Low estrogen and normal progesterone

by Rosemary
(Littleton, Colorado)

I have been dealing with what I believe is hormone imbalance for quite awhile maybe even 10 years. In the past year and a half I have been on a roller coaster with high levels of estrogen and testosterone and fairly normal levels of progesterone. Now my last 2 labs have shown low estrogen but normal progesterone and I am no longer taking testosterone.

I was given troches to take for the estradial and I got worse with breast tenderness and aches and pains but it still showed low estrogen levels. She told me I could stop the estrodial or maybe just use a cream once a week. I am on a low level of progesterone cream of 45 mg a day and she says (my PA) that is a good level. My breast tenderness went away when I stopped the troches but aches have not and mood problems with depression and anxiety and not sleeping enough.

My question is, could I still need more progesterone even though my estrogen is low? I just want to get rid of these symptoms and am not sure what to do. Thanks.

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Low estrogen and normal progesterone

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May 22, 2011
 Hormonal imbalance
by: Anonymous

Have you had your cortisol tested? Saliva testing is the only accurate way to test. Blood serum will show normal if they are low. You can do some things naturally to restore balance with hormones if you don't respond well to supplemental hormones. Look at trying some of the supplements on www.womentowomen.com. They know more about hormones than anyone in the country.
May 25, 2011
 Low estrogen and normal progesterone
by: Wray

Hi Rosemary The roller coaster sounds as if you are in Peri-menopause. This is a difficult time for many of us, it was for me. Or possibly you are now in Menopause. I don't believe any women needs more oestrogen, certainly not oestradiol the most potent of the three oestrogens. It's an inflammatory hormone, hence the breast tenderness and aches. I'm not sure of your age, but levels should be dropping as we get older. And as for giving a woman testosterone, this is not what we need, see here, here, here, here, here here, here, here, here, here and here. I do believe you would be helped with more progesterone. I recommend 100-200mg/day, dependant on symptoms. But if you consider increasing the amount, please read our page on Oestrogen Dominance first, as this can occur. Take care Wray
May 25, 2011
 Low estrogen and normal progesterone
by: Rosemary

Thank you Wray, as for your questions about my age, I am 60 years old so am actually post menopause. Is it possible for blood work to show low estrogen and stll have estrogen dominance? Prior to the last blood work I had high estrogen for about 1 1/2 years so it just now came down to low. I think my body has been out of whack for awhile. I did order the Natpro and will try taking more estrogen as my doc only has me on 45 mg a day. I know I will not feel good for awhile but hopefully will be worth it Anymore insight would be appreciated. Thanks.
May 26, 2011
 Low estrogen and normal progesterone
by: Rosemary

Hi again, I noticed in my last comment, I said I would try to take more estrogen and I did not mean that I meant progesterone, I have stopped taking the estrogen and having a lot of issues so I am thinking I need to increase the progesterone. My head feels kind of wierd and suffering from depression, body aches, etc. Thanks.
Jun 03, 2011
 Low estrogen and normal progesterone
by: Wray

Hi Rosemary Knowing your age does help. Oestradiol should be low post menopause. But it's not so much the amount of each hormone, but the ratio between the two that is critical. We've found from Saliva Tests we run, that the progesterone to oestrogen ratio should be 600:1 and over to feel well. Do you have your results, you could check this out if you do. I did think you meant progesterone and not oestrogen! Unfortunately you would get those symptoms stopping the oestrogen cold turkey. It's not dangerous just unpleasant. If you prefer to reduce it slowly, whilst using a higher amount of progesterone, you could go back on it. We do have more info on our page Coming off HRT. But if you're happy to stick it out, I suggest you use a high amount initially, maybe 150-200mg/day progesterone. This should help to overcome the symptoms more quickly. Something I see I forgot to ask you to do and that's to have a vitamin D test done. Most of us have too low a level, and it's such a vital nutrient. Plus a lack reduces the benefits of progesterone. It also helps depression. For more info see the Vitamin D council and GrassrootsHealth websites. Take care Wray
Jun 07, 2011
 Started bleeding while in menopause
by: Rosemary

