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[Betsy72]

To start, I am waiting on a call from the Dr to discuss these, it's just that the wait is making me crazy.
In September of 22, I went to the Dr complaining of fatigue so she ordered bloodwork. Never really discussed them with me but I looked them up...
LH 43.7
FSH 54.4
Estradiol 32.7
Now, I've seen a new doctor because the other left the practice. I've gone in because of hot flashes, night sweats, and increased exhaustion. My numbers were drawn again on Monday and I'm waiting on that call.
LH 17.2
FSH 31.1
Estradiol 15.9
I am 52 and I have a mirena which stopped my periods about 5 years ago.
Any thoughts?

[Nas]

You are probably low in oestrogen, given your symptoms. Maybe discuss HRT options if that is a route you wish to take?

[bombsh3ll]

Your body is screaming for estrogen, hence the symptoms you describe.

I don't understand why these blood tests were done at all let alone twice unless it was to determine the need for ongoing birth control if you are considering removing the IUS.

Menopause is a clinical diagnosis if you are in the appropriate age group, which at 52 you are.

Your second FSH although lower is still considered menopausal by most authorities. Numbers can fluctuate between tests but this is not significant.

Estradiol, although I am not clear if units are in pmol/L or pg/ml, is on the floor.

I would not be worried about removing your IUS from a birth control perspective.

It can be left in for longer but after 5 years should not be relied on as the progestin if you start hormone therapy. 

You are unlikely to bleed again with such low estradiol and having your lining thinned over many years with the IUS, although this is not an absolute.

Obviously it's a personal decision but in your shoes I would not be ending that call without a treatment plan, which in the absence of any contraindications should include hormone therapy.



 

[Betsy72]

Dr just called, said there's nothing in my bloodwork to explain the way I feel. I think I'll follow-up with my gyn. Maybe switch gp's.

[sheila99]

Are you in the UK or elsewhere? Here they should go on symptoms though sometimes you need to point out the blindingly obvious (I went with meno symptoms, mostly regular periods, aged 56. They still didn't consider meno). Might be worth asking if they have a doctor or nurse with an interest in meno who might be more clued up. If not I'd strongly advise you to see a meno specialist not a gynae as many are clueless about meno.

[Betsy72]

I am elsewhere. Just so frustrated.

[bombsh3ll]

is it possible for you to make an appointment with a menopause specialist?

I don't know where you live but most countries have a list of approved menopause specialists, and that is probably the best way to get your symptoms treated appropriately.

Telemedicine is becoming increasingly popular too so some clinicians will see people online who live too far away to travel, and in many cases can still prescribe treatment.

Yes you might have to pay out of pocket for it - sadly that's the case in many countries including the UK, but if you aren't well you can't enjoy any of the other things in your life, so for me at least, health is a priority.

[Betsy72]

I got in with gyn for this coming Wednesday but if no help I'll definitely be looking into a specialist. I have made a list of everything going on with me that could be related and I'm surprised at just how much!

[bombsh3ll]

It may be helpful if you print off and complete a  menopause symptom questionnaire such as the Green climacteric scale or similar that you can hand to the doctor at your appointment.

Also be direct about what you want - often patients beat around the bush and expect the provider to guess what they want.

The patient doesn't bring up hormone therapy, and the doctor either doesn't consider it or believes that most women don't want to take hormone therapy so they don't bring it up either.

I would go in and say something like "I am menopausal, these are my symptoms, and I am here to discuss hormone therapy".

If you also have any concerns about osteoporosis for example a family history or any personal risk factors, I would state that too.

That way you haven't wasted any time and you are both starting off on the same page.

If it is outside the scope of their practice, you could maybe ask them for a referral to someone specialising in menopause care.

[joziel]

Betsy if you're in the US, look into either Defy or Elevate - both tele-med providers who can prescribe to most States via online consults and who are 'up' on menopause care.