Why does this test require two blood tests?
Female hormones change across the menstrual cycle. A single test cannot accurately capture both baseline hormone levels and progesterone production.
Therefore, our test uses two strategically timed blood tests to measure:
Baseline hormone function early in the cycle
True progesterone output after ovulation
This design avoids false reassurance and false deficiency flags that occur with single-point hormone testing.
Vively provides two different blood test referrals, so its important to know which one to take to the testing centre at the correct time.
The 1st Test: When is the first test taken, and why?
The first test is taken between day 2–5 of your cycle (with day 1 being the first day of bleeding).
This timing captures hormones when they are at their baseline, before ovulation influences levels. It allows accurate assessment of:
Oestrogen baseline
FSH and LH signalling
Androgen levels
Thyroid and adrenal-related hormones
Early progesterone baseline (expected to be low)
This phase provides the cleanest snapshot of how your hormonal system is functioning without cycle-related distortion.
Please ensure you take the correct test referral to the testing centre (the one that contains all the markers above)
The 2nd Test: When is the second test taken, and why?
The second test is taken 7 days before the end of your cycle, and only includes Progesterone. Please ensure you take the correct test referral to the testing centre.
This timing captures progesterone at the peak of the cycle after ovulation, helping to capture the full pattern over the cycle.
What if my cycles are irregular — how do I know when to take the second test?
Irregular cycles make timing harder. That is understood and accounted for in this test design.
Step 1: Use your usual cycle length as a guide
Even irregular cycles usually have a typical range (for example, 26–35 days). Use your average cycle length over the last 3–6 months.
Average cycle length − 7 days = target progesterone test window
Examples:
Average 32-day cycle → test around day 25
Average 35-day cycle → test around day 28
Average 26-day cycle → test around day 19
This captures progesterone close to where it should peak if ovulation has occurred.
Step 2: If your cycles are very unpredictable
If your cycle length varies widely or you are unsure when your period will arrive:
Take the progesterone test when PMS-type symptoms usually appear (for example: breast tenderness, bloating, mood changes, poor sleep)
Or take it approximately 5–10 days after signs of ovulation, if you track these (cervical mucus changes, ovulation predictor kits, temperature shift)
If ovulation did not occur that cycle, progesterone will be low — and that result is still clinically meaningful.
Step 3: If you don’t bleed regularly at all
If periods are absent or extremely infrequent:
Complete the early-cycle test (day 2–5 equivalent) as instructed
Take the progesterone test 3 weeks later
This allows assessment of whether ovulation and progesterone production are occurring at all, which is often the core issue in amenorrhoea, PCOS, stress-related suppression, or perimenopause.
Important
You do not need to time this perfectly for the test to be useful.
Hormone health is assessed through patterns, not a single “perfect” cycle.
Can I do this test if I’m on hormonal contraception?
Yes — but interpretation depends on the type of contraception and your goal for testing.
Combined oral contraceptive pill (oestrogen + progestin)
This suppresses ovulation and natural progesterone production.
Early-cycle hormones will reflect suppression, not natural baseline
Progesterone will be low by design, not deficiency
This test can help explain symptoms like low libido, mood changes, or fatigue while on the pill, but it cannot assess natural cycle health or fertility hormones while you’re taking it.
Progestin-only pill, hormonal IUD, implant, or injection
These methods variably suppress ovulation and alter hormone signalling.
Results reflect a modified hormonal state
Progesterone patterns may be blunted or inconsistent
Interpretation focuses on symptom correlation, not cycle optimisation
This can still be useful for understanding why you feel the way you do, but it does not represent an unmedicated cycle
Copper IUD (non-hormonal)
This does not suppress ovulation or hormone production.
Testing reflects your natural cycle
Full interpretation applies as intended
If your goal is to assess natural hormone balance or fertility
Testing should be done after stopping hormonal contraception and once natural cycles resume. A short adjustment period is often required before results stabilise.
Key clarification
Hormonal contraception does not “fix” hormone imbalance — it overrides it.
This test can show the effects of that override, but it cannot reveal underlying cycle physiology until suppression is removed.
What if I mistime the progesterone test?
Mistiming usually leads to artificially low progesterone, not false reassurance.
If timing is clearly off, results are interpreted cautiously and repeat testing may be recommended. You are not penalised for biology that is already complex.
What if I don’t ovulate that cycle?
That information is still clinically useful.
Low late-cycle progesterone confirms an anovulatory cycle, which helps explain symptoms and guides next steps. Hormone health is assessed over patterns, not perfection.
Is this test useful in perimenopause?
Yes. Perimenopause is characterised by erratic ovulation and declining progesterone, often years before periods stop.
The two-test structure helps identify:
Inconsistent ovulation
Low luteal progesterone
Oestrogen-progesterone imbalance driving symptoms
Results are interpreted in context rather than against rigid reference points.
Why not just test progesterone once?
Single progesterone tests frequently misclassify women as “low” or “normal” due to timing error.
This test design removes guesswork and reflects how hormones actually work across the cycle.