As medical laboratory science improves, we become more able to test for chemistry that reflects how well or how un-well our bodies are functioning.  Some confusion has emerged as to which of the three available formats of hormone testing should be considered the Gold Standard.  Below is a brief description of each available format with comments and recommendations.

Urine Hormone Analysis: 
Urine testing provides the most comprehensive understanding of entry of a hormone into cells and the manner in which they are utilized.  In patients that receive HRT (Hormone Replacement Therapy) urine testing results reflect the supplemented hormones ability to enter into cells, be used for specific intracellular functions that leads to their breakdown as metabolites that are subsequently excreted in the urine by functioning kidneys.  Any break in this process shows up in the types and ratios of their metabolites. So as far as the ideal means of following HRT, urine testing is the most informative.

Serum Hormone Analysis:
Whether by mouth, injection or topically applied, hormones enter into the serum (blood) to circulate around the body allowing for tissue uptake by each individual cell. Measurement of their levels only tells us that they made it into the circulation.  This form of testing does not tell us anything about their entry into the cells (tissues) where their effects are produced but it does allow us to see the efficacy of the modality of application (introduction; i.e. oral, topical and injected.)

Salivary Hormone Analysis:
Of all the modalities available for hormonal testing, this is the least informative but the most convenient. It is unfortunate, that well educated physicians promote this form of laboratory testing as the most informative while in fact it just tells us that hormone has been concentrated in the salivary glands.  The presence of concentrated chemicals in the salivary secretion only tells us that the specific hormone/chemical got into the blood and then the tissues but does not give us any true measurement of the intracellular utilization or effect on cellular metabolism.