Should You Get a DUTCH Test? (Probably Not.)

The DUTCH test has been on your radar. So you Google it, but the more you research, the more confused you get. There’s one woman who claims it saved her life, and another who says it’s a total waste of time.

How can the same test get such wildly different reviews?

Let’s see if this test is worth your money or if you should spend that $500 elsewhere.

What’s The DUTCH Test?

DUTCH stands for Dried Urine Test for Comprehensive Hormones:  

• The How: you pee on filter paper four times throughout the day, mail it in, and get a report showing your sex (estrogen, progesterone, testosterone) and adrenal hormones.

Why Not Do a Blood or Saliva Test?

A blood draw or saliva test only captures one moment in time. But the DUTCH test tracks your hormones across an entire day:  

• Zoom In: That’s valuable, because your hormone levels fluctuate constantly during menopause. Multiple samples could reveal patterns that a single blood draw can’t.

The idea is that seeing your hormone patterns may reveal why menopause symptoms hit hardest at certain times of day, whether your body is absorbing hormone therapy properly, or if you need to switch dose and delivery methods.

But Can The Test Really Tell You That?

At first glance? The science points to yes.

Research shows that dried urine is as accurate as liquid urine and that four urine samples mirror a full 24-hour urine collection:

• Zoom In: The gold standard for measuring hormones in urine is to collect it every single time you pee for 24 hours. DUTCH claims its four samples are as effective.

A 2023 study also found the test can detect whether you’re getting more or less estrogen based on what dose patch you’re using. This sounds like it could help adjust your hormone therapy.  

HOWEVER, there is no evidence or expert consensus that we adjust doses of estrogen, progesterone or testosterone based on ANY test (be it urine, blood or saliva). We dose based on clinical feedback: how you’re feeling, not what a number is. (The only exception to this is adjustment of thyroid hormone based on TSH, as well as how you are feeling.)

• Doctor’s Note: I find at-home testing (whether it’s blood, urine, or DNA) exciting on many levels.

The science looks promising, but a lot of this research comes from the company’s own laboratory. This doesn’t cancel out the validity of the science, but it does warrant caution and means we need more independent research.

So…Should You Get The Test?

The DUTCH test can accurately measure your hormones. But measuring something and that measurement being useful are two different things. (Analytical validity is not the same as clinical utility!)

Here’s why it rarely changes care:

• Treatment stays the same. If you have menopausal symptoms, you'd consider hormone therapy regardless of what the test shows. The management plan doesn't hinge on these numbers.
• Hormone levels fluctuate. While the test captures one “snapshot” across a day, today’s numbers can’t predict tomorrow’s.

And in most cases? Doctors can guide your care perfectly well based on your symptoms. There’s no need for a fancy test when a doctor can just listen to you instead.

• Zoom In: This is why major medical organizations, from NICE, ACOG, to The Menopause Society, don’t recommend hormone tests to diagnose menopause or figure out if you need more or less hormone therapy.

Not to mention, the test is expensive ($499 for DUTCH Complete and $650 for DUTCH Plus) and rarely covered by insurance.

My Doctorly Advice

If you’re a healthy woman over 50 with classic menopause symptoms, we can usually start and adjust hormone therapy based on how you feel, your risk profile, and—when needed—standard labs like lipids or thyroid. Not a $500 urine panel.  

When might it be worth it?

In rare cases, it may help explore unusual questions. For example:

• If you’re using compounded hormones and want to compare them to FDA-approved products.  
• If there's concern that your body isn't absorbing the hormones properly.
• We’re answering a very specific question where dried-urine data could add clarity.

But even then, it only makes sense with clinicians who really understand the method's limits.

Otherwise, save your money for strength training shoes and calcium-rich groceries. And yes, I’ve bought tests I didn’t need to. It happens.