Estrogen/Progesterone Ratio & Elevated Testosterone

by Kate

I have a question about my estrogen progesterone and testosterone ratio. I am a 33-year old cycling female (have not been on birth control pills in over 5 months). I haven’t been pregnant and want to hopefully have children one day so I want to preserve or improve my fertility. I have many symptoms of estrogen dominance/low progesterone that include: fat gain around abdomen/hips/thighs; allergies; depression and anxiety; fatigue; memory loss; PMS; sluggish metabolism; uterine fibroids; strong sugar cravings; painful cramps and clotting during my period; night sweats; edema; and itchy skin to name just a few of my symptoms. I have been to three gynecologists, the last two specializing in BHRT and a reproductive endocrinologist. Now I feel more confused than ever.

The first BHRT doctor did blood tests on day 17 of a 28-day cycle. Results are as follows:

Testosterone/Total = 18 ng/dL

FSH = 20.5 mIU/mL

Progesterone = 1.1 ng/mL

Estradiol = 174 pg/mL

His nurse informed me my results were consistent with anovulation and that I should see an endocrinologist. The endocrinologist who told me to: a) get on birth control pills (which exacerbate my symptoms), b) try to get pregnant, or c) lost 20 lbs. (which I have trouble losing in the first place!).

After further research, I visited a holistic gynecologist who specializes in BHRT. I explained all my symptoms and she was convinced I was estrogen dominant. I completed a saliva test (by Diagnos-Techs) on day 21 of a 26-day cycle. She was pretty surprised by the results as it was not what she (nor I—following all the research I have done) expected, and are as follows:

E1 Estrone = 16 pg/ml

E2 Estradiol = 4 pg/ml

E3 Estriol = 18 pg/ml

Progesterone = 124 pg/ml

Free Testosterone = 51 pg/ml

She advised that my estrogen/progesterone ratio were fine. She based on response on a chart provided with the lab results which show I am within a wide acceptable range, but my testosterone was elevated. She recommended a high-fiber diet to help my body rid any excess testosterone and saliva re-testing in 2 months to check testosterone levels.

I am perplexed. The symptoms I am experiencing all point to low progesterone/estrogen dominance. Some of the symptoms—such as the night sweats, intense sugar cravings, and itchy skin worsens during the second half of my cycle. Could it be that even with these “in range” levels it’s not enough progesterone? And what’s the deal with the high testosterone?

Comments for Estrogen/Progesterone Ratio & Elevated Testosterone

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Oct 18, 2013
Estrogen/Progesterone Ratio & Elevated Testosterone
by: Wray

Hi Kate We do have a page on Hormone Testing you could look through. You'll see your first test showed progesterone in the follicular range, <1 ng/ml, i.e. you hadn't ovulated that month, it's not unusual. Your oestrogen is within range, 30 - 400 pg/ml. Your testosterone is slightly low, 30 - 95 ng/dL. Your second test showed progesterone slightly high, 12-100 pg/ml, oestrogen slightly high, 1.3-3.3 pg/ml, testosterone slightly high, 16-47 pg/ml. Most labs give a very wide range of ratios, from 100:1 up to 500:1 which I think daft. What's needed is a ratio which indicates the woman feels well! Well yours is 31:1 very low. We run Saliva Tests on our cream and find that after only a month the ratios are all over 600:1, and the women feel well. It could be the ratio doesn't have to be that high, but I know it works so suggest women aim for it. Unfortunately depending on symptoms it can be many months before the ratio rises. So you are right, your symptoms are all due to excess oestrogen and testosterone too, this can cause severe PMS. If bound to SHBG (sex hormone binding globulin) testosterone becomes inactive, progesterone raises levels of SHBG see here. Which of course binds the testosterone making it inactive. I would avoid the fibre! I see they didn't check for LH, this increases levels of testosterone, so do sweet, starchy carbs.. 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. Low SHBG is a marker for Insulin Resistance. 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. Continued below

Oct 18, 2013
Estrogen/Progesterone Ratio & Elevated Testosterone Part 2
by: Wray

Hi Kate Testosterone is notorious at increasing visceral fat, which causes abdominal fat gain, see here and here. Higher testosterone is also associated with an increased risk for IR 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, severe PMS can occur, another vicious cycle. We do have a few pages you could look through, How to use progesterone cream, Hot Flushes, Anxiety, Memory Loss and Fibroids. Many of your symptoms also point to low vitamin D, please have a test done. Fibroids being but one, they shrink if the level is high enough, see here, here, here, here, here and here. Low vitamin D causes IR, which I suspect you have as you find it difficult to loose weight. Continued below

Oct 18, 2013
Estrogen/Progesterone Ratio & Elevated Testosterone Part 3
by: Wray

Hi Kate I suggest you try the Ketogenic Diet. It's a very high fat, moderate to low protein and very low carb diet. 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. It's also essential to eat enough protein. This is based on 0.9g to 1.0g of protein per kg per day of lean muscle mass. Contrary to what is generally believed a lack of protein leads to bone loss. And get hold of Gary Taube's book Why We Get Fat: And What to Do About It. It's an excellent book which explains the role carbohydrates and insulin play in our body. And how damaging both are when in excess. But ignore his section on oestrogen, totally wrong! Two other excellent books are Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health and Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar--Your Brain's Silent Killers. Both are available via Kindle too. You might like to read this comment for encouragement, Update on using Progesterone Creme and Weight Loss with Low Carb diet. With all those symptoms you would need between 200-400mg/day progesterone, if you should consider it. Let me know how you get on. Take care Wray

Oct 19, 2013
Estrogen/Progesterone Ratio & Elevated Testosterone
by: Kate

Thank you, Wray! The information you have provided is fascinating. This all feels like a giant puzzle but slowly all the pieces are coming together!

