If you’ve been thinking about doing a DUTCH hormone test but aren’t sure which one to choose, this guide is for you. As a practitioner who works with women in all stages of hormonal health — from acne and painful cycles, fertility, to perimenopause and postmenopause — I often help clients decide between the different types of DUTCH panels. The goal is always the same: to get the most accurate picture of what your hormones are doing, and why. Let’s break it down.
The DUTCH Complete™ – The Foundation
The DUTCH Complete is the most used panel and, in many cases, the best place to start. It offers a detailed look at:
- Estrogens and their metabolites (including how well you’re clearing them through 2-OH, 4-OH, and 16-OH pathways)
- Progesterone and its metabolites
- Androgens (like DHEA and testosterone) and their pathways (5-alpha vs. 5-beta)
- Free cortisol and cortisone, across four timepoints (morning, midday, evening, night)
- Organic acids, melatonin, oxidative stress (8-OHdG), and neurotransmitter metabolites (like dopamine, norepinephrine)
This test is excellent for getting a broad overview of hormone production, detoxification, adrenal function, and nervous system balance.
When I recommend it:
- Irregular or painful cycles
- Acne or hair loss
- Fatigue or insomnia
- Mood swings, PMS, or breast tenderness
- Hormone detox concerns (e.g., high 4-OH)
- Suspected estrogen dominance
- PCOS or suspected androgen excess
- Adrenal dysfunction or burnout
It’s also the test I most commonly use to support fibroids, skin issues, thyroid imbalance, or early perimenopause.
The DUTCH Plus® – When We Need the Cortisol Awakening Response (CAR)
The DUTCH Plus includes everything in the DUTCH Complete but adds the Cortisol Awakening Response (CAR) using saliva samples. This gives an extra layer of insight into how your body responds to stress the moment you wake up. Why does this matter? Because some people have normal daily cortisol levels but a blunted or exaggerated rise upon waking, which can:
- Affect energy and focus
- Worsen anxiety and Autoimmune symptoms
- Contribute to burnout or depression
- Disrupt your HPA axis
When I recommend DUTCH Plus:
- Clients with anxiety, particularly morning anxiety
- Chronic stress and burnout
- Trouble waking up or crashing mid-morning
- Suspected HPA axis dysfunction
- Difficulty recovering from illness or intense training
Important note: This test requires very specific timing for saliva samples (immediately upon waking, and then 30 and 60 minutes later), so it’s best for people with a predictable morning routine.
DUTCH Cycle Mapping™ – When One Day Isn’t Enough
For clients with unusual, long, short, or irregular cycles — or fertility concerns — the standard single-day snapshot isn’t always enough. That’s where Cycle Mapping comes in. This test tracks estrogen and progesterone levels across an entire menstrual cycle. Cycle Mapping involves collecting multiple saliva and urine samples. The first 21 samples are collected over the course of one cycle. The final few samples are added either on day 4 of the next cycle or on day 33 if there’s no period to track
Results include:
- Nine (9) targeted estrogen and progesterone measurements taken throughout the cycle to characterize the follicular, ovulatory and luteal phases.
It helps:
- Determine whether and when you ovulate
- Clarify patterns in women with PCOS, anovulatory cycles, or hormonal migraines
- Investigate egg quality and ovulation timing in fertility clients
- Understand the estrogen rise before ovulation and progesterone peak in the luteal phase
There are 3 different collection protocols:
- Normal or short cycle
- Long cycle
- No period
I always combine Cycle Mapping with DUTCH Complete or DUTCH Plus for a full-cycle view of sex hormones plus cortisol, androgens, and organic acids.
When I recommend it:
- Fertility workups
- Ovulation uncertainty
- Cyclical migraines
- Mid-cycle spotting or persistent luteal symptoms
- Mirena IUD (no actual menstrual bleeding due to IUD but still has hormonal symptoms)
- Post-pill or post-IUD recovery when cycles are unclear
- When hormonal symptoms tend to fluctuate throughout the cycle
- Partial hysterectomy (ovaries intact but no uterus)
Cycle Mapping can also be used in perimenopause or with a Mirena coil, since even if you’re not bleeding, you may still be cycling. I’ve seen clients with Mirena who have no periods but show a very clear estrogen and progesterone curve on Cycle Mapping.
