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Low oestrogen, pre-menopausal. What are my options?(22 Posts)
In recent years (I'm 41) I've been suffering increasingly from fatigue, brain fog (especially just before my period) and mood swings and depression and anxiety.
Determined to get to the bottom of it I've been doing a whole bunch of private blood tests. My thyroid checks out fine, as does pretty much everything else. I probably have PCOS but it's never been officially diagnosed (cysts on ovaries, physical symptoms)
The only thing that stands out significantly is low 17-beta oestradiol (oestrogen, I presume). In my luteal phase it was something like 18 which is well below the value range of 122-1094 by the lab. I just had it done a few days ago on CD5, and it was 96 (below the value range of 98-571 for the follicular phase)
I am SO much more with it before ovulation, it's the only time I can get anything done, and that is presumably when my oestrogen is highest. Although I have a tendency to sometimes go a bit manic then. Clearly there's an issue here somewhere and I am fed up of living my life a slave to my cycle.
My LH and FSH and prolactin were all within range. Just the oestrogen.
For what it's worth, I started taking EPO and starflower oil after the first (luteal phase) low measurement back in February, and my moods and fatigue have improved a bit - it's definitely made a difference, but it's a long way from being enough.
I'm going to go to my GP with this information, but what can I expect or reasonably ask for? Is there anything they can actually do for me?
I'm a similar age with very similar symptoms including increasingly severe menopausal migraines, having read up on my symptoms I thought I could be peri menopausal, having seen the GP I've actually been diagnosed with severe PMS which is apparently not uncommon in women in their 40's in the lead up to menopause. It was absolutely awful but there is plenty that can be done to help, personally, the herbal route did nothing for me but I've been prescribed a low dose oral contraceptive which has made me feel human again, low dose HRT is also an option. Having an understanding GP is essential and you should not have to just put up with this, good luck
You need blood tests at a certain time of each cycle- from days 2-5 of the cycle, two months running.
These should include your FSH.
If you are peri meno at 41, you need HRT for protection of your heart and bones. Low estrogen is a risk factor.
I'd ask your GP to refer you to a gynae who knows about premature menopause, for some proper advice.
Don't bother with EPO- it doesn't do anything for peri meno- it's only use that's effective is for breast pain.
Had an almost identical estrogen reading at a similar age. I tried HRT but it didnt help as it wasnt enough to suppress ovulation (so I was still getting fluctuating levels and all the horrible side effects of this).
I then switched to a very low dose combined contraceptive pill called Qlaira and this has been massively more helpful. The stronger levels are enough to take control of my system - something that HRT didnt do. Took about 4-5 months to have an effect.I liked this pill as it is designed as a 'bridging' pill for people in peri menopause, but isnt as strong as conventional pills.
Once I am more into 'full' menopause, I will go back to HRT (bio-identical, probably patches and Utrogestan for a progesterone).
Check out this site for more info: www.menopausematters.co.uk/forum/index.php/board,5.0.html
Crucial thing is to get a GP who knows their stuff. Dont be fobbed off with 'you're too young' or 'it's all in your head'!
This is worth reading too:
Vitamin B in high dose can help with PMS, my GP once suggested this, and it worked for me. You have to take it for a month at least then keep taking it. You could ask your GP about this. To help with menopause symptoms in general you may enjoy reading Grumpy Old Menopause. Good Luck !
Can I butt in with a similar query? I'm early 40s and peri menopausal and have borderline osteoporosis so keen to increase oestrogen to protect my bones.
GP gave me low dose contraceptive pill (loestrin 20) and I was fine on this ( though still some night sweats). The gynae at the menopause clinic said the pill would not be protective enough for my bones and put me on HRT instead. But I thought HRT was a lower dose than the pill?
Clawdeen My gyne said the pill is stronger than HRT, hence why he swapped me over. I take a combined pill with bio identical estrogen, so it's more similar to HRT levels, but most pills have synthetic estrogen which is far, far stronger than HRT (so higher risks too, though still pretty low). I'm 45 and on it for similar reasons to you - bone and heart health.
I've had similar issues for a while - GP was totally useless, so I did a bit of reading up and put myself on the combined pill which I take back to back.
No more periods, fewer night sweats and my mind is much clearer and I have more energy.
Thank you all - very interesting and helpful!
