From my experience, this is usually symptoms-dependent. Based on the symptoms that a patient reports, a working diagnosis of one (or more) particular hormonal derangement will be made. Relevant investigation with blood and/or urine tests will be performed.
If the tests turn out to be abnormal, corresponding to the patient’s symptoms, the relevant treatment will be instituted and the patient will be advised to look for improvement in symptoms.
However, if a patient does not display any symptoms of hormonal imbalance, doing “routine” hormonal blood/urine tests are not recommended and may even cause unwarranted anxiety.