What lab work is done before starting BHRT?

The core hormone panel

Estradiol, progesterone, and testosterone give the direct picture. FSH and LH indicate what the pituitary is signalling, which helps place where you are in the menopausal transition. For men, total and free testosterone alongside SHBG and estradiol form the usual baseline.

Timing can matter. In cycling women, where in the cycle blood is drawn affects interpretation, which is why your provider may specify a particular window.

What is checked alongside the hormones

Thyroid testing is important because hypothyroidism causes fatigue, weight change, low mood, and cognitive complaints that overlap heavily with hormonal symptoms — treating one while missing the other is a common way to end up disappointed.

A complete blood count, metabolic panel, and lipids give a general health baseline and can flag issues that change the treatment plan. Vitamin D, iron studies, and B12 are frequently added where fatigue is a leading complaint.

Why baseline testing matters later, not just at the start

Without a baseline there is nothing to compare follow-up results against, which makes dose adjustment guesswork. Repeat testing after starting therapy is what tells us whether the dose and route are doing what they should.

If you have had recent labs done elsewhere, bring them — there is often no need to repeat everything, and prior results add useful context.