DUTCH Sex Hormone Metabolites (Dried Urine)
The DUTCH Sex Hormone Metabolites panel is a focused dried-urine profile measuring parent sex hormones and their metabolites — oestrogens across the 2-OH, 4-OH, and 16-OH pathways, androgens including DHEA-S and 5-alpha/5-beta metabolites, and progesterone metabolites — without the adrenal cortisol components of the fuller DUTCH panels.
3
Biomarkers
Urine (dried)
Sample
7–14 business days
Turnaround
No — however, collection timing is important (cycle timing in menstruating women), and patients should document all hormone therapy (and route), medications, and supplements before collection
Fasting
What is the DUTCH Sex Hormone Metabolites test?
The DUTCH Sex Hormone Metabolites panel is a focused dried-urine profile that measures the parent sex hormones and their downstream metabolites — oestrogens across the 2-OH, 4-OH, and 16-OH pathways, androgens including DHEA-S and the 5-alpha/5-beta metabolites, and progesterone metabolites — without the adrenal cortisol and diurnal components of the fuller DUTCH panels. Its purpose is to profile sex-hormone production and metabolism in a single at-home collection. Within hormone assessment, this is a functional and integrative tool rather than a replacement for established endocrine diagnostics. The dried-urine methodology captures hormone metabolites over the collection window, which appeals to practitioners wanting a view of oestrogen pathway balance, androgen metabolism, and the oestrogen-to-progesterone relationship that single-point serum measurements do not provide. Its reference intervals are proprietary to the method and not interchangeable with serum, and interpretive claims about metabolite-pathway ratios and disease risk are an area of active research rather than established practice. It does not replace serum measurement when a defined endocrine disorder is suspected, and results depend heavily on cycle timing, hormone-therapy route, and avoidance of topical contamination.
What does the DUTCH Sex Hormone Metabolites test measure?
Oestrogens (oestrone, oestradiol, oestriol) are metabolised through three hydroxylation pathways — 2-hydroxy, 4-hydroxy, and 16-hydroxy — followed by methylation. The relative flux through these pathways and the degree of methylation are of interest because the 4-OH pathway generates more reactive metabolites. Dried urine measures the parent oestrogens together with these downstream metabolites over the collection window.
Oestrogen-metabolite profiling is used in functional and integrative practice to examine oestrogen production and the balance of metabolic pathways, including methylation capacity. Interpretation regarding pathway 'preference' and any associated risk is an area of active research and is not an established clinical risk-stratification tool. Results are interpreted with cycle timing, menopausal status, and any hormone therapy.
DHEA-S is the principal adrenal androgen precursor, while downstream androgens including testosterone are metabolised via 5-alpha and 5-beta pathways to androsterone and etiocholanolone, excreted in urine. The relative activity of 5-alpha reductase, inferred from metabolite ratios, influences potent androgen exposure at tissue level. Dried urine captures these metabolites to profile androgen production and metabolism.
Androgen and DHEA-S metabolites are used to assess adrenal and gonadal androgen output and androgen metabolism in conditions such as PCOS, androgenic symptoms, and hormone assessment. The 5-alpha/5-beta metabolite balance is interpreted to gauge androgen activity. Findings inform functional assessment and are interpreted alongside serum measurements where definitive endocrine diagnosis is required.
Progesterone is metabolised to pregnanediol isomers excreted in urine, which serve as a surrogate for progesterone production over the collection window. Because progesterone itself is not measured directly in dried urine, these metabolites estimate luteal-phase progesterone activity. Levels vary markedly with cycle phase and are minimal outside the luteal phase and in postmenopausal women.
Progesterone metabolites are used to estimate luteal-phase progesterone production and to assess the oestrogen-to-progesterone balance in functional hormone assessment. As a urinary surrogate, the result reflects metabolism over the collection period rather than a single serum value, and cycle timing is essential for interpretation.
Why is the DUTCH Sex Hormone Metabolites test ordered?
- Functional assessment of oestrogen production and metabolic pathway balance, including methylation, across the cycle or menopausal transition
- Evaluation of androgen production and metabolism — including the 5-alpha/5-beta balance and DHEA-S — in androgenic presentations or suspected PCOS, alongside serum where definitive diagnosis is needed
- Assessment of the oestrogen-to-progesterone balance using progesterone metabolites in functional hormone assessment
- Characterisation of sex-hormone status from a single at-home collection where hormone-metabolite profiling is preferred to multiple venous draws
- Monitoring of hormone therapy where metabolite-level effects on sex-hormone metabolism are being tracked
- Integrative workups focused on sex-hormone metabolism without the need for the adrenal cortisol components of the fuller DUTCH panels
- Follow-up of hormone-focused interventions where a pattern-based dried-urine metabolite profile is preferred
Sample collection and turnaround
Sample type
Urine (dried)
Fasting required
No — however, collection timing is important (cycle timing in menstruating women), and patients should document all hormone therapy (and route), medications, and supplements before collection
Collection method
At-home collection kit
Turnaround
7–14 business days
Collection notes
Collect per the specified schedule, timed to the cycle where relevant in menstruating women. Avoid topical hormone contamination of collection devices, and document hormone therapy and route, medications, and supplements. Collect on a representative day.