My vitamin D levels were tested by the first doctor and results are:

Vitamin D, 35-OH total 33 ng/mL
Vitamin D, 25-OH, D3 38 ng/mL
Vitamin D, 25-OH, D2 <4

Doctor said I was "fine" because I was within the lab range of 30-100. Reviewing these numbers now I feel they are borderline low, no? LH was not checked in neither blood or saliva tests.

I have already visited my local library and checked out a copy of Why We Get Fat. Interestingly, I have type O blood so a diet focused on animal protein and fat makes complete sense. I'm just not a fruit and veggie girl even though I have been making a significant effort to "eat better", which ironically I thought it meant less meat and minimal fat. Will definitely read the other books too. In addition to diet adjustment, I will be ordering Natpro as I cannot find a comparable progesterone cream at stores and, as suggested and supported in other posts, will use the recommended 200-400mg dosage.

I have a follow up question on a supplement I have found called DIM-D. One capsule has 4000 IU of Vitamin D3, 150 mg of DIM, 100 mg of Calcium D-glucarate, 60 mg of green tea, 6.5 mg of lycopene. From what I think I have come to understand from These supplements: Would the DIM help minimize the effects of bad oestrogen (especially since progesterone activates oestrogen receptors and can make you feel worse), while providing much needed Vitamin D-3 and Calcium D-glucarate to avoid reabsorption of oestrogen after its been processed by the liver?

Oct 21, 2013
Estrogen/Progesterone Ratio & Elevated Testosterone
by: Wray

Hi Kate That's the term I use, a 'puzzle', and a giant one at that! It's trying to tie all the pieces together. make sense of them and get rid of them that takes time, patience, endurance too. Your vitamin D is very low. Yes labs give that vast range of 30-100ng/ml, but specialists are recommending no less than 50ng/ml, the less conservative 70-100ng/ml. I follow the less conservative! I try to keep mine up in the 90's. Best you take at least 10,000iu/day to get it up, 40,000iu/day is safe, see here. Very pleased you've got Taube's book out. I think you can put to rest the blood group diet, besides there are too many anomalies. Once you've read Taube's book you'll see why. We've been brain washed into believing meat and saturated fat are dangerous, whereas in fact they are not. That DIM supplement is good, but you'd need to take additional vitamin D to boost your level. 4000iu/day will not raise it fast if at all. Let me know how you get on. Take care Wray

Dec 02, 2013
I'm a believer!
by: Kate

I ordered Natpro and have been using it for the past three weeks at a level of 266-299 mg. per day. I'm having a bit of trouble with consistent dosage but am working on finding a better way to measure the cream. I have been using vitamin D (10,000 iu daily) in conjunction with Natpro. All I can say is...

Wow! Natpro is really effective!

I started applying the cream on day 6 of my cycle (same day I received it and have been using it nonstop). The night sweats are gone. The itchiness I get on my arms/legs during the second half of my cycle have been limited to just my legs, and it's been sporadic and not as severe. No night sweats. I repeat. No night sweats. I have gone up a few pounds but I will continue to work on reducing my overall weight. I haven't felt as overly-emotional as I normally do and sugar cravings aren't as bad as they've been before.

I got my period yesterday (day 26). Let me give you a synopsis of my period before Natpro. I would normally be taking naproxen, advil, and even strong chinese herbs for pain on days 1, 2 and sometimes 3 of my period. I would be spending a lot of time in the bathroom as my period normally upsets my stomach. My time not in the bathroom would then be spent resting on a heating pad to relieve the lower back pain. Depending on the severity, I've often have had to miss work.

Well, my cramps have reduced by 90 to 95%. I still feel a bit of discomfort--but not cramping! I've simply applied the Natpro directly over the areas where I've felt the discomfort and it's helped. I haven't used my heating pad. I haven't spent any time in the restroom dealing with stomach aches. No pain meds needed. It's been nothing short of amazing.

I know it's quite early to report such good results but this can't be a fluke. I know the Natpro has worked for me as it is the only thing I've done differently this month. I will continue to use the cream nonstop and will report back after my next period as well. As of now, though, I can't stress enough how grateful I am to have found this website, Natpro, and the priceless guidance from Wray. Thank you! Thank you! Thank you!

Dec 04, 2013
I'm a believer!
by: Wray

Hi Kate Bless you for telling me this! It is really early to see such results, but you are not in Peri-menopause. I find it's the women who start progesterone while in P-M that have the hardest time over coming any Oestrogen Dominance. You also used a high amount, plus you are taking 10,000iu of Vitamin D. This would have contributed hugely to your response. I cannot emphasise enough how important vitamin D is, in fact it's a waste to use progesterone if levels are low. Or too little is taken. I'm so delighted the night sweats have gone, those and the hot flushes were my worst! The pounds you've put on are water weight which should come off. Don't forget my suggestion about doing the ketogenic diet, it really does work to shed pounds. It also happens to be a delicious diet, and very healthy too. I can't believe all the trauma you went through whenever your period came, thank heavens I never suffered that each month. I would appreciate hearing how you fare with your next period. Don't be disconcerted if you have a set back, this can happen. Please continue using it daily until you feel 100% stable, and then you can follow your cycle again. But using up to 300mg/day I'd suggest you reduce very slowly to about 150mg/day before you stop it. By slowly I mean 1ml or 1/2ml per reduction, remaining on that for a few days to stabilise. If you need an accurate millilitre measuring spoon, you can buy them here. Take care Wray

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