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[orrla]

Blood tests results came back, and are low indeed, consultant wrote.. Oestrogen 67, Testo 0.7..

What is their proper level..at 69.. I wonder?

Anyone knows?

Thanks!

[bombsh3ll]

You haven't stated the units - if that estradiol is pg/ml that's quite respectable - but generally speaking in an untreated 69 year old both estradiol and testosterone levels will be in the toilet and there is little clinical utility in testing them.

I am not clear what you mean by a "proper" level - are you asking about treatment targets or just what a typical woman that age would have without any intervention?

Treatment is generally symptom based rather than focusing on specific blood levels, with the exception of ensuring testosterone doesn't get too high on treatment.

I do have personal thresholds for myself that I would not wish to be below, which are estradiol of 300pmol/L (cited by the late great professor studd as assuring bone protection) - both my parents have osteoporosis - and testosterone of around 2 nmol/ml based on probably having a touch of PCOS earlier in life and appreciating the athletic advantage and libido this conferred. I would not necessarily recommend this to others as treatment has to be individualised.

[Stockport1965]

I do have personal thresholds for myself that I would not wish to be below, which are estradiol of 300pmol/L (cited by the late great professor studd as assuring bone protection) - both my parents have osteoporosis -

I too have the personal thresholds that I am trying to achieve for that very reason.

[orrla]

hi,

Thanks!

I am on HRT from when I was 45, in 2000...

With local Meno clinic from 2011..

I can't say all was good but my body was fine, until the dr I was with, in 2018 told me I must cut down because of my age (63).. I was on Evorel 100 plus Mirena for ca 9 years..

The cut was phased. First 75 patch for ca 9 months, then Mirena went out and I got Evorel Conti..

Mid 2018 vascular problem appeared that took ca two years to diagnose and get controlled..

That's the average that takes my GP. to diagnose, ..

Then pandemic..3 UTIs, prolapse, spine pain, VA, etc..

Then, end of 2022, my Meno dr announces she's leaving NHS..

Last minute before, she cuts my Testosterone to half..

By that time I had energy of dead cat.. which I was telling her about each time I came to the clinic...

No response!

Come 2023 problem with spine... Osteopenia -1.8... degeneration..

X-rays and scans, blood tests, all fine!, appointments, physio, for whole 2023, but no one notices that my lumbar spine rings do not sit over each other properly...

I had to have a private consultation with an othopedist in London for him to spot it!

I now require spine fusion but GP does not know how to refer me because I am in Scotland and they have no such surgeons here.. They found a small tumour in chest and all got hooked on it instead...Want to do chest surgery! ... I said No.

Two or three months ago, I could hardly find energy to get up. When I did my whole body shook and trembled... I felt as 90 years old.. I thought I had cancer or something..  Three years after feeling fine, fit,  and being in reasonably good shape...

By accident, my old  acquaintance who turned antyvaxxer commented: oh that's vaccines!

He got me for a moment..It made me to sit down and analyse...all leading to that 2018 date..

I booked and went to see private gino with post meno and hrt experience... I asked for blood tests...

And bingo!

..mind you, adding half patch does not do much to me ...yet?..two weeks now..

But I sit and wonder, what that NHS is for now..?

..and about what sort of levels Oestrogen and Testosterone should be..  If they say Low or High, what's ok?

[Elizabethlovejoy]

Well I am 69 and currently on 4 pumps Oestrogel utrogestan daily plus testosterone( androfemme)at 0.5ml day

My test earlier this month from the Newson clinic gave the following reading for oestradiol of 318.97pmol/ l
And testosterone of 1.41nmol/ l

She said that a level of 300pmol/l or more for oestradiol was ideal for bone protection.
My testosterone level could be a little higher but if I was feeling ok then leave  that as it is.
I do feel good on these levels.
Hope that is a helpful guide but obviously everyone has different needs.

[orrla]

Thanks!

..I do not see these values on a reading I got...  It only says 67 and 0.7...

