Hormones

How are LH, Progesterone, and Estrogen Measured?

Clara Siegmund

Here’s everything you need to know about how Oova measures your hormones to help you track your cycle and understand your hormone health.

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Mar 23, 2024

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Hormone tests can help you better understand your body, cycle, and fertility.

To give you as much information as possible, Oova uses urine tests to look at three key reproductive hormones: luteinizing hormone (LH), PdG (a urinary metabolite of progesterone), and E3G (a urinary metabolite of estrogen).

Here’s what these hormones do, how Oova helps you measure and track them, and how to choose between a blood test or a urine test for hormone measurements.

What are luteinizing hormone, progesterone, and estrogen?

Luteinizing hormone (LH), progesterone, and estrogen are major reproductive hormones that play important roles in your cycle, reproductive system, fertility, and health. Their levels change depending on your age and where you are in your cycle.

Luteinizing hormone

LH controls ovarian function. A monthly rise in LH, or the LH surge, triggers ovulation (when your ovaries release a mature egg that can be fertilized by sperm).

LH fluctuates and rises during perimenopause and menopause.

>>MORE: Understanding the LH Surge: Your Key to Optimizing Fertility

Progesterone

Progesterone helps prepare the body and the uterus for a potential pregnancy, supports a pregnancy during the early stages, and regulates your cycle. Progesterone fluctuates and declines during perimenopause and menopause.

The Oova Kit measures PdG which is a metabolite of progesterone.

Estrogen

Estrogen is involved in ovulation and cycle regulation. It helps to trigger the LH surge, preps the uterus for pregnancy, and keeps your cycle regular. Estrogen fluctuates and declines during perimenopause and menopause.

The Oova Kit measures E3G which is a metabolite of estrogen.

How are hormones measured? Blood vs. urine tests

Different forms of LH, progesterone, and estrogen can be measured with blood or urine tests.

Blood tests give direct measurements of these hormones by looking at their serum levels (another word for blood levels). Urine tests offer the same information about your body’s hormone levels, but use a different marker to get there: hormone metabolites. Oova's hormone tests measure LH, PdG (a progesterone metabolite), and E3G (an estrogen metabolite).

As your body secretes and uses hormones, it also metabolizes them—meaning it breaks the hormones down into the useful parts and the parts it doesn’t need anymore. This process creates hormone metabolites, which your body gets rid of through urine.

The hormone metabolites can then be measured in your urine and used as an indicator of the equivalent, non-metabolized hormone levels in your body.

Essentially, the main difference between hormone blood tests vs. urine tests is what kind of sample the test measures:

Blood tests measure active hormones, or hormones currently circulating in your bloodstream
Urine tests measure hormone byproducts (metabolites), or what your hormones have excreted over time

Measuring LH in urine vs. blood

There’s no difference between luteinizing hormone in urine and luteinizing hormone in blood! LH can be measured directly through blood or urine.

There are a couple different ways to test LH, including:

Blood test: a healthcare professional takes your blood and sends it to a lab for LH analysis.
LH-only ovulation test: a urine test kit detects the LH surge to help you track your ovulation and fertile window. This type of test kit is generally used around the time of ovulation only, rather than throughout your cycle.
Multi-hormone test: a urine test kit measures LH alongside other hormones (often PdG and E3G). Multi-hormone tests allow you to track daily levels of multiple hormones, beyond just LH levels during the fertile window and ovulatory phase of your cycle.

Measuring progesterone metabolites in urine vs. progesterone in blood

P4 in blood and PdG in urine are two different markers of progesterone levels.

Blood tests measure progesterone directly by capturing this hormone in its pre-metabolized state. This form of progesterone is also called P4. Serum P4 levels (blood levels) are usually measured in nanograms per milliliter (ng/mL).

Urine tests, on the other hand, measure a different marker of progesterone: PdG (pregnanediol glucuronide), which is the hormone metabolite, or post-metabolized version, of progesterone. PdG is often measured in micrograms per milliliter (ug/mL).

