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[lisauk]

Please can someone help me with levels? My bloods show
312 pmol/L oestradiol,
3.6nmol/L progesterone,
1.2 nmol/L testosterone,
51 nmol/L sex hormone binding globulin 2.4% free androgen index.

I feel so rubbish I'm sure something isn't right somewhere. Can anyone help please?

[Milamam]

Hi, what dates of your period were the bloods taken? How old are you and how far into menopause? Were you also tested for FSH?

Bloods for estradiol and progesterone vary so much during woman's cycle so it is hard to respond if we don't know at what time of cycle.

At ovulation, both estradiol and FSH and LH are very high - i.e not indicative and conclusive. Usually, if you still mentruate regularly, all these tests are done day 3-5 of the menstrual cycle (counting day 1 when your period starts). Progesterone is usually assessed at day 21-24 of you cycle.

So I am sorry but I cannot comment unless I know at what day the bloods were done. Also - are you on HRT - this can affect the results.

Please let us know so that we can help!
Milamam

[Robin]

Hi Lisa,

Those levels look ok to me however the amount of oestrogen we need to feel well varies from person to person. I need a consistently high level. At least double what yours was at the time your test was taken. Others find their symptoms diminish with much less. This is why doctors tend to treat symptoms rather than use blood tests. Although can be useful to check if you're absorbing estrogen. Hopefully somebody will be along who can advise further

[lisauk]

Thank you so much for the replies.

I don't know where I am in my cycle because I haven't had periods for a few years - I have the Mirena coil fitted, which stopped them, but I don't know if it's solely about that, or if I don't have them anymore anyway.

I'm 46, and I found out that I was menopausal about 18 months ago - I asked to have my estrogen tested as I felt so tired and I'd read that it could be hormonal - my estrogen came back as 19 and my FSH was 104 - the doctor said these were in the 'post-menopausal' range. I started HRT then, and am currently on 100mcg Estradot patches (changed twice a week), 100mg Utrogestan (daily), and Tostran gel - 1 pump (10mg) 3 times a week.

I have always suffered with anxiety, but these days it is also accompanied by awful depression, tiredness, zero sex drive, zero enthusiasm for ANYTHING, and brain fog so bad I'm actually convinced I have dementia. Also back/hip/knee pain that prevents me from doing very much at all.

Feeling totally despondent

[Sgtvhilts]

HI
Not dementia me thinks, but you do sound pretty flat.
Have you thought of an antidepressant.
I am always blathering on about them................. primarily because they have worked so well for me (not everyone's experience- i know).
 I am now on HRT and SSRI's and the odd bit of amitryptaline. After a bit of tinkering around with the HRT, i have to say all that Brain fog, anxiety, and low mood have all but gone.
With all those meds some may wonder how i funtion at all, i am functioning really well at the moment, and would be blotto without them.
I figure anxiety is one of the most hideous of conditions, and what is the point of suffering with it ,, if you don't have to.

[lisauk]

Thank you for the reply. I am on antidepressants, yes, although I'm trying to very slowly wean off them as I think they might be partly responsible for me feeling so bad (particularly the brain fog). If coming off them doesn't help, I'll try a different one.

An update - I saw my menopause lady today and she's suggested I double my estrogen patches - from 100 to 200. She said some women do well on my levels of estrogen but others don't feel the benefits mood-wise until 500-600. I'm going to give it a try - anything is worth a go!

[Hurdity]

Hi there

Just to say your symptoms may partly be due to taking progesterone every day if this is what you are doing. Also if you have got the Mirena coil as well then no wonder! This is prog overkill! I take it cyclically and when I am on the prog phase I get just those symptoms - triedness and brain fog etc. progesterone depresses sex drive as do some anti-depressants. When did you have your last Mirena fitted? I would stop the utrogestan if it was fitted less than 4 years ago. I can't think why you have been given the utrogestan as well.

Sounds like a good idea to wean yourself off the ADs if you do not have an underlying depressive disorder and your feelings of depressions were due to menopause ie hormonal.

Then see how you feel once you've stopped the extra prog and weaned off the ADs - you may well be very surprised - pleasantly I would hope!! (obvs in consultation with your doc....ie tell the doc what you plan to do and why...).

OK your menopause specialist says increase the patches but actuallly i would do the other things first - was this a gynae? Going from 100 to 200 is a big jump. Maybe the idea will be to override the neagtive effects of the prog - but you still don't need utrogestan and Mirena ( if it is current ie less than 4 years).