Hi Wray, It is me again, thank you for your response, I have a question as I quit taking the bioidentical estriol and estradial about a month ago and have just been taking the progesterone. My PA had me on low dose of progesterone 45mg a day and I ordered your Natpro and have probably been taking that along with the compounded progesterone about 150 mg a day. Well a couple of days ago I started bleeding and I have been in Menopause for 12 years with no periods at all, is it part of the estrogen dominance after all these years that I could start a period. Am I taking to much or should I take more? Thanks.
Jun 07, 2011
 progesterone therapy and menopausal bleeding
by: Rosemary

Hi Wray, I sent this earlier but I don't think it went, thank you for your prior response, I now have a new problem hoping you can answer. I mentioned that I went off the bioidentical estriol and estradial about a month ago after being on them many years, I am now doing the low dose of progesterone that my PA gives me of the compounded 45 mg a day. I ordered the Natpro and started taking that with my other so I getting probably about 150mg a day now, so yesterday I started a period and haven't had anything like that in 12 years, could this be from the estrogen dominance and progesterone therapy? Should I take less or should I take more, a quick response would be greatly appreciated. Thanks.
Jun 21, 2011
 Started bleeding while in menopause by: Rosemary
by: Wray

Hi Rosemary Well your first query did come through. I'm sorry I can't answer quickly, too many queries now. Bleeding can occur in the first year of menopause, I've not heard of it 12 years later! I don't think there's any cause for alarm. We still make oestrogen in our fat cells to the day we die, however few or many we have. This is sufficient to build the lining, but as we are no longer ovulating in Menopause, there's no progesterone to cause the shedding. So I believe your lining has built up over those years, and has not been absorbed back into the body as it normally is. Using the progesterone would have caused shedding. If the bleeding is still continuing, I've found 400mg/day progesterone is needed to stop it. Please let me know how you get on. Take care Wray
Jul 06, 2011
 Progesterone dose hard to figure out
by: Rosemary

Hi Wray, Thanks for your last response to me, update on the period after 12 years, I had it the once and that was it but, of course my PA that I see said I should have an pelvic ultrasound so I did but haven't heard anything and it has been a couple of weeks. I don't think it will show anything. I am still having a lot of issues, I have been off the estriol and estradial now for about 2 months, but did not start taking a higher dose of progesterone till about 4 weeks ago and have gradually been going up. I think I am taking about 300mg right now, but I still have body aches, headaches, kind of wierd feelings in my head, high blood pressure, diarrhea a lot as I have anxiety and depression being the symptom I would like to get rid of most of all. I did read your info on depression, I don't do well taking tryptophan and have tried tyrosine but not much difference, is it normal to be taking this long and still having estrogen dominance symptoms? I don't think I mentioned that I have hashimotos and take a compounded thyroid pill for that and I know that can cause a lot of issues as well. I have read Dr. Michael Platts book on bioidentical hormones and thought it was great. I know sometimes he thinks a person might need a little testosterone or DHEA but you say you don't.

Any help would be appreciated as to what I can do to help alleviate some symptoms, I also take 5,000 IU of Vitamin D. My last blood test results were Estradiol 12.8pg.ml, progesterone 5.7ng/ml testosterone 20ng/dl, FSH Serum 24.9 mIU/mL. In the past my estrogen has been much higher and same for testosterone. About 6 mos ago tests were: Estradial 45.7pg/ml, Progesterone 3.1 ng/ml and testosterone 82. So I seem to be all over the board but for years now my estradial was always higher than progesterone. Sorry for such a long comment. Thanks.
Jul 06, 2011
 Also hair loss
by: Rosemary

Hi Wray, One think I forgot to mention is that I also started having hair loss about 4 weeks ago and it is getting worse every week. Would that be from all the changes in my hormones or what Thanks.
Jul 11, 2011
 Very anxious
by: Rosemary