While P4 and PdG are different versions of progesterone, and use different units of measurement, fluctuations in the two are correlated to one another. Both P4 and PdG are indicators of the progesterone levels in your body.

Measuring estrogen metabolites in urine vs. estrogen in blood

E2 in blood and E3G in urine are two different indicators of estrogen levels.

Blood tests measure estrogen directly by looking at estradiol (E2, one of the three key forms of estrogen) before it’s metabolized. The unit of measurement used for E2 blood tests is picograms per milliliter (pg/mL).

Urine tests look at a different marker of estrogen by measuring estradiol after it has been metabolized. These tests capture the hormone metabolite E3G (estrone-3-glucuronide) in urine. E3G is often measured in nanograms per milliliter (ng/mL).

How does Oova measure hormone levels?

Oova tests your hormones through urine by measuring hormone metabolites:

Luteinizing hormone
PdG (pregnanediol glucuronide) for progesterone
E3G (estrone-3-glucuronide) for estrogen

Some urine tests give you just a “yes” or “no” result to confirm the presence of hormone metabolites.

Oova goes further, reporting the exact metabolite concentration. In other words, Oova gives you the actual levels of LH, PdG, and E3G in your body, in real-time, every day.

This kind of quantitative, daily information offers you valuable insight into your reproductive health, ovulation patterns, and where you are in your cycle.

Let’s take a closer look at how Oova measures each hormone metabolite.

How does Oova measure LH?

Oova measures LH in urine using milli-international units per liter, or mIU/L, a standard unit of measurement in medical testing. Oova reports LH levels in the app using the same mIU/L measurement.

Everyone’s body is different, but generally, these are the LH ranges that you can expect to see during different phases of your cycle, after menopause, and when using hormonal birth control.

How does Oova track PdG?

Oova measures PdG, the urinary metabolite of progesterone. The Oova test picks up on PdG in urine using ug/mL.

How does Oova track E3G?

Oova measures E3G, the urinary metabolite of estradiol. The test captures E3G in urine using ng/mL.

How to choose between a urine test or a blood test

Hormones can be accurately and reliably measured using urine tests or blood tests. Choosing between the two depends on your situation and your needs.

Let’s take a look at the benefits of both urine and blood tests.

Benefits of urine tests

Urine tests are an accurate, convenient, and immediate way to get the most up-to-date picture of your specific hormone metabolite levels so you can more easily track and predict ovulation.

‍Accurate: you can get accurate, reliable, and precise measurements of your hormone metabolite levels through urine tests to track ovulation.‍
Quantitative: Some urine tests deliver quantitative measurements of each hormone concentration, which means you form a deeper understanding of your hormone levels.‍
Convenient: urine tests are convenient, simple, and can be done from the comfort of your own home (or anywhere else!). Blood tests typically require appointments and travel to a doctor’s office.‍
Non-invasive: urine tests are quick and painless—you just have to pee! Blood tests can be a more invasive experience.‍
Immediate: urine tests give you immediate results, meaning you get a real-time look at your hormone levels in the moment. Blood tests often have to be analyzed by a lab, which can require a waiting period between the blood draw and the results.‍
Up-to-date: hormones fluctuate a lot—even within a single day—but blood tests only give you a retroactive snapshot of your hormone levels on the day your blood was drawn. Urine tests, on the other hand, give you continuous, daily data about your body, offering a detailed picture of your day-to-day hormone fluctuations and an in-depth understanding of how your hormone levels fit into your cycle.

Benefits of blood tests

While blood tests can be more invasive and require more time for results, they can measure a wider range of hormones and pick up on a bigger range of hormone concentrations.

‍Variety of tracking: Urine tests track metabolites of reproductive hormones like LH, PdG, and E3G rather than their un-metabolized levels. Sometimes a blood test may be used to get even more results, like if your doctor wants to track a wider range of hormones or biomarkers.‍
Longer window of measurement: Blood tests have a wider window of measurement, meaning these tests can pick up on a bigger range of hormone concentrations. This may be useful, for example, if you’re going through IVF and/or on medications that spike your hormone levels, as this spike can lead to readings outside of the range an at-home test can pick up on.

