Don't know how I have been functioning.

by Ashley
(NM)

Hi Wray,
I told the beginning of my story in my post, "Severe PND and anxiety" a few weeks ago and I finally got my test results back and wow, they really confirm why I have felt so horrible. My estradiol was 1.79pg/ml, which is at the lowest of the range, but my progesterone is at a 75.97pg/ml and the range is 127-446. The results said my Prog/E2 ratio is at 42.44 and it should be 200-600. I can't believe my levels are so low and it is scary for me to think how I am really at risk for all sorts of cancers being in such an estrogen dominance mode. At the same time, however, I think I am low on estrogen too since I get night sweats, super light periods and many of the other common symptoms of low estrogen too. So, could it be that I am estrogen dominant but with low estrogen? Is there such a thing?
I have been studying a lot about hormones and a lot of the literature I read says estrogen should be around 50-150pg for women to feel good, but yet on a lot of reference ranges from these hormonal tests, the ranges are between 1.0-10.8pg so I am confused. In your experience what should estrogen levels be at? I am only 31, almost 32. I know that you have said that progesterone levels should be 600:1 so does that mean 600pg to 1pg of Estrogen?
I can't believe with these levels that I have been able to conceive and carry two babies to term with these low hormones. Please help me! Thank you in advance for your help and all your wisdom you have shared on this website.

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Dec 20, 2012
Don't know how I have been functioning
by: Wray

Hi Ashley I've just had a look through your comments, if you want the link to the page it's here. We do have a page on Hormone Testing you could look through. It appears you had a saliva test, am I correct? I'm not sure which lab you used, but the reference ranges I have, taken from ZRT Labs which are one of the best, differ from yours, see ZRT Labs. For instance their range for a premenopausal woman is 1.3-3.3 pg/ml, which means your level is normal. Their progesterone range is 12-100 pg/ml for the follicular phase, and 75-250 pg/ml for the luteal phase. You don't say when your test was done. It's pointless testing for progesterone in the follicular phase as levels will always be lower. The test should be done ±7 days after ovulation or before bleeding, i.e. at peak mid-luteal phase. As you've found, reference ranges vary, which is why I stick with ZRT, they have done a huge amount of research too, they don't just do blood or saliva tests. Their oestradiol range for a premenopausal woman is 30 - 400 pg/ml, as you can see a huge range. But the critical factor is not the level of a hormone, it's the ratio. A woman could have both progesterone and oestrogen within normal range, but if progesterone is low normal and oestrogen high normal, all hell will break out! The 600:1 I give is based on Saliva Tests we run. In a saliva test progesterone and oestrogen is measured in pg/ml, so yes it's 600pg to 1pg. Your low hormones are due to just having had a baby, nothing to do with your levels prior to having one. They always drop after birth. But progesterone drops from a great height to very low, oestrogen doesn't. This sends many women into PND. Continued below

Dec 20, 2012
Don't know how I have been functioning Part 2
by: Wray

Hi Ashley You might like to see the paper here, also done by ZRT Labs. You'll notice progesterone drops from 1441.05 to 17.38, whereas oestradiol drops from 32.69 to 1.39. Doctors believe that Hot Flushes are due to a drop in oestrogen, but from the literature I've found this doesn't seem to be the case. Blood lost during normal periods varies from 10 to 80ml, the average being about 35ml. 10ml is only 2tsp, which could be the amount you loose, but still within the normal range. You say you have other symptoms of low oestrogen, take a look through this page on Hormone Balance to see if you can pick any out. You can't have both excess oestrogen and low oestrogen. I think quite possibly the 'low oestrogen' symptoms you've been given are in fact low progesterone. Thanks for the kind words about the site. Take care Wray

Dec 21, 2012
how much progesterone cream to use? and when to use?
by: May

Hi Wray,

Estradiol.. 207 pmol/L or 56.3 pg/mL
Progesterone...0.71 nmol/L or 0.22 ng/mL
FSH ....5.6 IU/L
LH... 3.84 IU/L
Prolactin ... 0.86 nmol/L or 10.77 ng/mL

So, im estrogen dominant?

For this kinda readings,
How much progesterone cream to use?

Dec 21, 2012
how much progesterone cream to use? and when to use?
by: Wray

Hi May I've answered you on the other page you wrote. The link is here. Take care Wray

Mar 14, 2013
Estrogen dominant?
by: Jackie

Hello I'm hoping you can help me,

My saliva test results show my estradiol is 5.3 pg/ml and progesterone 319 pg/ml and testosterone 59.3 pg/ml. Which I guess would put my P/E ratio at 60.19?

My symptoms are: horrid migraines all the time, which are worse around ovulation, before menstruation and as menstruation is ending. I have lost so much scalp hair, around 1/3. I have had two utis in last 3 months. I have constant recurring bacterial vaginosis which occurs every time I have sex. I also bleed during sex and have to take it slow as its painful, almost like a sharp pain when he penetrates completely.

I'm 26 years old and all my symptoms began after stopping the birth control ortho tri cyclen a year and nine months ago.

I'm working with a natural doctor who has me taking chasteberry with some black cohosh in the formula. It has helped only a little. I can't afford to keep seeing her as my insurance doesn't cover her, but she also doesn't seem to know much about hormones, all she's really suggested is going gluten free.

Again, I hope you can help me. Thank you for your time.