Hi Wray again, I know I haven't received a comment on the other comments I made, but everything seems to keep changing for me so here is another question. I have been feeling very anxious and am having some palpitations and high blood pressure and diarrhea. Sometimes I feel I feel that way after taking the progesterone cream. I have been doing the higher doses of about 250mg every day sometimes more, I have been doing the progesterone therapy for about 6 weeks gradually going up so I have been at this level for about 3 weeks. I don't know if it is the progesterone or if it is affecting my thyroid (hashimotos)that is making me feel this way but it is very uncomfortable and I am concerned about the high blood pressure, I would love to get your thoughts on what is going on. Still having muscle aches and some headaches and depression. Thanks for any comments.
Jul 14, 2011
 Progesterone dose hard to figure out
by: Wray

Hi Rosemary I'm answering your three queries in one. I'm pleased that the period was the only one, I would have been surprised if you'd had more than two. I have found possibly one more can occur after the first. Your ratio is quite good, at 445:1, although I think it could be higher. I gave you the saliva tests page, you'll see from that that the ratio of progesterone to oestrogen ranges from 600:1 to over 1000:1. Pity you didn't respond well to tryp, were you taking it with some carb and at night only, as I instruct on the page I gave you? Dr Platt is so good, in fact he uses Natpro for his patients. But quite possibly he hasn't seen the studies on DHEA or testosterone yet. I'm pleased you're taking 5000iu's vitamin D per day, but have you had a test done recently? Thyroid problems often indicate too low a level of vitamin D, so possibly the 5000iu's is not sufficient for you. Please have a test. The hair loss would be due to the changes. Unfortunately all your symptoms point to oestrogen dominance. Ironically testosterone increases before oestrogen, as progesterone is first converted to testosterone, before the oestrogen conversion. So rising testosterone would cause the hair loss, it should stabilise soon I hope. Oestrogen is responsible for the high BP, it causes constriction of the smooth muscle which surrounds blood vessels. Progesterone on the other hand is a vasodilator, see here and here. I'm running out of space, so will start a new comment below. Take care Wray
Jul 14, 2011
 Progesterone dose hard to figure out
by: Wray

Hi Rosemary Oestrogen also causes prolongation of the QT interval, which results in palpitations, arrhythmia and Torsades de Pointes. Whereas progesterone shortens the QT interval, see here, here, here, here and here. So your symptoms all point to excess oestrogen in ratio to progesterone. Please read these comments from users of high amounts of progesterone, I hope they would encourage you to persevere, see here, here, here and here. Take care Wray
Jul 14, 2011
 Muscle aches
by: Rosemary

Hi Wray, Thank you for your reply, it is always a relief to hear from you or I feel like I am on my own. Last time I had my Vitamin D checked (back in Dec.), it was 61, so it could be higher but I am out in the sun more now also. I did start adding more progesterone but it seems I always feel worse when I do that. I have been having really bad muscle aches all over. I am confused as you said my ratio of progesterone to estrogen was pretty good but could be higher. Would it still be causing all of these symptoms?

I am feeling more fatigued also. I know that I have probably been estrogen dominant for many, many years and I think it took its toll on my body (if I had only known). Also, in reading all the comments from other people on their symptoms, no one seems to have digestive issues. Is that part of the estrogen dominance, I get diarrhea, loose stools a lot and sometimes burning in my stomach. I have been trying to eat pretty healthy, but not always. As for the tryptophan, I did take it at night 500 mg and tried to eat a carb. I would like relief for the depression, I am hoping the progesterone will do the trick. Thanks for all your help and everything you do to help women. Thanks.
Aug 16, 2011
 High cortisol
by: Rosemary

Hi Wray, the last post I sent was quite awhile ago and I think maybe you missed it, anyway it is the one above this one. I have some more questions.

