Women

• Fatigue or low energy: Persistent tiredness that may relate to adrenal or hormonal imbalance.
• Low mood or depression: Changes in mood, motivation, or emotional wellbeing associated with hormone fluctuations.
• Reduced libido: Lower sexual desire or satisfaction that may coincide with changes in oestrogen or testosterone levels.
• Premenstrual or cycle-related symptoms: PMS, irritability, or mood swings occurring before or during menstruation.
• Perimenopausal or menopausal changes: Hot flushes, sleep disturbance, or other symptoms linked with hormonal transition.
• Weight gain: Gradual or unexplained weight increase potentially influenced by cortisol or sex hormone changes.

Men

• Fatigue or low energy: Persistent tiredness or reduced vitality possibly linked with testosterone or cortisol changes.
• Low mood or depression: Ongoing low mood or motivation that may reflect hormone imbalance.
• Reduced sex drive: Decline in libido or sexual performance associated with changes in androgen levels.
• Sleep disturbance: Difficulty falling asleep or staying asleep linked with altered cortisol rhythm.
• Hair loss: Thinning hair or reduced growth that may correspond with hormonal shifts.
• Weight gain: Increase in abdominal fat or overall body weight possibly influenced by hormone balance.

The DUTCH Plus builds on the DUTCH Complete by combining dried urine and salivary hormone testing to assess sex hormones, adrenal hormones and their metabolites alongside the Cortisol Awakening Response (CAR). This expanded profile provides a detailed view of hormone production, metabolism and daily cortisol rhythm, supporting evaluation of hypothalamic-pituitary-adrenal (HPA) axis function.

This type of assessment may be relevant in contexts such as menstrual or menopausal symptoms, fatigue, mood variation, sleep disturbance, reduced libido or changes in body composition. In women, it can help explore patterns of oestrogen, progesterone and androgen metabolism across different life stages. In men, evaluation of testosterone, DHEA and cortisol dynamics may provide additional perspective on energy levels, stress resilience and recovery.

Results are interpreted alongside symptoms, lifestyle factors and clinical history. Reviewing hormone patterns in this broader context may help practitioners guide personalised nutrition, lifestyle or therapeutic strategies and allows comparison over time when monitoring response to interventions.

Practical

Sample Type:

4 x dried urine and 5 saliva samples collected during one day

Turnaround time:

Maximum of 21 days

Restriction:

This test is not available for patients below 12 years of age.

Research

* Adam EK, Doane LD, Zinbarg RE, Mineka S, Craske MG, Griffith JW. Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence. Psychoneuroendocrinology. 2010 Jul;35(6):921-31