Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Perinowpost]

Hi

Does anyone know the average/ranges for post meno estradiol levels? I've just had my bloods done and my estradiol level is 388. I haven't had it explained to me except to say results have confirmed I'm post menopausal and thyroid is normal.

Thanks

[Hurdity]

Hi there - there is no normal! Post-meno in the absence of HRT is less than 130 pmol/l - see GP Notebook:

pmol/L

    50-200 males

    70-510 females: early fol. phase (day 5)

    390-1480 females: preovulatory peak

    70-600 females: luteal phase

    < 130 post-menopausal

Taking HRT - I did read that the aim is to replicate the average estradiol level throughout the normal menstrual cycle - which will also be a range of values since estradiol levels vary hugely between women - as you can see from the ref ranges above. The average was somewhere in the ealry 300's - but many women will feel fine post-meno on HRT way below this. Mine measured 212 when I last had them measured although should be higher now as I am on 62.5 mcg rather than 50.

Remember also that blood tests are only a snapshot of what your levels actually are.

Also to note that 388 is a very healthylevel - and quite high I would say for post-meno so if you are feeling OK then great! That result (or estradiol) cannot confirm you are post-meno!!! If you are on HRT then it's the reading due to the HRT (or your cycle if not or both). No conventional blood test (ie FSH, estradiol) can confirm menopausal status. https://www.menopausematters.co.uk/diagnose.php

Do ask also for your thyroid reading - normal represents a wide range and docs should go by symptoms and also often TSH is the only hormone measured. Are you experiencing symptoms for which underactive thryoid could be an explanation?

Hurdity x

[Tc]

Crickey. Mine was 129 and that's on hrt!!

[Salad]

The range I was given was 200-300 ish but I was told to go on symptom control rather than the level.

Infact the clinic then went on to say don't get tested again 

[Tc]

My doc did say blood levels aren't the whole picture and how your symptoms are is important. My symptoms are not being controlled at all but I guess if a woman feels well and symptoms managed then levels are secondary

[Emerald2017]

Hi! I was told that estradiol at blood tests isn't the main issue. If you feel ok and you are symptom free it is ok! My level of estradiol was about 293 on hrt.

[Conolly]

Hello Perinowpost,


Depending on the method used to assay oestradiol levels in blood, the reference range may vary.
It's important to always ask the reference range along with the results.

Here's an example https://www.gloshospitals.nhs.uk/our-services/services-we-offer/pathology/tests-and-investigations/oestradiol/
If your test followed this assay method, you are considered postmenopausal.


Conolly X

[Perinowpost]

Thanks all for your replies.  It's the first time I've ever had oestrogen levels measured and googling produces many ranges which can be confusing.

My consultant's letter says the following: “Free thyroxine and FSH, LH were normal and Beta oestradiol suggests she is post-menopausal “.

I'm not surprised because I'm 54 and felt i was post by now. No other information was given, the secretary gave me my oestradiol readings when I rang and asked.

I feel really well on HRT (and Testim gel) and plan to stay on it as long as possible. I saw the consultant because I struggle with the progesterone part and wanted to explore other (if any) options.  He is suggesting the skyla coil and has written to a colleague who is expert in this field for a second opinion. I previously had the Mirena but had it removed after 6 months because it was too much for me.  He said I'm an interesting case!!! Clearly isn't privy to this form then!!!

Anyway I'll keep you posted and thanks again for all your help it's much appreciated.

And Happy New Year xx

[Tc]

Glad you are feeling well perin
I was interested to see your comments with the progesterone. I'm in surgical meno so definitely post. I have only tried sequi patches and the progesterone phase has been truly awful.
Good to hear you have a doc who will  take the time to find out the things he doesn't know.
I have read bout the Skyla and it looks interesting.
May I ask what form of E you are on?

[Perinowpost]

Hi Tc

I'm on evorel 50 patches. I couldn't tolerate noresthistetone which is the progesterone in sequi, so switched to Utrogestan. Utrogestan is better but still not perfect. Hope this helps.

[Tc]

Thank u

[Hurdity]

Hello Perinowpost,


Depending on the method used to assay oestradiol levels in blood, the reference range may vary.
It's important to always ask the reference range along with the results.

Here's an example https://www.gloshospitals.nhs.uk/our-services/services-we-offer/pathology/tests-and-investigations/oestradiol/
If your test followed this assay method, you are considered postmenopausal.


Conolly X

Whatever method is used as I said before menopausal status cannot be determined from blood tests of either FSH or estradiol and the reference ranges usually only distinguish two  states for adult women :  the normal menstrual cycle with its various phases, and post-menopause. Peri-menopause is not considered and it is well known (not by all GPs!) that values for FSH and estradiol particuarly - can go into the post-menopausal range during peri-menopause. This means some GPs wrongly tell women they are post-menopausal from a single blood test leading to much confusion - as has been reported several times on here.

The link you gave Connolly confirms this:

"Serum oestradiol levels are not useful for:

    monitoring oral oestrogen replacement (non-oestradiol HRT preparations contain high concentrations of oestrogens which the assay does not detect; oral conjugated equine oestrogens are altered on first pass through the liver to an undetectable form)
    assessing the menopausal state, as variable amounts of oestrogen are secreted in the perimenopausal period (i.e. one year before the menopause) and fertile cycles may follow even with very low oestradiol levels."

Also the ref range given is nonsense! A level of 505 wouild be very high in post-menopause and also sinece it is in the middle of the other ranges (for the different parts of the menstural cycle) then is meaningless. I think this is an error unless it is including women on HRT.

Perinowpost - I am very puzzled by the response of your consultant - that estradiol level does not suggest post-menopausal and in any case if you are taking oestrogen measurement of estradiol levels cannot usually help in this context! As you are 54 and if you had been peri-menopausal for some years before starting HRT then you could well be post-menopausal by now - according to this site ( I think) 80 % of women have reached menopause by age 54.

What is important for you is that your oestrogen dose is sufficient for you to feel well!

Hurdity x

[Conolly]

Hello Hurdity,


https://www.esht.nhs.uk/wp-content/uploads/2017/08/Clinical-Biochemistry-reference-ranges-handbook.pdf


https://www.ukas.com/wp-content/uploads/schedule_uploads/00007/9058%20Medical%20Multiple.pdf


http://www.rochecanada.com/content/dam/roche_canada/en_CA/documents/package_inserts/ESTRADIOL%20III%20_06656021190_CAN_V4_EN-final.pdf


“Note that reference ranges may vary between laboratories”


https://www.gpnotebook.co.uk/simplepage.cfm?ID=570818627

Conolly X

[Perinowpost]

Thanks Hurdity and Conolly for your input.  I must admit I get a bit blinded by all the numbers and do tend to go on symptoms.

Hurdity I also wondered how the consultant worked out how I was post Meno from that but hey who am I to quibble. I'm just glad to be taken seriously re the progesterone intolerance thing - this is the NHS after all so I feel very fortunate they're investigating this issue. Also  I do feel I am post by now as I started peri at 47.

And yes the oestrogen I'm on is sufficient to make me feel well which as you say is the main thing x

[Conolly]

Hello Perinowpost,


Sorry for the number of links and numbers in general 


Of course what matters is that you are doing well on your HRT regimen.


Anyway, next time you have your estradiol levels checked just ask for the lab range values so you can have a better idea of how your body is responding to the therapy.


Conolly X