After visiting my PA recently, she had done some tests, the pelvic ultrasound showed that my uterus lining was thin and she said that is a sign of low estrogen, she thinks I should go on a low dose of estriol and small dose of testosterone as that was borderline low. Also, my adrenal saliva test came back with me having high cortisol and she is having me take phosphotydlserine, she switched my thyroid (hashimotos) back to Armour after being on Westhroid. I also am now taking 100mg of troche progesterone. I still add some of yours. Still having issues of low energy, and some muscle aches but somewhat better. I am concerned about the high cortisol as I have been having the high blood pressure, along with depression, digestive issues and anxiety.

Any input would be appreciated. Thanks.
Aug 19, 2011
 Muscle aches
by: Wray

Hi Rosemary I don't understand how I could have missed your post, so sorry! You are having a tough time, but it seems there's more to it than just a progesterone issue. Has anyone checked for coeliac disease? This is more often than not found together with thyroid problems, see here, here, here, here, here and here. Some of your symptoms fit too, please have this checked out. Although your vitamin D is a good level, it could be higher. Vitamin D is vital for a healthy gut, see here and here. Please increase the amount you are taking, and see if that helps. It can take time, so don't expect a quick fix. And please have another test done. It should be done every six months to be on the safe side. As I told you, vitamin D is also important for the thyroid too. And don't give up on the aminos, I've found tryp can take up to 6 months before relief is found. Oral progesterone, into which I classify troches, is the least effective Delivery system. Much of the troche is swallowed, so you are getting little benefit. Did I give you our page on Insulin Resistance? This could explain the fatigue, although I think that's due to your gut problems. You're not getting sufficient nutrients into your system. Please get checked for coeliac disease, and let me know. Take care Wray
Sep 06, 2011
 Body temp.
by: Anonymous

Thanks Wray for your last comments, I have a few more concerns. I see my PA later this month and will ask about Celiac test, I did have a stool test a few years ago and said I was borderline gluten tolerant but no mention of celiac so don't know if they tested that.

Anyway, I have a question about body temp, I know progesterone affects that and mine has been staying up for about 2 or 3 months now and sometimes goes up to 92.0. Is that normal and is affecting my hashimotos, I feel like when I take my Armour thyroid, my temp goes even higher. Could the progesterone have anything to do with it, I don't know if means I don't need as much thyroid. Normally, my body temp is on the low side because of hashimotos, do you have any idea what could be going on.

Thanks for your help.
Rosemary
Sep 27, 2011
 lab work
by: Rosemary

Hi Wray, I think you missed my post again from about 3 weeks ago, it does say anonymous but it is me. I did get labwork back for my hormones. She said my progesterone is 4.0 ng and my estrodial is 10 pg. That seems like that is a 4 to 1 ratio, she says my estrogen is to
low and it certainly appears to be. She prescribed some estriol 1.8 and estradial .2. 60 mg progesterone but I add some of the natpro to that so I am taking probably between 100 and 150 mg. She thinks my progesterone is good but I don't understand why she would lower the dosage as I was taking 100mg of troches, I had her give me the cream this time as I didn't like the troches and I remember you said they are no
good.

What do you think of pellets? I have been reading some info on those and they seem to be pretty good. I feel like my body must need some
estriol as it is so low. I have been having a lot of hairloss since June and not getting better, that is about a month after I stopped my estrogen, so it seems like I need it. My testosterone level is not high, it is more on
the normal low side. Just wanted your opinion on this and also my previous post. Thanks.
Oct 05, 2011
 Body temp.
by: Wray

Hi Rosemary For some reason I miss your posts! I'm puzzled you say your temp goes up to 92, as the average body temp is about 98.4. But it depends on where the temp is taken too. The range of human oral temps varies from 92 to 101 °F. But to answer your question, progesterone is thermogenic, ie it does raise temps very slightly, from 0.2 - 0.9 °F, which means it also increases metabolism slightly. So it does help the thyroid. The ratio between your progesterone and oestrogen is 400:1, the progesterone is measured in ng/ml and the oestrogen in pg/ml. A ng is 1000 times greater than a pg, so you have to divide the oestrogen result by 1000 to bring it to ng, and then divide. This isn't a bad ratio, although we've found it's better if over 600:1. So no your oestrogen is not too low, as it must be viewed as a ratio to progesterone, it's not the actual level which is critical. In other words you need more progesterone and no more oestrogen. Particularly oestradiol, see our page on HRT. You ask about pellets, I think you should read these comments here and here before using them. Hair loss is not caused by lack of oestrogen, but excess testosterone, and it's the free testosterone which is important, not the bound. Take care Wray
Oct 06, 2011
 Body temp
by: Rosemary

