Anybody want to read my results? Post menopausal.

[GarlicGrace]

Just got my results back from a Randox blood test. Ideally I'll be able to give them to my GP with some informed comments! I'm finding wild variations in online sources - well, I guess we should be happy Medicine has finally noticed perimenopause, us oldies probably come after ...
Here they are.

Oestradiol <18.4 pmol/l
Reference:
45 - 854 Follicular Phase
151 - 1461 Ovulatory Phase
82 - 1251 Luteal Phase
<505 Post Menopause

Follicle Stimulating Hormone (FSH) 36.0 IU/l
Reference:
3.5 - 12.5 Follicular Phase
4.7 - 21.5 Mid Cycle
1.7 - 7.7 Luteal Phase
25.8 - 134.8 Post-Menopausal

Luteinising Hormone (LH) 19.3 IU/l
Reference:
2.4 - 12.6 Follicular Phase
14.0 - 95.6 Ovulatory Phase
1.0 - 11.4 Luteal Phase
7.7 - 58.5 Post Menopausal

Progesterone 0.80 nmol/l
Reference:
<0.616 Follicular Phase
0.175 - 13.20 Mid Cycle
13.10 - 46.30 Luteal Phase
<0.401 Post Menopausal

Prolactin 204 mlU/l
Reference:
102 - 496

Testosterone 0.910 nmol/l
Reference:
<0.10 Low
0.10 - 1.42 Optimal
>1.42 High

Sex Hormone Binding Globulin (SHBG) 85.30 nmol/l
Reference:
<27.1 Low
27.1 - 128 Optimal
>128 High

Free Androgen Index 1.1
Reference:
<0.19 Low
0.19 - 3.6 Optimal
>3.6 High

All I can see here is that oestradiol looks very low, but progesterone doesn't.
I'm quite pleased about my 'optimal' androgens, as these were high during the reproductive years (PCOS, and I didn't reproduce). I'll be glad of any informed comments.

Can you say why you had this test?

It's just that NICE doesn't advise blood tests in women over 45. Perimenopause is diagnosed only by symptoms. This is because blood tests are inaccurate. They are a snap shot of that minute and can vary throughout the day.

The only relevant one in the above is your FSH which if over 30 usually implies post menopause (but that isn't always accurate either.)

What do you want to happen now you have these results? Is your GP not sympathetic towards menopause? Do you want to use HRT?

Thank you, @JinglingSpringbells. My GP's dragging his heels over HRT - I don't think he's against it, just unconvinced. It's six years since I stopped it and I have other health conditions (ME-CFS, depression, COPD). With the advent of transdermal delivery and more data on that, I think it's worth trying again as the risks are so much less.

My mum has osteoporosis and I've got some collapsing vertebrae in my neck, I'm concerned about CV condition - it seems OK atm but I can't exercise - and there's a chance HRT might help my mental health as well.

I knew the blood test wasn't going to be definitive of anything except menopause, really! I was hoping some stats would help inform my next discussion with the GP. Not sure they will, though.

My mum has osteoporosis and I've got some collapsing vertebrae in my neck,

Oh my goodness.
Have you got osteoporosis in your neck/ back?

This should be enough to prescribe for you.

No one should have to fight for HRT like this.

Just say you have read all the guidance, you are aware of the small risks, but considering family history on bones, you want to go back on it.

If that doesn't work, can you swap GPs or if you can afford a private consultation, do that?

Thanks for the cheerleading, @JinglingSpringbells, I needed it since this has been trailing on for so long!

I do eat prunes, @JudyEdithPerry; I love 'em. And sardines. I take regular calcium, magnesium, D & K2 as well. The one thing all sources agree on, though, is that HRT makes the big difference.

I'm firing up DEMAND mode! 💪

Get a different gp ... surely we don't have to fight for hrt now . Mine practically offered it to me even though I'm 48 and still having periods .

Check out the nice guidelines and go back and see another doctor

Did you have your thyroid, iron and vitamin D checked too? Low levels in any of these can produce your symptoms too, as well as your low estrogen. My private blood test a few years ago highlighted my need for thyroxine, ferrous sulphate, vitamin D as well as HRT.

Ask to see a female GP. I had my coil changed and she told me my cervix was showing signs I was peri menopausal and put me straight on HRT

Check out the practice guidelines from British Menopause Society and the NICE guidelines, take them with you if necessary - hrt should be prescribed on basis of symptoms and age, not blood tests and your doctor sounds woefully uninformed! Take a friend with you if that will help, and have a look at Menopausal Not Mad website, she's brilliant on how to get what you need from a gp appointment.

@GarlicGrace Do you have a diagnosis of osteoporosis- when you said you have collapsing vertebra? Have you seen a specialist about this?

Picking up on a PP comment, about the BMS, this is what they say on that:

Summary

The British Menopause Society Council aims to aid health professionals to inform and advise women about post reproductive health. Osteoporosis affects 1 in 3 women. This guidance regarding oestrogen and non oestrogen based treatments for osteoporosis responds to the controversies about the benefits and risks of individual agents. Treatment choice should be based on up to date evidence based information and targeted to individual women’s needs.

Summary practice points

• HRT reduces the risk of both spine and hip as well as other osteoporotic fractures.

• Oestrogen remains the treatment of choice for osteoporosis prevention in menopausal women, and especially in those with premature ovarian insufficiency.

• Bisphosphonates are effective for treatment of established osteoporosis, reducing both spine and hip fractures.

• Bisphosphonates have a very long skeletal retention time and hence should be used with caution in younger postmenopausal women (e.g. those aged below 65 years).

• Denosumab is an effective treatment for reducing spine and hip fractures in osteoporotic women.

• Denosumab should be avoided in women with increased susceptibility to infections.

• There may be an increased risk of fractures after denosumab discontinuation.

• Provision of adequate dietary or supplemental calcium and vitamin D is a part of osteoporosis management

• The effects of calcium and vitamin D supplements alone on fracture reduction however, are contradictory and may depend on the study population

https://thebms.org.uk/publications/consensus-statements/prevention-and-treatment-of-osteoporosis-in-women/