Hurdity x

[lisauk]

Hi Hurdity,

My Mirena is due to come out next month so not much progesterone happening there now I shouldn't think. Also I feel even worse without the Utrogestan - soooooo anxious. I was taking 200mg a day which I preferred, but the new consultant I'm seeing wants me to only take 100. That's half the problem with all this stuff - different consultants say different things. I have read a lot about progesterone though, and I do think we need more of it than many people seem to think.

Yeah I agree that 100 to 200 estrogen is a big jump - I've decided to use halves for a while and see how I get on - so 150. She's also told me to lower my Tostran, because I told her that all that seems to do is make me angry and hairy!

This whole menopause thing sucks bigtime 

[Hurdity]

That is quite  high dose of Tostran - I think the Chelsea and Westminster recommend starting at 2 pumps and most of us take a small pea-sized blob of the weaker T gel ( the sachet Testogel) daily.

Funny that you like so much prog - I think perhaps in your case as you were taking such a high dose daily then it was more for medicinal purposes ie a pharmaceutical dose rather than what your body would have normally ( except in pregnancy). Personally I would reduce the prog before increasing the oestrogen but would be interesting to see how you feel following what the gnyaecologist suggest - after all she is the expert....

We don't actually have much prog in our bodies except during pregnancy and it increases during the second part of the menstrual cycle to prepare for pregnancy. Most women who suffer pms do so either because of the prog phase of their cycle (intolerance to it) and/or the fall in oestrogen just before the bleed. In pregnancy the levels of both hormones are extremely high - which is a special case.

I still think your symptoms are indicative of too much prog - ie progestogenic side effects. It is exactly how I feel on the prog part of my cycle - as do many other women on here. I think the high progesterone is inhibiting the positive effect of T on your sex drive. I never feel like sex when on the prog phase! However you feel what you feel....!

I do hope whatever changes you make help you to feel better - and do report back and let us know?

Hurdity x

[lisauk]

Hmm that is all very interesting. Maybe I should have the Mirena changed for a new one, and try without the Prog then. Is that most women's preferred method to taking Prog orally every day?

[NorthArm]

Hi lisauk - I agree with Hurdity, that is a LOT of prog, especially with the Mirena as well. On Utrogestan I feel exactly as you describe, I couldn't imaging how I would have felt taking it daily!

I had a Mirena fitted a week ago, and tbh I haven't felt this hormonally stable for several years - and it's been almost two years since the late peri hell hit me. However, it's early days, so I am monitoring myself closely without being obsessed if you know what I mean?

If you've been happy with the Mirena until now, and it's due for replacement, why not have it done and try without the Utrogestan for now?

Also, weaning off your ADs as you are, which one are you on, and are you taking it very slowly? ADs such as paroxetine and venlafaxine need to be tapered very gradually as the withdrawal period can be dreadful. I was on 5mg (yep, half the therapeutic dose) of Paroxetine for 11 years and tried to stop it many times - it ended up taking about three months.

Good luck with it all xx

[lisauk]

Yep - the dreaded Venlafaxine! I am tapering super slowly, but it's still very hard to know which symptoms are that, which are menopause and which are just me!!

I think you ladies are right - I'll probably get the mirena replaced and try without the Prog for a while. Do you definitely get enough prog from the mirena alone though?

[lisauk]

I've just looked at my old blood results and noticed that my estrogen level on this last test is actually lower (on 100 patches) than it was on my previous test (on 50 patches). How can that be?

Does anyone know what it's actually meant to be? My last blood test said 312 pmol/L - is that high or low or ok?

I've upped my patch to 150 now but pretty sure I'm feeling even more brain foggish 😢

[Saffy]

It's possible that you were still perimenopausal when you had the previous test and have now become postmeno, hence the drop in levels despite the increase in patch strength? Is it the same brand of patch?

312 pmol/L is a reasonable level, perhaps towards the lower end but not really low. Some women require much higher levels to manage symptoms and feel good 'though. You could safely increase quite a bit without risking your levels becoming being too high, I would think.

Totally sympathise about the brain fog  . Fairly sure mine is due to too low oestrogen but I don't seem to be able to get my oestrogen levels high enough to combat this. Your symptoms do point towards a lack of oestrogen but could also be exacerbated by the constant progesterone from the Mirena.

[NorthArm]

Hi lisauk

Yes, you will get enough prog from the Mirena alone to protect your uterus xx