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Related Experiment Video

Updated: Jul 17, 2026

Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers
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Published on: December 18, 2013

Steroid analysis in saliva: an overview.

John G Lewis1

  • 1Steroid & Immunobiochemistry Laboratory, Canterbury Health Laboratories, Christchurch, New Zealand. john.lewis@cdhb.govt.nz

The Clinical Biochemist. Reviews
|February 3, 2007
PubMed
Summary

This review summarizes the use of saliva for steroid hormone analysis. Saliva is a non-invasive and convenient alternative to blood for measuring hormones like cortisol and progesterone. It is used in endocrinology to assess adrenal and ovarian function, and in diagnosing conditions like Cushing's disease. However, challenges include variability in saliva composition, binding proteins, and reference ranges. The review highlights the benefits and limitations of using saliva in clinical and research settings.

Keywords:
salivary hormone testingnon-invasive diagnostic methodssteroid analysis techniqueshormone measurement in saliva

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Area of Science:

  • Clinical endocrinology diagnostics
  • Biological fluid analysis techniques
  • Hormone metabolism research

Background:

Steroid analysis in saliva has gained attention over the past three decades. Researchers have explored non-invasive sampling methods to reduce patient discomfort. Saliva offers a stress-free alternative to blood sampling. It is particularly useful in pediatric and sports medicine settings. The appeal lies in its ease of repeated collection. Prior research has shown saliva contains measurable steroid hormones. However, challenges remain in standardizing collection and interpretation. This paper reviews the progress and limitations of using saliva for steroid analysis.

Purpose Of The Study:

The goal of this review is to summarize the use of saliva in steroid hormone analysis. It addresses the popularity of saliva as a diagnostic fluid. The study highlights applications in endocrinology and psychobiology. It examines the diagnostic value of specific steroids like cortisol and progesterone. The paper also considers the limitations of saliva-based testing. It aims to clarify the variability in collection and interpretation methods. The review provides a balanced view of current practices and challenges. It seeks to guide future use of saliva in clinical and research settings.

Main Methods:

The review draws on published literature on steroid analysis in saliva. It includes studies on diagnostic applications and methodological challenges. The authors examine the use of saliva in assessing ovarian and adrenal function. They analyze the role of salivary cortisol in diagnosing Cushing's disease. The review considers factors like matrix variability and binding proteins. It evaluates the sensitivity and stability of steroid measurements. The authors also assess collection techniques and reference ranges. The synthesis focuses on current practices and unresolved issues.

Main Results:

Salivary steroids have been used for over thirty years in clinical diagnostics. Saliva is non-invasive and suitable for repeated sampling. Progesterone and oestradiol are used to assess ovarian function. Cortisol is a key marker for adrenal function and Cushing's disease. Saliva contains free steroids not bound to plasma proteins. Collection methods significantly affect measurement accuracy. Binding proteins in saliva can interfere with steroid assays. Reference ranges vary, complicating interpretation of results.

Conclusions:

Saliva remains a valuable fluid for steroid analysis despite limitations. It is widely used in endocrinology and psychobiology. The diagnostic value of salivary progesterone and cortisol is well-established. However, variability in collection and matrix composition persists. Binding proteins and reference range anomalies require attention. Researchers must balance convenience with accuracy in interpretation. The review highlights the need for standardized protocols. It suggests further work to improve reliability and clinical utility.

Saliva offers non-invasive and stress-free sampling, making it ideal for repeated measurements in clinical and research settings.

Commonly measured steroids include cortisol, progesterone, and oestradiol, which are used to assess adrenal and ovarian function.

Collection techniques affect the accuracy of steroid measurements due to variability in saliva composition and binding proteins.

Bedtime salivary cortisol levels have been proposed as a screening test for Cushing's disease, reflecting adrenal function.

Challenges include matrix variability, steroid stability, binding proteins, and inconsistent reference ranges.

The review suggests the need for standardized protocols and further research to improve reliability and clinical interpretation.