What if I’m on the pill, patch, ring, or implant?
Hormonal contraceptives like the pill, patch, ring, or implants shut down your natural cycle by blocking ovulation — which means estrogen and progesterone levels on a DUTCH test will be very low. That’s expected and just shows the medication is doing its job. If you’re still on hormonal birth control and want to understand your symptoms, we can still test adrenal function, androgens, and detox pathways — but we won’t get an accurate picture of your natural hormone rhythm. If you’re thinking of coming off birth control and want to test hormones, I usually recommend waiting for three full natural cycles before testing. This gives your body time to re-establish communication between the brain and ovaries.
What if I have an IUD?
If you’re using the copper IUD, it doesn’t contain any hormones, so it won’t impact your natural hormone rhythms. You can test as usual — typically around day 19–21 of your cycle if it’s roughly 28 days long. The Mirena (or other hormonal IUDs) is different. It contains a synthetic progestin, which thins the uterine lining and can reduce or even stop bleeding — so it’s harder to know which cycle day you’re on. But from what we see in hormone testing and Cycle Mapping, most Mirena users still cycle. Even if you’re not bleeding, your body may still ovulate and produce estrogen and progesterone in a typical rhythm. So yes — you can absolutely test while using the Mirena. Just know that progesterone levels may be lower on the test, especially if ovulation is partially suppressed. But in many cases, I’ve seen women with Mirena still showing a normal estrogen rise, followed by a luteal progesterone peak. If we’re doing Cycle Mapping, this is especially helpful — even with no visible period — because it shows if and when ovulation happens, and how estrogen and progesterone fluctuate through the month. Note** If patient has had Mirena for less than a year It’s not unusual to see low estrogen and progesterone with cycles suppressed on the DUTCH test
Add-Ons: CAR and OATs Panels
You can also run the Cortisol Awakening Response (CAR) or Organic Acids (OATs) panels on their own in certain cases. For example:
- CAR alone for clients already working on adrenal recovery who want to monitor waking cortisol response
- OATs to dive deeper into neurotransmitter metabolites, inflammation, B-vitamin markers, and oxidative stress without repeating a full DUTCH hormone test
What About Supplements, Coffee, or Caffeine?
For the most part, I want to see what your body is doing as is — so I rarely ask clients to come off supplements. If we’re starting from scratch with a new plan, we might pause them for a couple of weeks. But generally, it’s better to test under your usual lifestyle conditions. Exceptions:
- If you’re taking tyrosine, mucuna, or other dopamine-boosting supplements, pause them 2–3 days before DUTCH Complete, since they affect the HVA marker.
- DIM may lower estrogen and change the pie chart appearance (often reducing parent estrogens and pushing metabolism towards 2-OH).
- Pregnenolone may increase progesterone metabolites, making it look like you’ve ovulated when you haven’t — pause it for a few days if you’re doing a Cycle Map.
- Resveratrol can slightly reduce COMT activity.
Caffeine and alcohol? Unless you’ve been told otherwise, keep your usual habits. If we see an issue on your results (e.g. cortisol drop after coffee), we can address it after.
Final Thoughts
Choosing the right DUTCH test depends on your symptoms, your cycle, and your goals. For many, the DUTCH Complete is the ideal starting point. But when we need to understand your waking stress response, or how your hormones change throughout the month, the DUTCH Plus and Cycle Mapping tests can be incredibly valuable. Still unsure which DUTCH test is right for you? Let’s chat. Disclaimer: This content is for educational purposes only and does not replace medical advice. Always speak with your healthcare provider before making any changes to your testing, supplements, or health plan. All clinical examples have been modified for privacy.
DUTCH TEST UK PRICES
- Dutch Complete- £249
- Dutch Plus – £319
