Oregon and Idaho.
Want more than a test? If you join the Evergreen Complete Year within 30 days of your results visit, the full $749 counts toward it. The Complete Year is for patients in Washington and Idaho.
Get Started
Enter your name and email. We'll take you to the next step and email you the order link.
About Paul
Paul Milani, PharmD, ABAAHP, ABHRT
Paul is the founder of Evergreen Longevity & Functional Medicine in Spokane. He is a pharmacist clinician who sees patients. He is board certified in anti-aging and regenerative medicine and in advanced hormone therapy. He uses this test to help plan safe, personal hormone care.
Learn: How your body breaks down estrogen
Your body does not just get rid of estrogen. First, the liver breaks it into smaller parts called metabolites. There are three main ones. This test measures all three.
Step 1: Three paths
| Metabolite | Enzyme | What it does |
|---|---|---|
| 2-OH | CYP1A1 | The most stable form. This is the path we want your body to use most. |
| 4-OH | CYP1B1 | Can turn into a reactive form that may harm DNA if it is not cleared fast. |
| 16-OH | CYP3A4 | Acts a lot like estrogen. It tells tissue to grow. |
Everyone makes all three. What matters is the balance between them, and how fast your body clears them.
Step 2: The two we watch most
4-OH. If it is not cleared, 4-OH can change into a quinone. A quinone can bind to DNA and damage it. Research has linked higher 4-OH levels with higher breast cancer risk. Your body has a second step that makes 4-OH safe. It is only a concern when that step is slow.
16-OH. 16-OH pushes tissue to grow. Too much of it may add to heavy periods, fibroids or endometriosis. We want it in balance before adding more estrogen.
Step 3: Making 4-OH safe
- Phase 1: Break down. Liver enzymes turn estrogen into 2-OH, 4-OH and 16-OH.
- Phase 2: Neutralize. An enzyme called COMT adds a small methyl group to 4-OH. This is called methylation. It turns 4-OH into a safe form the body can remove.
COMT needs B vitamins and magnesium to work. Methylation can be slow because of your genes (such as a COMT variant), low nutrients or stress. When it is slow, 4-OH can build up. The test shows how well this step is working for you.
Step 4: Why we test before hormone therapy
Hormone therapy adds estrogen to your body. That can help a lot with symptoms. But more estrogen also means more metabolites to clear. If your body clears them well, that is good to know. If clearing is slow, we can support it first. Then we can start hormones with more confidence.
Step 5: What your results help us do
- Support methylation. If it is slow, nutrients like B12, folate, B6, magnesium and choline may help.
- Favor the 2-OH path. Cruciferous vegetables (like broccoli), fiber, a healthy weight and less alcohol can help.
- Choose the right hormone plan. Your results help guide the type, form and starting dose.
- Set a starting point. Testing again later shows how your body handles therapy.
Key points
- Everyone makes 2-OH, 4-OH and 16-OH. The question is how well you clear them.
- 4-OH needs methylation (COMT) to become safe. The speed of this step differs from person to person.
- Testing before hormone therapy lets us support weak spots first.
- Diet, nutrients and hormone dosing can all change how you clear estrogen.
Questions and answers
How much does it cost?
$749 total. That is the test on sale for $649 (normally $891), plus $100 for your 45-minute consult and interpretation. You pay once, at checkout.
Does insurance pay for it?
No. This test is cash pay. You may be able to use an HSA or FSA card. Check with your plan.
How do I collect the samples?
At home. You collect saliva and urine, and there may be an optional cheek swab. The kit has clear steps and a prepaid return label. If you still have periods, follow the kit's steps for which day of your cycle to collect.
Who orders the test?
A licensed physician with Evexia's partner service orders it and releases your results. Paul then reviews them with you.
How long do results take?
We will email you as soon as your results are ready.
Do I need to stop my hormones or supplements first?
Do not stop anything on your own. Call the clinic at 509-720-6314 before you collect.
Who can order?
Adults who live in Washington, Oregon or Idaho.
What happens after my results visit?
You get a written plan. If you want ongoing care, we will explain your options, including our membership and the Evergreen Complete Year. If you join the Complete Year within 30 days, your $749 counts toward it. There is no pressure to join.
This page is for education only. It is not medical advice or a diagnosis. Talk with your provider before you change hormones or supplements.