Specimen requirements
Dried-urine filter strips per the Precision Analytical kit; samples dried and returned per kit instructions. Follow the laboratory's stability and transport requirements.
What can affect DUTCH Sex Hormone Metabolites results?
Sex-steroid metabolite interpretation depends on cycle timing in menstruating women and on the specified collection schedule. Mistimed or missed collections invalidate the cycle and metabolite interpretation.
Oral, transdermal, troche, and vaginal hormone preparations alter measured hormones and metabolites unpredictably depending on route, and topical contamination of collection devices can falsely elevate results. Hormone therapy and route must be documented.
Dried-urine concentrations are corrected to creatinine, so extremes of hydration, muscle mass, or renal function affecting creatinine excretion can influence the reported values.
Hormonal contraceptives, 5-alpha reductase inhibitors, aromatase-affecting agents, and other drugs can distort the metabolite profile. A full medication and supplement history is required.
Because the panel relies on urinary excretion and creatinine correction, significant renal impairment alters metabolite excretion and complicates interpretation.
The interpretation of oestrogen-metabolite pathway ratios in relation to disease risk is not established consensus, so such claims should be bounded and treated as exploratory.
What do DUTCH Sex Hormone Metabolites results mean?
Elevated
Elevated sex-steroid metabolites are interpreted against sex, cycle phase, menopausal status, and any hormone therapy, with topical contamination a key cause of spuriously high results to exclude first. Metabolite-pathway shifts are described in the report but their risk implications remain research-level rather than established.
Normal
Results within the method's reference intervals suggest a typical metabolite profile for the sex, cycle phase, and life stage sampled. Because these intervals are proprietary and pattern-based, a normal profile does not exclude a defined endocrine disorder warranting conventional testing.
Reduced
Low sex-steroid metabolites are read against age, sex, and reproductive status, and may reflect ovarian or testicular decline, suppression, or, for progesterone metabolites, an anovulatory or non-luteal collection. Cycle timing must be confirmed.
Note: This is a functional, proprietary dried-urine metabolite panel whose reference intervals are method-specific and not interchangeable with serum. It is highly dependent on cycle timing, hormone-therapy route, and avoidance of topical contamination, and oestrogen-pathway risk interpretation is not established consensus. It does not replace serum sex-steroid measurement for diagnosing defined disorders, and results should be interpreted by a practitioner familiar with the methodology.
Frequently asked questions
It measures parent sex hormones and their downstream metabolites in dried urine — oestrogens across the 2-OH, 4-OH, and 16-OH pathways, androgens including DHEA-S and 5-alpha/5-beta metabolites, and progesterone metabolites — without the adrenal cortisol components of the fuller DUTCH panels.
How to access the DUTCH Sex Hormone Metabolites test
The DUTCH Sex Hormone Metabolites reference page is free and open to all practitioners. Create a free practitioner account to see pricing, save tests to your list, and generate requisition forms. Verification takes 1–2 business days.
Create Free AccountAbout this page
Published: June 2, 2026
Last reviewed: June 2, 2026
- Newbold RR, et al. Oestrogen metabolism and disease: mechanistic considerations. Environ Health Perspect. (2006)
- Ziegler RG, et al. Epidemiologic studies of oestrogen metabolism and breast cancer. Steroids. (2015)
- Stanczyk FZ, et al. Limitations of direct oestradiol and testosterone immunoassays. Steroids. (2007)
- Newman M, et al. Analytical validation of a dried urine steroid hormone metabolite assay. BMC Chem. (2021)
This content is for licensed healthcare practitioners only and does not constitute medical advice. Clinical decisions should be based on the full clinical picture and not on any single test result.
Related tests
adrenal stress
DUTCH Plus
The DUTCH Plus is a comprehensive dried-urine hormone profile that adds a timed salivary cortisol awakening response to the standard DUTCH panel. It measures the diurnal free cortisol pattern, metabolised cortisol, adrenal and sex-steroid metabolites, melatonin, and adjunctive oxidative-stress markers from at-home collections.
female hormones
Oestradiol
The oestradiol (estradiol, E2) test measures 17-beta-oestradiol, the most potent endogenous oestrogen, in serum. It is used to assess ovarian function, characterise the menstrual cycle, evaluate the menopausal transition alongside FSH, and monitor follicular response in assisted reproduction.
female hormones
Progesterone
The progesterone test measures serum progesterone, the principal hormone of the luteal phase and early pregnancy. Its main clinical use is confirming ovulation, with a mid-luteal rise providing biochemical evidence that a corpus luteum has formed.