The DUTCH test is a dried-urine hormone panel that measures your sex hormones, how your body breaks them down, and your cortisol pattern across a day. It is a legitimate laboratory test and can answer some questions a single blood draw cannot. It is also more than most women need for routine menopause care, which is why we use it selectively: Golden Leaf Health can order and interpret DUTCH testing when it will change a plan, and we can review results you already have, but we don't currently sell the kit online.
Estradiol, estrone and estriol, plus the pathways your body uses to break estrogen down (2-hydroxy, 4-hydroxy and 16-hydroxy), and how well the next step, methylation, is working.
The breakdown products that reflect progesterone production.
Testosterone, DHEA-S, androstenedione and their metabolites, including the pathway that produces the more potent DHT.
Four or five readings across the day, plus their metabolites, which together show both the daily rhythm and the total amount produced.
Melatonin, 8-OHdG (a marker of oxidative stress), and some markers related to B-vitamin status and to the breakdown of dopamine, norepinephrine and serotonin.
In short
Definition
DUTCH stands for Dried Urine Test for Comprehensive Hormones.
Instead of one blood draw, you collect four or five small urine samples on filter paper over the course of a day, let them dry, and mail them to the laboratory.
Because the samples are spread across the day, the test can show patterns, such as how cortisol rises and falls, that a single sample can't.
There are a few versions. DUTCH Complete is the standard panel. DUTCH Plus adds salivary cortisol at waking. DUTCH Cycle Mapping tracks estrogen and progesterone across a full menstrual cycle, which is used for women who still have cycles.
Measured items
Estradiol, estrone and estriol, plus the pathways your body uses to break estrogen down (2-hydroxy, 4-hydroxy and 16-hydroxy), and how well the next step, methylation, is working.
The breakdown products that reflect progesterone production.
Testosterone, DHEA-S, androstenedione and their metabolites, including the pathway that produces the more potent DHT.
Four or five readings across the day, plus their metabolites, which together show both the daily rhythm and the total amount produced.
Melatonin, 8-OHdG (a marker of oxidative stress), and some markers related to B-vitamin status and to the breakdown of dopamine, norepinephrine and serotonin.
The report runs to many pages. The useful question is whether any result changes what you and your clinician would do.
Comparison
The two tests answer different questions. Neither replaces the other.
DUTCH vs blood test compares them, along with saliva testing.
Evidence
Yes.
It is performed by a CLIA-certified laboratory, the measurements are real, and the method has been published and compared with blood and saliva testing. Many integrative and naturopathic clinicians use it.
The main question is usefulness, not accuracy. Menopause guidelines from the major societies don't recommend urine or saliva hormone testing to diagnose menopause or to guide hormone therapy dosing, because symptoms and, where needed, blood levels do that job. Some of the markers on the panel, particularly the estrogen-metabolism ratios, are interesting but their value for day-to-day decisions is still being researched. A long report can also lead to treating numbers rather than the person.
When it helps
Wired-but-tired, 3 a.m. waking, or stress symptoms where a daily cortisol pattern would change the plan.
A clinician may want to see which breakdown pathways are favoured before or during treatment.
For women still cycling, where a single-day sample would miss the pattern. See DUTCH Cycle Mapping, explained.
Many patients arrive with a DUTCH report from another practice and want it explained. We do that, and our guide to reading DUTCH results walks through each section.
Limits
Deciding whether you are in perimenopause or menopause. Symptoms and age do that; a hormone level on one day often misleads.
Setting or adjusting a hormone therapy dose. Symptoms first, blood levels when needed.
As a general "check my hormones" screen. The report is long, and most of it won't change anything.
Next steps
The result leads to a treatment conversation, using the treatments we already provide:
opens the question of cyclic progesterone or hormone therapy for mood, sleep and bleeding.
with symptoms is the ordinary case for hormone therapy, decided on how you feel, with blood levels as the check once you're on it.
points to the sleep and stress work on our fatigue and sleep pages, and sometimes to treating the night sweats that are driving it.
inform the options for hair thinning and low libido.
The result informs the same treatment conversation, starting with a $99 video visit, with pricing published.
Bring it to your first visit and a clinician will go through it with you, section by section.
Our use
We can order and interpret DUTCH testing when a clinician believes it will change your plan, and we're glad to go through results you already have.
We don't currently sell the DUTCH kit through our website; that may return.
Lab prices depend on what is tested, and your provider will tell you what they recommend and why before anything is ordered, so the price is in front of you when you decide.
Our guide to hormone tests covers the blood panel we use most often and when testing is useful at all.
Before testing
What question will this test answer that my symptoms don't?
Would a blood test answer it?
What would we do differently depending on the result?
What does it cost, and is that covered by anything?
If the answers are vague, the test may not be needed yet.
Golden Leaf Health's care team treats perimenopause and menopause by video in the states we serve. Book a first visit to review your symptoms and any results you already have.
Questions
DUTCH stands for Dried Urine Test for Comprehensive Hormones. You collect four or five dried urine samples over a day at home and mail them to the lab. It reports sex hormones, their breakdown products (metabolites), a cortisol pattern across the day, and a few other markers.
Estrogens and how they are metabolised, progesterone metabolites, testosterone and other androgens with their metabolites, DHEA-S, cortisol and cortisone across the day with their metabolites, melatonin, and markers such as 8-OHdG and some B-vitamin and neurotransmitter metabolites.
It is a real test run by a CLIA-certified laboratory and used by many clinicians, and it measures what it says it measures. The open question is clinical usefulness: for most menopause decisions, a focused blood test or your symptoms give enough information, and major menopause guidelines don't recommend urine or saliva hormone testing to guide hormone therapy dosing. It is most useful when a clinician has a specific question that only metabolites or a daily cortisol pattern can answer.
We can order and interpret DUTCH testing when a clinician thinks it will change your plan, and we can review results you already have. We don't currently sell the DUTCH kit online. That may change.
For most women starting or adjusting hormone therapy, symptoms plus a blood test are enough. DUTCH adds information about how you metabolise estrogen and about your cortisol rhythm, which can matter in specific situations. Your provider will say which, and why, before anything is ordered.
Get started
A video visit with a clinician who treats perimenopause and menopause, in 33 states.