I do already take lots of B6/B12 - so much so that it was suggested I reduce my supplementation, whoops! I was taking the methylcocobalamin sublingually, and methylfolate too. So it's almost certainly not that.
I'm interested in the combined pill being offered. I was on it in my 20s, but found once I came off it, it was like "waking up" and I hadn't realised how much it had been suppressing things like my libido and general drive to do things. And my personality in general I think.
I also had an unfortunate incident with Microgynon whereby I went seriously aggressive (totally against my nature) and nearly lost not only my future DH but my best friend as well as I basically was so angry all the time. Luckily when I realised the root cause and came off the pill three months later, I went back to normal and they forgave me! Seriously scary though.
So I'm a little wary, which is why I'm interested in your experiences. I've been on no contraception since my late 20s as I've either been TTC, breastfeeding (and not worried about conceiving) or in more recent years, DH has had the snip.
It does sound like the lower dose pills might be an option though as I'm fairly sure I was on the full fat ones back in the day - Marvelon was one I was on for years, and Loestrin I think it was.
Anyway you've encouraged me to go to my GP and see where it goes from there. It's luck of the draw whether I'll get a sympathetic GP though (it's one of those massive practices with about twenty GPs!) so I may have to try a second opinion and ask for a referral if I don't get any luck!
The reason I am on Qlaira is that I couldnt cope with the stronger or more progesterone dominant pills. Microgynon is one of the cheapest and most progesterone dominant, hence the reason it has those side effects on many. (Look where it is on the pill ladder, bottom of this link):
Qlaira is much less potent, but very expensive - so you have to really 'push' to get it!
PS If you get a choice, try to see a GP with a DRCOG qualification. Good luck!
That's very useful and interesting, thank you! Yes, I definitely have an issue with progesterone - I was on it about six months ago to delay my period by a week and it was a real battle to keep my emotions in check. I've also always had big problems with hormonal acne my entire life so it sounds like the right pill could potentially kill a few of my problems here..
Rufus- thank you, that's really helpful. I've been on HRT for a month now and feel dreadful. I know you're meant to give things at least 3 months to settle down but quite frankly I can't face feeling like this for 3 months. Am seeing my GP this morning so will ask to try Qlaira.
GP wasn't much help at all but went to see a gynae ( about a different issue but thought I'd get my money's worth!). She said she liked HRT like contraceptive pills for peri menopausal women and would prescribe me one.
She's prescribed Zoely. When I googled it later at home, I've noticed many reports of acne. I am hoping this is not the case as have finally got clear skin after a course of roaccutane for a life of acne! Fingers crossed.
Had no idea that HRT etc was such trial and error
Zoely is very similar to Qlaira but with a slightly more androgenic progesterone and four blank days rather than two. I'd give it a go, but ask for Qlaira if Zoely affects your skin. So glad you found a gyne who is supportive - shame about your GP. That seems to be a common story.
What dose of B6 are you taking daily, LeftOvercrab?
Very high (and I mean VERY high) doses of B6 can cause neurological problems.
Thank you Rufus, that's really helpful. Much appreciated.
lljkk - 100mg I think. It's high but not super high, and I've been taking similar levels depending on what is on special offer (sometimes it's the 50mg) for over ten years now.
Update - I chose a GP at our surgery who specialises in menopause stuff. I only knew this because I saw in a surgery newsletter that she was doing a talk on it so I figured she'd be good to see! Anyway, she was very reasonable, listened to me and quite happily agreed to prescribe me Qlaira. She says most people don't ask for it, and would have originally suggested Yasmin but was happy for me to try this as I wanted to.
She said to give it three months and come back. I started taking it right away (day 6) with her approval as it's not like I need it for contraceptive reasons. Day 9 now, so not much to report obviously!!
That's good news! Yasmin is stronger, more synthetic and has a slightly higher risk than Qlaira. I wanted to take it as it has a good tolerance rate, but wasnt allowed to due to having migraines and my age. Good luck with Qlaira. I did have some initial side effects (itching being the one I remember most!) but things improved after three or four months.
Thank you! I'll give it a good few months to see how it goes unless it's clear it's seriously disagreeing with me. I've become so in tune with my body and moods due to trying to work out what's up (and life experience!) so I'm hoping I won't have a repeat of the Microgynon episode if it doesn't work out!
Meant to add, as it's such a low dose, you may get spotting for a few months. Again, it clears up. I now get no bleed at all, which is an added bonus! d
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