Jackie

Mar 16, 2013
Estrogen dominant?
by: Wray

Hi Jackie Your ratio is low, we've found from Saliva Tests it's best if it's over 600:1. Your testosterone is on the high side, levels range from 18-55 pg/ml, this would not be helping either. Progesterone is excellent for Migraines. Adverse symptoms can occur at ovulation too, oestrogen peaks then, progesterone should too. But if it doesn't things can become very unpleasant. It does help Hair Loss, as do a number of nutrients. Oestrogen also exacerbates any vaginal infection. D-mannose is sometimes effective. It's believed that the bacteria, if present, will adhere to the D-mannose and be excreted. A more likely explanation is the lining of the urinary tract, including the bladder, has become damaged by inflammation. The lining is a thin layer of glycoproteins, these are a combination of a sugar molecule and a protein. The D-mannose can be used for glycoprotein biosynthesis, see here. This would strengthen the lining preventing possible attack from bacteria or inflammation. The amino acid arginine can help too, see here. Mast cells are implicated, see here. Progesterone inhibits mast cell secretions, see here. Excess oestrogen and a lack of progesterone appear to be a reasonable cause, see and here. Oestrogen is an excitatory, inflammatory hormone, it's involvement is hardly surprising. Particularly when looking at the statistics, far more women get UTI's than men. Interestingly oestradiol increases mast cell histamine secretion, which is initiated by substance P. This is a pro-inflammatory, nociceptive neuropeptide. Continued below

Mar 16, 2013
Estrogen dominant? Part 2
by: Wray

Hi Jackie Even more interesting, progesterone and it's metabolites are suppressed by substance P, see here, unless sufficient is used, see here and here. I've found too many women suffer after stopping Contraceptives. Both the herbs you are taking are oestrogenic, I don't think you need more oestrogen. Although their influence is minimal, they are still oestrogens and over time can have an effect. Going gluten free would mean you would avoid all the grains, which is a good thing. These supply carbs to the pathogens, plus disturbing gut flora. We do have a page on Candida you could look through. Although about a fungus, the page does give advice on what you can take to help, and food to eat. If you do try progesterone, I think you'll need at least 200mg/day, possibly more. Vaginal application is helpful, although the cream can sting initially due to the inflammation, progesterone is an anti-inflammatory which will eventually help. There's more info on our page How to use progesterone cream. You also need probiotics to suppress the pathogenic bacteria. Take care Wray

Mar 17, 2013
Follow up question
by: Jackie

Thank you so much for your response Wray. I wanted to ask some follow up questions. 1) do I buy normal progesterone cream and insert the 200mg you suggest vaginally? 2) according to zrt lab references both my estradiol and progesterone levels are high, why would that cause the bv/uti? I thought estrogen was good for the vagina as it thickens the walls making them less prone to infection? 3) do you think my high level of testosterone is causing my hair loss? Would going a sugar free diet help lower my testosterone levels?

Thanks again for all your help Wray

Mar 18, 2013
Follow up question
by: Wray

Hi Jackie I prefer the cream having tried suppositories before. The added benefit is they can be applied anywhere, the suppositories can't. Progesterone is excellent if applied directly to any sore spot, under the ears and on the neck for migraines, minor wounds, piles etc. It should be used a minimum of twice a day as levels begin dropping after about 13 hrs. So you could apply some of the cream in your vagina, best at night as it leaks during the day, and the rest on your skin. It's not the level of hormones that are critical, but the ratio, yours is low. We do have a page on Hormone Testing you could look through. Oestrogen is a mitogen, so does cause cells to proliferate, so would increase cells in the vagina. But it's also an excitatory inflammatory hormone, plus increasing the glycogen content of the vagina, and this encourages bacterial/fungal growth. Please look at the papers on the pages I gave you, it's on those. Your testosterone is high, and yes it does increase scalp hair loss. Progesterone does reduce levels. If bound to SHBG (sex hormone binding globulin) testosterone becomes inactive, progesterone raises levels of SHBG, see here, so preventing the rise of free testosterone and severe PMS. SHBG drops if sugars are eaten, even those found in all grains, legumes, processed milk and sweet starchy fruits and vegetables. Fructose, sucrose and glucose, reduce SHBG by 80, 50 and 40% respectively, see here. Thereby allowing testosterone to rise. It's best to avoid all the foods and sugars mentioned. Wine and beers contain carbs, so it's best to avoid those too. Plus alcohol affects hormone levels in women, see here and here. It decreases progesterone levels and increases androgen levels, both the total testosterone and free testosterone become higher. Testosterone is notorious at increasing visceral fat, which causes abdominal fat gain, see here and here. The lowered progesterone, higher testosterone probably accounts for the increased risk in breast cancer risk among women, see here and here. Continued below

Mar 18, 2013
Follow up question Part 2
by: Wray

Hi Jackie Higher testosterone is also associated with an increased risk for Insulin Resistance and heart disease, see here. Sugars and large meals also drop progesterone levels, see here. Plus insulin drops levels too, see here. This means SHBG also drops, testosterone rises, another vicious cycle. Incidentally if testosterone is high, oestrogen generally is too. All our oestrogen comes from the conversion of any testosterone we make. A sugar free diet would help greatly. We do have a page on Nutrition you could look through. There are links to three excellent ways of eating. There's another you could look at, not on our site. It's called the Ketogenic diet, and in it's strictest form is very difficult to adhere to. But this is usually only used for people with epilepsy and cancer, which it does help. The reason being it reduces glucose levels to the barest minimum, and the body uses ketones for energy. It's a very high fat, moderate to low protein and very low carb. Only the good fats should be used, i.e. MCT oil, coconut oil, butter, olive oil or macadamia oil. The first three are saturated fats, the other two mono-unsaturated fats. The best is the MCT oil, an extract from coconut oil. The body converts the fatty acid into ketones, in fact the brain does better on these than glucose. MCT oil forms ketones more efficiently than the other oils. The diet varies from a 4:1 ratio of fat to protein/carb down to a 1:1 ratio which is the easier to follow. The best and clearest explanation I've found of the 1:1 is this web site on the Basic Ketogenic Diet. Take care Wray

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