Your urine can tell you a lot about your reproductive health hormones. Unfortunately, at-home testing can be cumbersome, involving collecting samples that are then mailed out to labs. That’s what health startup Mira is trying to simplify with its $249 Ultra4 Hormone Monitor.

The pitch is to make highly accurate, readily available hormone testing for at-home users. The Ultra4 is technically two separate products. The first is the actual Hormone Monitor, which is a standalone, egg-shaped gadget that analyzes test results. The second is the Ultra4 Wand, which is a little stick you pee on that contains the actual test for four reproductive hormones: follicle stimulating hormone (FSH), luteinizing hormone (LH), estrone-3-glucuronide (E3G), and pregnanediol 3-glucuronide (PdG).

By testing these four hormones simultaneously, Mira CEO and cofounder Sylvia Kang says users can not only track fertility, but also gain insights into conditions like polycystic ovary syndrome (PCOS), premenstrual dysphoric disorder (PMDD), perimenopause, menopause, and even metabolic health. The hope is that by regularly testing at home, you can customize treatment for these conditions as well as notice trends based on long-term hormone levels.

“The goal is to help women to manage their health more proactively,” says Kang, who notes that at-home hormone testing wasn’t really a thing back when she founded Mira in 2018. “I saw so many friends trying to conceive at a late age, and the journey was really challenging. They had no idea what was wrong with them, but the only products they could purchase were ovulation kits or basal body thermometers. Neither has lab-grade accuracy or provides real understanding about what’s going on in your body.”

That’s since changed. “Hormone balancing” has been a trending wellness topic over the last two years, and while influencers rarely get the facts right, the increased interest in at-home testing speaks to how frustrating treating hormonal conditions can be. Technically, Mira has been around for nearly a decade, and the new Ultra4 kit was soft-launched in late August. The company’s at CES 2026 to say the kit is now more widely available. Mira sent me an analyzer and Ultra4 Wands ahead of the show, and as someone with PCOS – who’s also right in the time frame for perimenopause — I was curious to see what using the device is like.

In a nutshell, you fill out a detailed survey within the Mira app about what you’re looking to find out (i.e., fertility windows, hormone management, insight into irregular cycles, etc.) Then you pee into an included collapsible silicone cup and stick a test wand in. After about 15 seconds, you then stick the test into the analyzer and wait for 16 minutes to view your results both on-device and in the app. Depending on your goals, the app will generate a customized testing schedule.

That part was easy enough, though it’s still too early for me to say what insights I’ll learn. Supposedly, a single test can give insights into cycle health and how many eggs you might have in reserve, as well as identify root causes for irregular cycles or hormonal issues. For now, my custom plan told me that I’ll need to test for five consecutive days for two straight cycles to figure out if I’m showing signs of perimenopause. Meaning, this is a device that’s meant to be used over several months to build a hormonal baseline for users. Even so, the app does provide explainers as to what each hormone does for the body and what high or low levels can mean.

One note: Mira isn’t intended to be used as a contraceptive. It’s firmly in the realm of wellness. The gadget itself is FDA-listed as a Class I device — meaning the agency views it as very low-risk and requires less scrutiny compared to features or devices requiring clearance or approval.

Kang also says that fertility isn’t the only focus for its users anymore.

“Right now, 40 percent of our users are not trying to conceive. They’re interested in menopause, PCOS, and hormones in general. Specifically, in symptom management,” Kang says. The hope then is to give those users data they can use to better understand how they can improve their health. For example, a user may notice that when a certain hormone spikes, they experience specific symptoms like headaches or nausea. Knowing that specific timing may help someone discuss with their doctor how to approach treatment.

Applying that logic further down the line, Kang says Mira hopes to one day expand to other biological fluids like blood and saliva for hormonal analysis. Eventually, the goal is to move beyond just reproductive health and toward “longevity” or preventive health. For example, Kang notes that early research shows that there may be a link between certain hormones and metabolic health as well.

For now, cost is the biggest barrier. The Ultra4 Hormone Kit starts at $249, and replacement wand packs cost roughly $99. The analyzer alone costs $149. Even so, this all dovetails with where health tech has been heading. The covid-19 pandemic popularized and increased access to at-home testing. Hormone testing and perimenopause tech were also featured at last year’s CES. Meanwhile, Withings, Oura, and Whoop are all examples of health tech companies who have recently explored blood tests and urine as a means of promoting healthy aging.