The takeaway: How Oova measures LH, PdG, and E3G

Urine tests are a great tool to get you accurate, reliable, and precise measurements of your hormone levels.

Here’s a recap of how Oova measures your hormones:

Oova tracks your LH by measuring urinary LH in mIU/L, then reports LH in mIU/L in the app.
Oova tracks a metabolite of progesterone by measuring urinary PdG in ug/mL.
Oova tracks a metabolite of estrogen by measuring urinary E3G in ng/mL.

Choosing between the two types of tests depends on the information you’re looking for and your particular needs. Oova's hormone tests are intended to track and predict ovulation while your doctor may use blood tests for additional information about your hormones and cycle patterns.

No matter how you choose to measure your hormones, learning more about your hormone levels can give you invaluable insights about your body, cycle, and fertility.

About the author

Clara Siegmund is a writer, editor, and translator (French to English) from Brooklyn, New York. She has a BA in English and French Studies from Wesleyan University and an MA in Translation from the Sorbonne. She is passionate about literature, reproductive justice, and using language to make information accessible.‍

Sources

‍Roos J, et al. (2015). Monitoring the menstrual cycle: Comparison of urinary and serum reproductive hormones referenced to true ovulation.

perimenopause-periods

Should I still see my gynecologist if my periods are just "weird" but not painful?

Yes. Annual visits remain important during perimenopause. Your provider can help determine if your "weird" periods are typical perimenopause changes or something requiring attention. They can also discuss management options to improve your quality of life.

perimenopause-periods

How long do irregular periods last before menopause?

Irregular perimenopause periods typically last 4 to 8 years before your final period, though this varies greatly. Some women experience irregularity for just a few months, while others have irregular periods for over a decade before reaching menopause.

perimenopause-periods

Is it normal to have two periods in one month during perimenopause?

Yes, this can happen, especially in early perimenopause when cycles shorten. You might have a 21 day cycle, meaning you could have a period at the beginning and end of the same calendar month. Track these patterns to distinguish between short cycles and abnormal bleeding.

perimenopause-periods

Why are my periods suddenly so heavy in my 40s?

Heavy perimenopause periods often result from estrogen dominance. When progesterone drops but estrogen remains high, your uterine lining builds up more than usual, causing heavier bleeding when it sheds. This is common in perimenopause but should be evaluated if it affects your daily life.

perimenopause-periods

Can I still get pregnant if my periods are irregular during perimenopause?

Yes. As long as you're having periods, even irregular ones, you may still be ovulating. Pregnancy is possible until you've gone 12 full months without any period. If you don't want to become pregnant, continue using contraception throughout perimenopause.

perimenopause-and-weight-gain

Can you prevent perimenopause weight gain completely?

While you may not prevent all weight changes during perimenopause, you can minimize gain through proactive strategies. Starting strength training before perimenopause, maintaining consistent sleep habits, and managing stress can help your body adapt to hormonal changes more smoothly. Remember, some body changes during this transition are normal and healthy.

perimenopause-and-weight-gain

At what age does perimenopause weight gain typically start?

Perimenopause weight gain can begin in your late 30s or early 40s, often coinciding with the first hormonal changes. Many women notice gradual changes starting 5 to 10 years before their final period. The timing varies greatly based on genetics, lifestyle, and overall health.

perimenopause-and-weight-gain

Does everyone gain the same amount during perimenopause?

No. Perimenopause weight gain varies significantly. Some women gain 5 pounds, others 20 or more, and some maintain their weight. Factors include genetics, starting weight, activity level, stress, sleep quality, and how dramatically hormones fluctuate. Your experience is unique to your body.

Is perimenopause weight gain different from regular aging weight gain?

Yes. While metabolism naturally slows with age, perimenopause weight gain has distinct characteristics. The hormonal shifts cause fat redistribution to the midsection, even if overall weight doesn't change dramatically. This abdominal weight gain pattern is specifically linked to declining estrogen and progesterone, not just aging.

perimenopause-and-weight-gain

Will the weight come off after menopause?