Hi Wray, Thank you for your response, I don't know what happens when you miss my post, hopefully you will get this one. I definitely put in the wrong temp on my previous post, it should not have been 92, but 99.0. The more progesterone I take, the higher my temp goes and I also perspire which I don't normally do. So that is what I was asking if that is normal.

Also a question on your comment I dont understand if the estrogen is so low, what if it showed 0.00 estrogen even if progesterone is ok, are you saying you would still not need it as I know we need some estrogen? That would mean I have none wouldn't it? Thanks for all your help.
Oct 19, 2011
 question on estrogen
by: Rosemary

Hi Wray, I think you missed my last post again. Hopefully you will see this one as I do want to know about the body temp and estrogen levels if they get to 0.00 meaning you don't have any even if the progesterone is ok. Is there ever, ever a need for any estrogen or testosterone if the levels are flat? Thanks.
Oct 21, 2011
 Body temp
by: Wray

Hi Rosemary It really is most bizarre that I keep missing your posts! Thanks for giving me the correct temp. I was really puzzled how it could go 'up' to 92, when that is the lowest within the normal range! Progesterone is thermogenic, so does increase temperature, so yes it is normal. I mentioned it went up by 0.2 - 0.9 °F. I have never come across anyone who has 0.00 oestrogen. Our fat cells make it, particularly after menopause. But it's oestrone they make, and this is never tested for, only oestradiol, which is the pre-menopause oestrogen. Oestradiol should be low after menopause. It varies from 0 - 30 pg/ml, see Medline Oestradiol. Oestrone is about 30 pg/ml, see BNET Menopause: Understanding the reproductive cycle and Medscape Menopause Take care Wray
Apr 21, 2012
 Oxytocin
by: Anonymous

Hi Wray,
As you can see it has been awhile since I made any comments. I have a question about Oxytocin.
My doctor prescribed me this a few weeks ago using it to help my moods. He says it has helped some of his patients. I am taking about 200 to 300 mg of progesterone. My doctor still really thinks I need a little estrogen, can't seem to change their mind on that but I obviously don't have to. Any comments would be greatly appreciated. I have had issues with high cortisol and adrenals just not being quite right.
Apr 23, 2012
 Oxytocin
by: Wray

Hi Rosemary Well at least this time I saw your post in time! I'm puzzled why it's taking so long to resolve your issues, there's obviously more than a lack of progesterone behind them. Did you ever get a vitamin D test done? I know you were taking 5000iu's per day, but it could be you're not absorbing it well. Particularly as you had problems with your gut. It's so important for the gut too. And did they check for the celiac disease? If your cortisol is too high, please take zinc, about 15-45mg/day, this does reduce it, see here and here. I've heard magnesium can help too. This is generally low in our food, and it's the most important co-factor for vitamin D. Please take a look at this site on Adrenal Fatigue. Oddly enough sodium can help the adrenals too, are you taking enough salt? I have no experience with oxytocin, other than knowing it's called the 'love hormone'! It is partly responsible for the contractions we get during labour, also contracts the milk ducts when breast feeding. Seems it could be involved in the contractions of orgasm too. I would be most interested to hear if it helps you, as progesterone suppresses it! It rises just prior to giving birth, due to the dropping progesterone levels. It's not until after birth when progesterone has dropped substantially that oxytocin comes into it's own, and breast feeding commences. Do let me know if it helps, I'm fascinated. Take care Wray
Apr 23, 2012
 Thanks
by: Rosemary

