When we first started working together, we did baseline saliva hormone testing, looking at: estrogens (estrone, estradiol, estriol), progesterone, testosterone, DHEA, and her daily cortisol pattern.

The results pointed to:

• progesterone levels that were lower than ideal
• DHEA levels that had room to grow
• a cortisol pattern consistent with established (phase 3) HPA axis dysregulation

Based on what the data showed and what Penny had been experiencing, we put together an initial plan that included progesterone support, DHEA support, and targeted HPA axis support. We also identified some simple lifestyle shifts: small dietary changes and breathing exercises to help her system find its footing.

Penny did an amazing job staying consistent. When we checked in two months later, the changes were real — and she felt them.

The anxiety she'd been carrying had eased — even though the life stressors hadn't gone anywhere. Her sleep, energy, and motivation had all shifted for the better. She was starting to feel like herself again.

But about six months later, things changed.

Penny started noticing heightened anxiety again and described herself as feeling "stuck in fight or flight." Little things were bothering her, and no matter what she tried — massage, breathing exercises, mindfulness practices, or extra HPA axis support — she just couldn't shake it.

Like many women, Penny had done her own research and become convinced it was time to add estrogen. She felt sure systemic estradiol would help with the anxiety, brain fog, and general sense of being unwell.

But instead of immediately adding estrogen based on what she was experiencing alone, we decided to repeat her saliva testing.

Almost a year had passed and the picture had changed. Rather than guessing which hormone might be "off," we wanted to use the data as a roadmap.

It turned out to be a great decision.

The new labs showed that her estradiol was not only within the expected range — it was essentially the same as it had been on her first test.

Since the data showed no meaningful change in estradiol, that wasn't what was driving what she was feeling.

But something else had changed significantly: her cortisol pattern.

The testing revealed she had shifted from an established (phase 3) HPA axis dysregulation pattern into an early (phase 1) pattern.

This new pattern no longer needed the level of HPA axis support she had been taking. In fact, she had started adding extra support, thinking it would help her feel calmer.

But instead, it was overstimulating her system — and contributing to the exact changes she was trying to address.

Penny's story is a great reminder that:

• what we're experiencing alone doesn't always tell us which hormones need attention
• many hormone imbalances share overlapping patterns
• more support is not always better
• testing can help us make more targeted and effective decisions

Saliva hormone testing can act like a roadmap. Instead of guessing which direction to go, it helps guide us toward the right path more quickly — and more confidently.