How accurate is a hormone saliva test at predicting menopause onset?

The accuracy of saliva tests that measure estrogen, progesterone, and testosterone is not established. Hormone levels in saliva are not biologically meaningful, and the saliva levels do not correlate with the severity of a woman’s symptoms. It is not possible to test for the concentration of free unbound hormone in the saliva.

Further, there is no biological relationship between salivary sex steroid hormone concentration and the amount of free hormone in the blood. There are large differences in salivary hormone concentrations between individual women that are not understood, as well as variability for individual women at different times during their menstrual cycle and during different phases of menopause. Salivary hormone levels will also vary with diet, the time of day of testing, and the specific hormone being tested.