would appreciate input on sex hormone levels and prescribed treatment

I would really appreciate some input on my sex hormone levels and the treatment prescribed. I had labs on July 29, and saw my doctor a week later. I was then prescribed Oestrogel (0.06%) to be applied to skin day 5-25 of cycle, along with Utrogestan (200 mg), to be taken at bedtime day 15-25 of cycle.

I went to the lab on day 21 of cycle as directed; however, since my periods have been slightly irregular lately, and I had two periods within six weeks in May and June, it's not easy to know exactly when that is...

Anyway, my levels looked like this:

FSH 5.0 UI/L

ref follicular phase 3.0-8.1

ref ovulary peak 2.6-16.7

luteal phase 1.4-5.5

menopause 27-133

LH 5.4 UI/L

ref follicular phase 1.8-11.8

ovulatory peak 7.6-89

luteal phase 0.6-14

menopause 5.2-62

Oestradiol 101 pg/mL

follicular phase 21-251

ovulatory peak 38-649

luteal phase 21-312

menopause <28

Progesterone 4.3 ng/mL

follicular phase <0.3

luteal phase 1.2-15.9

menopause <0.2

I have read several times that you should never take estrogen before menopause, only progesterone if peri-menopausal. Don't my lab results clearly indicate that I am not yet menopausal? I am 47.

I'd appreciate any input on this, as I don't want to take more hormones than necessary, especially not a controversial hormone such as estrogen, even if it's bio-identical.

My doctor is a so called Hertoge doctor.

Lately, I have seen a new pattern emerging: my periods tend to come every three weeks instead of every four weeks.

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  • Bioidentical oestrogen isn't controversial any more than thyroid hormone is. The idea is to replace the hormone you should be producing on your own with the same thing in physiological amounts. Fake progsterone is very controversial but yours in bioidentical. I've never heard that you shouldn't take oestrogen pre menopause if you need it (remember all of us oldies who were on oestrogen only contraception?). Irregular periods suggest peri-menopause.

    Can't comment on levels as I never had mine done when I was healthy, but I think the ranges are as wide as the thyroid hormone ones.

    If you had no symptoms of illness, why did you have your sex hormones tested?

  • The Hertoghe doctors always test all your hormones - thyroid, adrenal, sex hormones...a complete hormonal panel, the idea being that you need to balance all your hormones in order to feel completely well.

    I have read that peri-menopausal women are estrogen dominant, and therefore should avoid estrogen, and take progesterone only...

  • I don't think I was ever really oestrogen dominant. And I think you can be unbalanced but still have too little of everything. Why not ask the doctor to explain?

  • What I have read is that if your FSH is >22, and your oestrogen levels are <150, you are menopausal. My oestrogen levels are well <150, but my FSH is only 5...so my estrogen levels are menopausal but not my FSH levels...! I found this info in a book called Female brain gone insane, written by a Nurse Practitioner in the US who seems to know what she is talking about.

    But I agree, I think you can be deficient in both hormones even if you are not yet menopausal...it's really confusing.

  • If your TSH is > 22 you are very hypothyroid. People can be hypothyroid at any time of life it isn't specifically related to the menopause.

  • Sorry, I meant FSH, not TSH...! I will correct it asap.

  • I was deficient in all sex hormones except testosterone. On meds, my FSH is 69, oestradiol 348, progesterone 52, DHEA-s 4.9, but I'm way past menopause.

    The lab range for FSH is > 25.8 for post-menopause, they don't give a range for pre- or peri-

    oestradiol for post-meno is <183 (which is higher than the bottom end of the ranges for fertile women in any phase).

    Like thyroid hormones, I suspect it depends on the lab ranges - they won't all be the same.

  • OK, I see what you mean...in Belgium, where I see my doctor, they seem to consider a FSH above 22 as menopausal. Thanks for your input!

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