Hi Wray,
I will let you know on the Oxytocin, I have read that it does help with moods. As for the Vitamin D, the last it was checked it was 70 which they say is good, I think it could be a little higher so maybe I should take more. As for my gut, my doctor thinks it is more of an adrenal problem.
I have got that calmed down somewhat, my doctor
is doing T-3 therapy only as I have a high reverse T-3 and it has come down a little but needs more so he says when we get that down, it should help my thyroid to work as it is suppose to. My gut problems have also gotten better. The last time they checked my hormones about 2 months ago, my estrogen was to high so I know that was causing some issues, anyway I am taking the higher dose of progesterone and hope it will help.
Thanks
Apr 24, 2012
 Mine is different - yet the same
by: Wray

Hi Gayle It's unfortunate, but what you say echoes most people's experience. Many now turn to alternative therapies, which often help, and at least do no harm. I do understand your feelings about Hot Flushes having had them. Luckily I found progesterone, although I have since learnt that about 400mg/day is needed to stop them. I don't believe any woman needs more oestrogen in any form, for more info see our page on HRT. Progesterone is protective against clots, see here and here. So too is vitamin D, see here, here, here and here. You live in Seattle, you're not getting enough sun to make vitamin D, please have a test done. For more info on vitamin D levels, test kits etc see the Vitamin D Council, GrassrootsHealth, Birmingham Hospital and Vitamin D Links websites. Blood levels should be 70-100ng/ml or 175-250nmol/L and not the 30ng/ml or 75nmol/L most labs and doctors regard as adequate. The minimum daily dose should be 5000iu's per day, although the latest research indicates it should be 10,000iu's per day, see here. Take care Wray
Apr 24, 2012
 Thanks
by: Wray

Hi Rosemary I'm pleased your doctor seems to know what he's doing. rT3 is very rarely checked for, and it inhibits T3. Your vitamin D level is good, surprising as too many have very low levels. It wouldn't harm to get it higher, as it does help the gut. I'd be interested to hear if the higher progesterone does help, and whether the oxytocin does too. I hope things resolve soon for you. Take care Wray
May 09, 2012
 Hair loss
by: Rosemary

Hi Wray,
As you can see from all my posts, still dealing
with issues, it probably is my fault as I keep
changing things. Anyway, the doctor I see I really like but he did have me taking bioidentical estrogen along with the 200 mg of
progesterone. I decided once again to try and go off the estrogen, I have done this several times and everytime I go off of it, my hair loss gets horrible, if I start up on the estrogen again, it gets better, what are your thoughts on it? The first time, I stayed off for 6 weeks, and this time I have been off of it for 3 1/2 weeks. I can't help but think, it is because I need some of the estrogen. Thanks for all your help.
May 11, 2012
 Hair loss
by: Wray

Hi Rosemary Hair Loss has baffled people for centuries. Many things cause it, in menopausal women it's more often than not excess testosterone, specifically the more potent testosterone DHT. Oestrogen works as a weak 5-alpha reductase inhibitor, which prevents testosterone converting into DHT, see here. They compare it with the known 5-alpha reductase inhibitors, finasteride and progesterone. The paper says…."In our experiments finasteride was the best inhibitor of DHT formation in a dose-dependent manner, followed by progesterone. Even 1 nM finasteride inhibited DHT synthesis in DP by 86% and 1 nM progesterone by 75% in DP, but 1 nM 17alpha-E did not inhibit DHT formation and 1 nM 17beta-E by 59%" It appeared that 100 nM 17alpha-E inhibited DHT formation in DP, but only by 20%. I would not have thought worth the risk. These are a few more papers on 5a-reductase, see here and here. I wish I could help you more, but I have exhausted my limited knowledge on hair loss! I will have to leave it up to you and your doctor to decide which is the best route. It could be your hair loss is not testosterone related, but stress related, in which case I still believe progesterone is the better bet, as it's a known anxiolytic. Possibly you need far more progesterone than the 200mg/day, and have you had your vitamin D checked? This is critical to the anagen phase of hair growth. Take care Wray

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