What Is the DUTCH Test? Advanced Hormone Testing in Hong Kong

The DUTCH test is an advanced hormone assessment that uses dried urine samples to evaluate hormone levels, how they are metabolised, and selected markers related to stress, sleep and nutritional status. DUTCH stands for Dried Urine Test for Comprehensive Hormones.

At OT&P in Hong Kong, the DUTCH test is used as part of a broader functional medicine and longevity approach, particularly in the assessment of perimenopause, menopause, hormone replacement therapy and complex hormone related symptoms.

Unlike a single blood test taken at one time point, the DUTCH test involves collecting several small urine samples over approximately 24 hours. These samples are placed on absorbent cards, dried and sent to a laboratory. Because multiple timed samples are taken, the test can show daily hormonal patterns, for example the rhythm of cortisol across the day, rather than providing a single snapshot.

What Does the DUTCH Test Measure?

The most commonly used panel, DUTCH Complete, measures several groups of markers.

Sex hormones Different forms of oestrogen, including estrone, estradiol and estriol, are measured alongside progesterone and androgens such as testosterone and DHEA S. Importantly, it also evaluates hormone metabolites and precursors.
Adrenal hormones Cortisol and cortisone are assessed together with their metabolites to map stress hormone rhythm and overall adrenal output.
Hormone metabolism Breakdown products show how the liver and kidneys process and clear hormones. In women, this includes detailed oestrogen metabolism pathways.
Melatonin The primary sleep hormone is typically measured overnight.
Organic acids and nutritional markers Selected markers relating to B vitamins, oxidative stress and neurotransmitter pathways are included in some panels.

Some versions of the test also assess neurotransmitter metabolites linked to mood and stress regulation.

What Can the DUTCH Test Be Used For?

Clinicians commonly use DUTCH testing when symptoms may be hormone related. These include:

Perimenopause and menopause
Management and optimisation of hormone replacement therapy
Irregular, heavy or painful periods
Premenstrual syndrome or suspected oestrogen dominance
Polycystic ovary syndrome and fertility concerns
Low libido or suspected low testosterone in men
Erectile dysfunction or andropause
Chronic stress, fatigue and sleep disturbance
Weight gain or difficulty losing weight where hormones may be contributory

For patients in Hong Kong experiencing complex or persistent symptoms, this form of advanced hormone testing can provide additional insight beyond standard blood investigations.

How Does the DUTCH Test Differ from Standard Blood Tests?

Conventional blood tests typically measure a limited number of active hormones at a single time point. For example, estradiol, progesterone, testosterone, TSH or a morning cortisol level.

The DUTCH test expands this picture by measuring multiple forms of each hormone, their metabolites and daily rhythm patterns. This allows clinicians to assess not only hormone production, but also metabolism and clearance. In functional medicine, this broader view can be clinically useful when symptoms do not correlate neatly with serum values.

How Does the DUTCH Test Help in Perimenopause?

Perimenopause is characterised by hormonal fluctuation rather than simple decline. The DUTCH Plus test can help clarify how shifting hormones and the stress response are behaving over a full day.

In perimenopause, the test may help by:

Measuring oestrogens, progesterone metabolites and androgens to identify patterns such as falling progesterone, fluctuating oestrogen or relative oestrogen excess
Assessing oestrogen detoxification pathways, which may contribute to heavy bleeding, breast tenderness or higher oestrogen related risk
Confirming low luteal progesterone, often associated with anxiety, insomnia and shorter cycles
Mapping the cortisol awakening response and daily cortisol rhythm, which may be altered in burnout, anxiety or chronic fatigue
Distinguishing between genuinely low cortisol production and altered cortisol metabolism
Evaluating melatonin and selected nutritional markers that may contribute to night waking, low mood, brain fog or hot flushes

This information can guide more targeted interventions, including timing and dosing of hormone replacement therapy, lifestyle modification, stress management, light exposure strategies and targeted supplementation. It allows care to move beyond trial and error towards a more personalised approach.

Summary

The DUTCH test is an advanced hormone test that provides more detailed information than standard blood hormone panels. It can be particularly useful in the management of perimenopause, menopause and hormone replacement therapy, as well as in complex stress related presentations.

At OT&P in Hong Kong, it forms part of a structured and holistic assessment, ensuring that testing supports clinical judgement rather than replacing it.