Perimenopause weight gain often stabilizes after menopause when hormones level out, but the weight doesn't automatically disappear. The metabolic and body composition changes that occur during perimenopause tend to persist. However, with consistent healthy habits, weight management becomes more predictable post menopause than during the fluctuating perimenopause years.

https://www.oova.life/blog/progesterone-supplementation-guide

Can I take progesterone if I'm breastfeeding?

Yes, progesterone is generally safe while breastfeeding and doesn't significantly affect milk supply. However, always discuss with your healthcare provider before starting any hormone supplementation while nursing.

https://www.oova.life/blog/progesterone-supplementation-guide

Is it safe to take progesterone throughout pregnancy?

Yes, when prescribed by your healthcare provider. Progesterone supplementation in early pregnancy is safe and can reduce miscarriage risk in women with low progesterone or a history of pregnancy loss. Most providers continue supplementation through the first trimester (weeks 10-12) when the placenta takes over.

https://www.oova.life/blog/progesterone-supplementation-guide

Can progesterone supplementation cause weight gain?

Progesterone can cause temporary water retention and bloating, which may show up as a few pounds on the scale, but it doesn't cause true fat weight gain. Most women don't experience significant weight changes from progesterone supplementation.

https://www.oova.life/blog/progesterone-supplementation-guide

Can I switch from pills to suppositories or vice versa?

Yes, but only under your doctor's guidance. The dosing and timing may need adjustment when switching between forms since they're absorbed differently. Never switch on your own, especially if you're pregnant or undergoing fertility treatment.

https://www.oova.life/blog/progesterone-supplementation-guide

Will progesterone supplementation delay my period?

Yes, progesterone keeps the uterine lining intact, so if you're not pregnant and continue taking progesterone, your period will be delayed. Once you stop taking it, your period should start within 2-10 days. If you are pregnant, progesterone helps maintain the pregnancy and you won't get a period.

https://www.oova.life/blog/progesterone-supplementation-guide

Should I take progesterone pills orally or vaginally?

For fertility and pregnancy support, vaginal progesterone is usually preferred because it delivers higher concentrations directly to the uterus. For perimenopause or general hormone balance, oral progesterone often works well and is more convenient. Your doctor will recommend the best route based on your specific needs.

https://www.oova.life/blog/progesterone-supplementation-guide

When should I start taking progesterone after ovulation?

Typically, progesterone supplementation for luteal phase support starts 2-3 days after ovulation (confirmed by LH surge or temperature rise). Your doctor will give you specific timing based on your protocol. Some women start immediately after a positive ovulation test.

https://www.oova.life/blog/progesterone-supplementation-guide

What's better: progesterone cream or pills?

Pills (oral micronized progesterone) are generally more effective and reliable than creams because absorption from creams is inconsistent. For medical conditions like fertility issues, low progesterone, or HRT, prescription pills or suppositories are strongly recommended over over-the-counter creams.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

How can I tell if I have low or high progesterone?

The only definitive way to know is through hormone testing via blood tests or at-home urine tests that measure progesterone metabolites. However, symptom patterns can provide clues: anxiety and irregular periods suggest low progesterone, while bloating and extreme fatigue suggest high progesterone.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

When during my cycle should I test progesterone levels?

Test progesterone levels during the luteal phase, typically 7 days after ovulation or around day 21 of a 28-day cycle. This is when progesterone should be at its peak, making it easier to identify if levels are too low or too high.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

What are the main differences between low and high progesterone symptoms?

Low progesterone typically causes irregular or heavy periods, anxiety, hot flashes, and sleep issues. High progesterone causes bloating, fatigue, intense breast tenderness, and depression-like mood changes. Low progesterone symptoms persist throughout your cycle, while high progesterone symptoms are most intense during the luteal phase.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

Can you have symptoms of both low and high progesterone?

Some symptoms like breast tenderness and mood changes can occur with both low and high progesterone, making it confusing. However, the timing, intensity, and accompanying symptoms differ. Hormone testing is the best way to determine which imbalance you're experiencing.