Primary Care Doctor just says "menopause" no abnormalities, labs say P:E2 is 1.68:1

by Jennifer

My progesterone to estradiol ratio is 1.68:1 and my doctor thinks that it is fine! So I now think she has no clue. I am 40 years old, have irregular periods (always short) and bleeding, on birth control pills (the highest dose available apparently). For the past 10 months, I have experienced sweating and overheating, red face, with any form of movement, not even exercise. It is hard to clean my house, do laundry, or even get ready for work, I get too hot and start sweating! It never comes on while I am just sitting still. I do get night sweats, however, while sleeping. My doctor just says I’m going into menopause. I am hypothyroid, my TSH was .43

Last September, I saw an OBGYN due to irregular and sometimes heavy bleeding and low pelvic pain. Via ultrasound, he said I was producing ovarian cysts and increased my dosage on birth control pills (Sprintec). The bleeding got lighter, but I still spot for 2 days around week 3, more than one week before my period. It was after this new BCP dosage that the sweating started.

I went to my primary care doctor last week for my annual exam, and told her about my concerns. Since I was 25, my periods had begun to skip an entire 24 hour period of time on about day 5 of my period, then come back and bleed for days 6 & 7. No doctor I've ever mentioned it to had a clue why this was happening. At age 30, when I tried for my third baby, I had three miscarriages. My basal temp chart was showing ovulation but a very short luteal phase of 10 days or less. My original OBGYN put me on Prometrium used vaginally, and I was successfully pregnant within 2-3 months. I stayed on Prometrium until 15 weeks pregnant, when the placenta was making enough progesterone to support the pregnancy. The last time I actually felt good was when I was pregnant.
Rational thinking says if I had progesterone problems when I was 30, I probably still the problem (only worse) at 40! My current family doctor says “prometrium level (0.15) is a postmenopausal level, and estradiol (77.2) is a pre-menopausal level. Endometrial biopsy was normal, with proliferate cells preparing for ovulation and menstruation.” She thinks my estrogen just hasn’t caught up yet. Yeah, right. So my ratio comes out to 1.68:1 (I figured this up, she didn't even mention my ratio). Even if I am perimenopausal, that can’t be a healthy ratio.
I have so many low progesterone symptoms, weight gain and horrible cravings, fatigue including when I wake up in the morning, dry hair and skin, ovarian cysts, near constant breast tenderness, chronic headaches, muscle aches and pains. And my current doctor thinks this is all fine. I hope to consult with an actual endocrinologist, somewhere near southeast Wyoming, northern Colorado, or eastern Nebraska, but it is hard to find one qualified/really experienced in this kind of women’s health issue. Either way, I think I will go on progesterone replacement therapy, with or without a doctor!
What do you think about my ratio and history? Thank you so much!

Comments for Primary Care Doctor just says "menopause" no abnormalities, labs say P:E2 is 1.68:1

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Aug 07, 2015
Primary Care Doctor just says "menopause" no abnormalities, labs say P:E2 is 1.68:1
by: Joy

Hi Jennifer

I simply can't believe that your doctors did not picked up that you are in Peri-Menopause and suffer from terrible Estrogen Dominance symptoms. Peri-Menopause can be a difficult time for some, but with the help of progesterone it will help you through this stage and prepare you for Menopause. Your P:E2 ratio is 2:1 it should be 600:1, no wonder you are feeling they way you are. Please read the Hormone Testing page, you can check your other results on this page too. Why do doctors think that BCP cures everything? Rubbish!! It merely adds to adverse symptoms. All drug based contraceptives have a potential to cause harm.

Guess you have just answered your own question really, "the last time I actually felt good was when I was pregnant". Why can't doctors work this out? There are a number of things which contribute to a miscarriage, low progesterone levels is one of them, stress too plays a huge part. Perhaps the Menstrual Cycle page will help you to understand a little more.

I must just correct you though, your symptoms are due to excess estrogen, way too much for progesterone to have any effect. This is why we all need to supplement with progesterone and it is vital that the correct progesterone cream is used. Please read How to use Progesterone Cream. For hot flushes 400-500mg of progesterone cream is needed per day for 4-6 days or until they stop, it could take longer, it all depends on just how much excess estrogen your body has. If you are thinking of trying progesterone cream, it should be used every day from now on with NO breaks.

Do you know what your Vitamin D3 level is as a deficiency reduces the benefits of progesterone. It is also connected to every single cell in our bodies and their formation.

I hope this helps.

Aug 27, 2015
Ordered Nat-Pro, So Excited!
by: Jennifer

Thank you so much for the response! I still haven't heard a further word from my doctor about my estrogen dominence. I guess she just drew the labs so that she could either tell me that she was right, I was in menopause, or that I'm imagining everything and I wasn't in menopause. But when the P is at a post-menopausal level, and the E is at a pre-menopausal level, according to the lab, she should have realized there was a major imbalance (estrogen dominence) going on. I don't think she ever had any intention of treating the problem, even when I told her that my previous doctor put me on Prometrium after the 3 miscarriages, which then resulted in a healthy pregnancy.

I started taking Pro-Gest nearly a month ago as I could get it easily, but I don't think it has a high enough dose of progesterone per pump to take care of my problems, even at 3 pumps a day. So I ordered a bottle of NatPro from your company and it will be here in a couple of days. I did notice even on the Pro-Gest that my period was better, not so heavy, but had several stops and starts to the bleeding, and still a lot of cramping/low back pain (I did take Pro-Gest straight through). So I'm thinking the higher dose of NatPro will really make the difference! The sweating is still lingering (my doctor told me to try Zantac for this, and it does help quite a bit), but the night sweats are much better. I will definitely try the 400-600mg dose to start off. I have noticed increased energy, so I have high hopes for Nat-Pro after feeling so run down for the past 7-8 years.

I do take supplemental Vitamin D after reading your information, plus magnesium and potassium (I was found in lab tests to have low potassium). I can tell how my body is functioning with these vitamins and electrolytes by the number of muscle cramps I get. My physical therapist I see for headaches says my muscles and trigger points are so tight and don't want to relax, even with dry needling. Reading more about low progesterone, it is all starting to make more sense for me.

I really look forward to starting Nat-Pro in a couple of days, and I appreciate your response, the vast information this website provides, and the affect you are having on all of these women's lives. Other people, especially doctors, just dont' understand the feeling when I realize my youngest son, age 8, has never seen me feeling truly well and energetic.

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