Newson clinic is too far from me... I am in deep province and that seem to be reflected in quality of care I receive.. slow, inefficient, uninformed..provincial!

What puzzles me is that so many people think it's normal..and ok.  ..like these GPs who think VA and incontinence are normal,.. and ok...

Never heard anyone being appalled ...yet.?

[bombsh3ll]

Orrla,

That's heartbreaking and against the guidelines for effective treatment to be arbitrarily withdrawn based on age.

You can't continue to rely on the NHS having been let down like that, your health is too precious and the consequences of going untreated or under treated are irreversible.

I don't know about Newson but there are online clinics that will prescribe for you after you have a video consultation.

[orrla]

I am hoping still some can be reversed.. Shall see!  Spine is getting worst, though.. no referral for surgery made yet!

Started with that private gino, not sure what to expect. GP went along with his recommendation of adding extra half patch, until review in mid September. Strangely, pharmacy issued only enough for three months of Testosterone which I had increased last October by Meno clinic, so unrelated to that review gino wrote to gp about Evorel Conti... but gino wrote to me we will be looking at it too hence I left it. ..

Worrying is that these blood tests are in some different units to one women talk about here.. How do I suppose to know where I am with it..?!

oh, eh..

I thought I will spent my retirement on painting and travelling..not on studying vaginal issues and medicine, stuck!

[Hurdity]

Hi orrla

First very sorry to hear about your health issues...

- re the readings you got - somewhere the units will have been recorded. eg I see my results of all tests online at my GP practice and the units are always given as well as the lab range. Do phone and ask if you really can't see. Here in UK units on NHS are generally given as pmol/l but some private gynaes and I think possibly in US they may be given as pg/ml. All the levels we discuss here on the forum refer to pmol/l so important to know what yours are. To convert from pg/ml to pmol/l multiply by 3.67 .

I'm not quite clear about your mentioning of adding half patch? In your long post giving your history on HRT you said this: "..mind you, adding half patch does not do much to me ...yet?..two weeks now..". and then in your recent post you say "GP went along with his recommendation of adding extra half patch, until review in mid September. "

So I gather from this you are now on an extra half patch? Of Evorel conti? You have been on Evorel conti since about 2019? The blood tests presumably were taken while you were on this? I mean it is conceivable, but unlikely that you could achieve the equivalent of  245 pmol/l (if your reading was in pg/ml) on 50 mcg patch but I would say unlikely unless you absrob really well.  Also the level is likely to vary depending on when in your patch change cycle the blood was taken. For example a few years ago I had blood tests just before I was due to change my  (50 mcg patch) and they were approx 90 something (pmol/l) but later when I was half way through eg on Day 2 - they were around 200 pmol/l. I don't think my levels were ever much above that though I am now on a slightly cut down 75 mcg Evorel patch - so the recommendation that a 50 mcg is sufficiently protective against osteoporosis may not be the case for some women whose levels decrease over the lifetime of the patch.

Incidentally I change mine every three days because of this. Fortunately though similar age to you (71) I have not lost any height whatsoever so in my case it has been protective (though I've never had a dexa scan). I'm also keen to stay on HRT as long as possible because my mum has osteoporosis and has lost several inches (now in her 90's) though it is not causing her any problems fortunately (she broke a bone a few years ago but healed OK and is very careful to avoid falling).

I hope you manage to resolve this by getting suitable treatment....

Hurdity x

[Hurdity]

You haven't stated the units - if that estradiol is pg/ml that's quite respectable - but generally speaking in an untreated 69 year old both estradiol and testosterone levels will be in the toilet and there is little clinical utility in testing them.

I am not clear what you mean by a "proper" level - are you asking about treatment targets or just what a typical woman that age would have without any intervention?

Treatment is generally symptom based rather than focusing on specific blood levels, with the exception of ensuring testosterone doesn't get too high on treatment.

