Estrogen/progesterone ratio: go off estrogen or... - Thyroid UK

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Estrogen/progesterone ratio: go off estrogen or increase progesterone?

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So my labs came back (blood drawn on 21 day of (irregular) cycle as instructed):

FSH 18.0 UI/L (ref luteal phase 1.4-5.5; ref menopause 27-133)

LH 13.0 UI/L (ref luteal phase 0.6-14; ref menopause 5.2-62)

Estradiol 37 pg/mL (ref luteal phase 21-312; ref menopause <28)

Progesterone 1.0 ng/mL (ref luteal phase 1.2-15.9; ref menopause <0.2)

Using an E/P ratio calculator, my E/P ratio came back at 27.03. An optimal E/P ratio is said to be 100-500, possibly dropping to +/-50 around menopause. But 27.03 is clearly indicative of estrogen dominance.

However, given that I use Oestrogel (two pumps daily for 25 consecutive days), my estradiol levels don't seem that high...just above menopausal levels while on HRT. I know it's about the ratio between E and P and clearly my P levels are too low relative to E levels, but what I am wondering is if I should raise progesterone instead of going off E...? I have been taking 100 mg of Utrogestan along with Oestrogel, but maybe I need 200 mg daily instead (when I was taking P ten days a month, I took 200 mg)? Estrogen dominance does not necessarily require one to go off E altogether, but can be corrected by raising P.

Not sure how to interpret my testosterone results:

total testosterone 0.29 ng/mL (ref 0.10-0.70)

free testosterone <0.01 (ref <0.01)

bioavailable testosterone 0.06 ng/mL (ref <0.25)

Not sure which one of this tests is the most telling...?

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6 Replies
Cooper27 profile image
Cooper27

From the little bits I know, during the luteal phase, progesterone levels ought to be high and estrogen should be low. Obviously if you're taking estrogen, I'd expect estrogen might not be as low, but I'd still imagine progesterone should be higher than yours is (if you're meant to have ovulated).

What day in your cycle were the tests taken? You say luteal, but was it day 15, day 21, day 27?

I think you need to work on progesterone levels, but I'm not an expert so someone may know more than I do.

Good diet and reducing stress (especially in the first 2 weeks of your cycle) are the first things to look at. You can also look into pre-natal vitamins, as I've been told they're beneficial for balancing hormones (because at the end of the day, that's what our hormones are aiming for).

in reply toCooper27

Day 21 of cycle as instructed by doctor.

Yes, I agree my P levels seem very low so probably need to work on getting them up.

Cooper27 profile image
Cooper27 in reply to

That's fine. I ask because your progesterone levels should be at their highest 7 days before your next period. If your cycle is irregular, they tend to use day 21, on the presumption most people have a 28 day cycle.

If your test turned out to be 7 days before you next period, then that's showing your progesterone levels at their peak, and it's definitely too low.

in reply toCooper27

Yes, I've been having irregular periods for the past year. Thanks for your input!

in reply to

Looking back, I realise my estrogen levels were never very high on Oestrogel, so I have been wondering if I absorb it well enough or if patches would be an option...a while ago, my gynaecologist gave me a script for Elleste Duet which has some really good online reviews, but contains oral estrogen and synthetic progesterone. The Hertoghe doctors are adamant oral estrogen is to be avoided and progesterone needs to be bio-identical, not synthetic. But are oral E and synthetic P really that bad for you? Just trying to get a clearer picture of my options and their pros and cons. My P levels are very low according to labs so I am beginning to wonder if Utrogestan is strong enough for me...

So any input on synthetic vs bio-identical would be most welcome!

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