Women’s Hormone Health Screening in Malaysia

: 12 September 2025; Health Info

Women’s Hormone Health Screening in Malaysia: When It’s Needed, Common Tests & Key Considerations

This article is prepared by Prinz Klinik, referencing MOH Malaysia, NICE, Endocrine Society, ACOG, and NAMS guidelines. It is for health education only and should not replace medical advice.

What Is Women’s Hormone Health Screening?

Hormone assessment is not a “one-size-fits-all” panel. Whether you need blood tests, which hormones to measure, and when to measure them depends on symptoms, age/reproductive stage, and risk factors. For example, irregular periods, excessive hair growth, hot flashes, abnormal lactation, infertility, or thyroid symptoms may indicate targeted testing. Routine “full panels” for asymptomatic women are not recommended.

When Should You Consider Hormone Testing?

Irregular or absent periods (after excluding pregnancy): evaluate thyroid (TSH ± Free T4), prolactin, FSH/LH/E2; rule out functional hypothalamic amenorrhea or other causes.
Suspected Polycystic Ovary Syndrome (PCOS): based on symptoms and imaging; also requires metabolic screening (weight/BP, cholesterol, glucose tolerance or HbA1c).
Signs of androgen excess (hirsutism, acne): test total testosterone (± free testosterone/SHBG), DHEA-S, and 17-OHP (morning sample) to exclude congenital adrenal hyperplasia.
Perimenopause/menopause symptoms: women ≥45 are usually diagnosed clinically; routine FSH testing is not needed because of fluctuations.
Thyroid-related symptoms (fatigue, weight change, cold/heat intolerance): TSH is the first-line test.
Abnormal lactation (not pregnant or breastfeeding): prolactin test, and rule out thyroid or medication causes.

Common Hormone Tests & Interpretation

Test	Indication	Timing / Notes	Key Points
TSH ± Free T4	Thyroid dysfunction, menstrual disturbance, infertility	No fasting required; biotin supplements may interfere with results	TSH is the first-line screen; confirm with Free T4 if abnormal
Prolactin	Amenorrhea, galactorrhea, pituitary evaluation	Morning, at rest; avoid exercise or nipple stimulation before test	High prolactin can cause anovulation; check thyroid & medications
FSH / LH / Estradiol (E2)	Cycle irregularity, ovulation assessment, infertility workup	Day 2–5 of cycle for baseline; luteal progesterone ~7 days before period	For women ≥45, diagnosis of menopause is mainly clinical
Progesterone	Assess ovulation	~Day 21 in a 28-day cycle; or 7 days before expected menses	Reflects that cycle only; should be interpreted with other findings
Total/Free Testosterone, SHBG, DHEA-S, 17-OHP	Hirsutism, acne, androgen excess	Morning sample; if suspicion remains, check free testosterone; add 17-OHP for CAH screening	Helps distinguish ovarian vs adrenal causes
AMH (Anti-Müllerian Hormone)	Ovarian reserve (mainly in infertility)	Can be done any day; not recommended as fertility predictor for healthy women	Not useful for predicting menopause or fertility in general population
Metabolic tests (glucose/OGTT, HbA1c, lipids)	PCOS, obesity, family history	Fasting required; PCOS often needs glucose tolerance test and lipid follow-up	Metabolic health is key in PCOS management

Key Focus by Life Stage

Adolescence: evaluate growth/development; primary amenorrhea (no period by age 15 or >3 years after breast development) requires workup
Reproductive age: assess thyroid, prolactin, sex hormones, and androgens if irregular cycles; PCOS requires metabolic screening
Perimenopause/menopause: usually diagnosed by symptoms (hot flushes, irregular cycles); blood tests rarely required

Practices to Avoid

Routine “full hormone panels” for asymptomatic women — not recommended
Using AMH as a fertility predictor in non-infertile women — misleading
Saliva/urine hormone tests for menopause or HRT monitoring — unreliable
Over-the-counter menopause FSH kits — results may mislead due to fluctuations

Preparation Before Testing

Inform doctor about medications (OCPs, HRT, steroids, etc.) — may interfere with results
Stop biotin (vitamin B7) supplements before testing, as advised
Time blood tests according to cycle (Day 2–5 for baseline, Day 21 for progesterone, etc.)
Most hormone tests are best done in the morning

What Prinz Klinik Offers

Symptom-driven, personalized testing (not “one-size-fits-all panels”)
Evidence-based evaluation of thyroid, sex hormones, prolactin, androgens, AMH
Metabolic screening and lifestyle/medical management for PCOS
Guideline-based menopause care and HRT monitoring

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