I do have personal thresholds for myself that I would not wish to be below, which are estradiol of 300pmol/L (cited by the late great professor studd as assuring bone protection) - both my parents have osteoporosis - and testosterone of around 2 nmol/ml based on probably having a touch of PCOS earlier in life and appreciating the athletic advantage and libido this conferred. I would not necessarily recommend this to others as treatment has to be individualised.

Hi Bombsh3ll

Do you have any research backing up this figure of 300 pmol/l as being the right level to protect sufficiently against osteoporosis? I know this figure is quoted widely but I haven't found any papers. Some years ago I did find a paper with research (trials) on oestrogen levels and one measurement - possibly bone turnover (can't remember now as it was 2011 when I read it), which suggested something like 165 pmol/ml was the minimum level, (if I'm remembering correctly) which is much lower. The licensed doses of HRT  are also only medium oestrogen doses so I have been curious about this but not spent time searching the literature. If you're familiar with the research ( apart from Studd's  recommendation) it would be really interesting to see it?

Hurdity x

[Bungo]

Re levels for bone density, I also wonder if need higher oestrodial levels in the years around menopause day when bone density drops significantly. eg a level of 165 might be adequate when 5 years post meno when not losing alot of bone but need the higher levels of 300 during the period when bone loss is rapid?

[orrla]

Thanks Hurdity!

Please note that none from these issues would be there if not lazy, uninformed, brushing off attitudes of medical professionals whom I turned to for help!

I look back with disbelief at how that doctor at Meno Clinic dealt with me!  ..almost as if bad intended and cruel!?

With my completely ignorant GP...!

I am looking at these blood tests results now, and they say:

Oestradiol.  67
                     Follicular.  114 - 332
                     Ovulatory.  222 - 1959
                     Luteal.        222 - 854
                     Post menopausal  18.4 - 505
                     Please note new Roche Oestradiol method in use
                     from 07/06/2024.
                     Changes to ranges and clinical values may
                     be observed, which may require re-baselining of
                     patient.

Testosterone.   0.7.                                                       0.1 - 1.42.  nmol/L


?  ..so, where am I..?

[Mary G]

Orla, if you are in the UK that oestrogen reading will be pmol and it is far too low to do anything useful let alone promote bone protection.  Even if it did happen to be pg/ml, it would still only be 245 pmol which is OK but not quite enough for bone protection if you have a family history of osteoporosis.

The optimum oestrogen figure of 300 pmol is the figure the private clinics like to aim for post menopause because of bone protection and it's a kind of mid cycle type figure that most women find eradicates their symptoms.  They are basically going on their own clinical experience having treated thousands of women over many years.

Thousands of menopausal women in the UK seem to have been short changed by the NHS and lazy doctors and my sister is one of them. That is why so many people use private health care.  I would like to think your new government will make a difference but I don't see how they could possibly afford to support women through all that is needed (scans etc) in the more complex menopause cases.  The NHS only seem able to deal with straightforward cases and bog standard prescriptions even that is questionable at times.

[orrla]

Yes, I can see that now, Mary!  My GP, and all other NHS drs, act as if they were NHS salesmen. I thought they were there to help!  ..not to damage my health.. but..

You'll only get from them what NHS offers!

I am getting it now re my spine, too. Apparently older people spine deformities are not treated in Scotland, only of children, other than with pain management.

..you know, opioids..!

So I have a situation now that I need spine surgery or will not walk by next spring, .. But, I could be referred to some surgeon in England but that referral must be made by consultant.. and my GP can't find any...

Don't know where he looks.. Shall I tell him to check local garage too? .

.. because I did a long research for him, and sent precise address where to find out...  even Hospital in London called them..

I am not referred yet!  ... meaning what?!

And,, now you know how old people became disabled!!

[Cassie]

 I had a blood test 2 weeks ago my Estrogen level results showed <88 pmol which indicates post menopause. I am on 1 pump of gel and unsure if I should increase it. What is the ideal range for Oestrogen to be post meno in order to do its job. My Dr said I should do a bone density scan to see if the oestrogen is sufficient.