Why isolated labs miss the whole picture in women's hormone health

Women frequently experience symptoms and notice changes in how they feel two to five years before any screening test reflects a problem—and that gap between lived experience and laboratory confirmation is exactly why a more comprehensive, longitudinal approach to hormone testing is warranted, according to Carrie Carda, MD, MMS, MHS, national medical director for 10X Health.

"When they reach my door, I know I've got to be more comprehensive about things," Carda said. "I can't just take one isolated event and act on that." The disconnect between symptom onset and screening test failure is not an edge case in her experience—it is the norm. Women present already not feeling their best, long before conventional thresholds are crossed, and addressing that gap requires a framework that goes beyond isolated data points.

Carda described comprehensive hormone workups as requiring a whole-body-systems orientation rather than single-value assessment. Hormones fluctuate substantially, and their effects extend across multiple physiologic systems—meaning that evaluating them in isolation, or relying solely on screening thresholds designed to rule out major pathology, leaves the clinician with an incomplete picture.

"Labs in isolation are just not really that helpful anymore," she said. "Screening tests in isolation—their best place is to rule out big diseases and big pathology. But in general, they're not going to give you the optimal person sitting in front of you."

She was also direct about the limits of what laboratory data—however comprehensive—can accomplish on its own. Genetics, biotoxin exposures, and individual psychological responses all shape how a patient experiences hormonal change, and those dimensions cannot be captured by any testing panel.

"Nothing is ever going to replace the patient talking to you about their symptoms, the history that you've gotten from them," Carda said. The concern she raised about artificial intelligence tools was not about their utility—she acknowledged artificial intelligence is becoming increasingly helpful for practitioners—but about the risk of displacement.

"We can never, ever, ever forget the person sitting in front of us is attached to multiple body systems, multiple physiologic things going on." Ferreting out those interconnections, she argued, remains a clinical task that no algorithmic tool can perform.

The framework she described—longitudinal, systems-oriented, grounded in patient history and trend data rather than single-point screening—reflects a broader shift in how proactive women's health care is being conceptualized, particularly in the perimenopausal and menopausal space where hormonal variability is high and symptom burden often precedes measurable change.