The DUTCH Complete is a dried urine test that measures sex hormones, adrenal hormones, and the metabolites your body produces as it processes them. It's been popular in functional medicine circles for years, and it's a test you may have heard of if you've been researching perimenopause, hormone therapy, or estrogen metabolism.
We want to be honest with you about this one. It's offered here because some women specifically want it, and because access to your own health data is a principle Discreet Health takes seriously. But it's not a test we routinely order in our clinic, and we'd rather tell you why than oversell it.
Women who have specifically researched the DUTCH and want it for their own reasons.
Women already on hormone therapy who want additional detail on how their body is metabolizing the hormones they're taking.
Women specifically curious about estrogen metabolism pathways, cortisol rhythm patterns, or hormone breakdown products that blood testing doesn't measure.
If you're earlier in your journey and just want a thorough hormone baseline, a comprehensive blood panel may answer the same clinical questions with more reliable data.
The case for it: The DUTCH measures things blood work doesn't. Hormone metabolites tell you how your body is processing each hormone, which pathways it's favoring, and where things may be getting stuck. Cortisol is measured across four points in the day rather than a single snapshot. For women who want this level of detail in one collection, the DUTCH delivers.
The case against it: Hormone levels fluctuate significantly during perimenopause, and a single collection, urine or otherwise, is still a snapshot in time. The metabolite data is interesting, but the clinical decisions we make (whether to start hormone therapy, what dose, what form) are most reliably guided by symptoms, medical history, and targeted blood work showing actual serum hormone levels. The research that guides HRT dosing for bone and cardiovascular protection is based on serum estradiol, not urine metabolites. The DUTCH produces a long, complex report that can feel revealing without necessarily changing what a clinician would recommend.
This isn't a criticism of women who choose it. It's an honest acknowledgment that the extra information the DUTCH provides doesn't always translate into better clinical decisions, especially when a thorough symptom history combined with targeted blood work typically tells us what we need to know.
A comprehensive assessment of sex and adrenal hormones and their metabolites, including:
Estrogen (estrone, estradiol, estriol) and estrogen metabolites. Measured across the 2-OH, 4-OH, and 16-OH pathways, which reflect how your body is processing estrogen.
Progesterone and its metabolites. The active hormone and its breakdown products.
Testosterone and its metabolites. Including markers of androgen activity.
DHEA and DHEA metabolites. An adrenal hormone and its processed forms.
Cortisol (4-point) and cortisol metabolites. Cortisol measured at four points across the day, plus cortisol metabolites that reflect total cortisol production.
Melatonin (as 6-OH melatonin sulfate). A marker of sleep-related hormone production.
Organic acid markers. Including markers of B vitamin status, neurotransmitter activity, and oxidative stress.
Lab results are data, not a diagnosis or a treatment plan. The DUTCH Complete produces a detailed, multi-page report that can be difficult to interpret without clinical context, and a single collection window doesn't capture the wider hormone fluctuations typical of perimenopause.
If you'd like help understanding what your results mean and you live in Virginia, Maryland, DC, or Delaware, you can book an interpretation visit with Discreet Health for a clear, educational walk-through of your results. If you live elsewhere, we recommend following up with a licensed clinician in your state. If you're looking for a treatment plan or ongoing care, that lives in our clinical programs (only available to residents of VA, MD, DC, and DE).
Collection Method
This test uses dried urine samples collected at home. You'll receive a kit with collection strips and detailed instructions. The standard DUTCH Complete protocol involves four urine samples collected over a roughly 24-hour period (typically late afternoon, bedtime, waking, and two hours after waking), which lets the test capture cortisol patterns across the day.
Cycle Timing (if you're still cycling)
If you're still having regular cycles, the standard recommendation is to collect on day 19, 20, or 21 of your cycle, counting the first day of your period as day 1. If your cycles are irregular or have stopped, you can collect any time.
If You're on Hormone Therapy
If you're currently using hormone therapy (including HRT, birth control, or other hormonal medications), the test will reflect your hormone picture while on that therapy. This may be exactly what you want (to see how your body is processing the therapy) or you may want to time the collection around a specific point in your dosing cycle. We recommend reviewing the timing guidance in the kit and on Precision Analytical's website before collecting, and discussing timing with your prescribing clinician if you're unsure.
Supplements and Medications
Certain supplements and medications can interfere with DUTCH results, including biotin, certain herbal supplements, and some prescription medications. Review the materials included with your kit and the guidance available on Precision Analytical's website (dutchtest.com) for specific instructions. If you're uncertain whether a supplement or medication you take could affect your results, check with your own clinician before collection.
A look at how your cortisol rises, falls, and settles across the day. Useful for understanding stress patterns, sleep issues, and HPA axis dysregulation when blood cortisol alone doesn't tell the full story.
A comprehensive stool test that identifies gut bacteria, yeast, parasites, and markers of digestion, inflammation, and intestinal barrier function. Often chosen by women investigating digestive symptoms or the gut-hormone connection.
A urine-based test that measures mycotoxins (toxic byproducts of mold) in your body. Often chosen by women with a history of water-damaged buildings or unexplained symptoms that haven't responded to other interventions.
An at-home test that uses DNA analysis to identify the bacteria, yeast, and organisms living in your vaginal microbiome. Often chosen by women with recurrent symptoms or those investigating the connection between hormones, the gut, and vaginal health.
Compassionate, evidence-based hormone health care for women, delivered through secure telemedicine.
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