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[Dr. Heather Currie]

Measuring hormone levels, there's more to it than you think.
I am aware and concerned about a number of posts on this forum discussing hormone levels and worryingly messages about changing HRT doses according to blood results.
During this episode of Menopause Matters, Let’s Talk podcast our guest Dr Clare Spencer does an amazing job of simplifying this incredibly complex topic. You might be thinking…mmm…not the sexiest topic to listen to but, please do because by the end not only will you have a greater understanding about blood tests but you’ll also be reminded about a few basics - understanding how other unmeasurable factors influence your symptoms as those hormones merrily fluctuate away and why it’s so important to disentangle how you really feel during this hormonal storminess.

We drill down into the nitty gritty. dispelling myths and misinformation along the way and give invaluable insight into a very misunderstood topic.

So, would you ever measure hormone levels? If so, is there a right time, what about age factors, what are they actually testing for, how accurate is it, what about absorption levels, are there target levels to aim for, how do you interpret a result, where do environmental factors & genetics come in, how best to avoid tachyphylaxis and what about prescribing HRT for bone health? I know, they cover a lot…we told you it was worth a listen!
Listen here
https://shows.acast.com/menopause-matters-lets-talk

[lizzy76]

Fantastic- thank you! Exactly the information I was looking for!

[Kathleen]

Hello Dr Currie


Many thanks for the podcast link, I will definitely take a look as soon as I can.


Best wishes.

K.

[Konijntje]

This was a great listen, thank you. It was my first podcast (haven’t been a member here for long yet) and I’m scanning through the episodes what I’m going to listen to next.

(Will probably be the testosterone episode, as that is not covered in the Dutch guidelines at all. Dutch guidelines on menopausal treatment are pretty conservative compared to the British guidelines.)

[Dr. Heather Currie]

Thank-you so much for the great messages. This is episode 3 of series 5--we have covered a lot but much more to come!

[Sophya]

That episode was surprisingly good. Dr Clare Spencer made the whole hormone testing thing sound logical instead of intimidating. Worth a listen if you are adjusting HRT or just trying to understand your results better.

[Dr. Heather Currie]

Thank-you Sophya.
Key message is don't rely on blood tests!

[bombsh3ll]

I personally do feel there is a role for blood tests, particularly in asymptomatic or minimally symptomatic women choosing to use hormone therapy for long term health rather than palliation of vasomotor symptoms.

There are also published studies looking at blood levels on oral estradiol, and these do have utility as long as it is oral estradiol not ethinylestradiol or equine estrogens.

However I agree that people testing left and right when they are still perimenopausal and/or using gel are in most cases wasting their money.

In some cases, rather than paying for lots of blood tests, a baseline DEXA scan at menopause and a follow up DEXA in 2-5 years would be a better use of their money, with results either providing reassurance or identifying bone loss at an actionable time point.

[Mary G]

Blood tests might not have much value in peri menopause but I think they most definitely do post menopause and it's the only way to know how well you are absorbing oestrogen. You haven't got very much oestrogen of your own post menopause so anything meaningful that you do produce will be from HRT.  I've got 20 years worth of blood tests and I can say with absolute certainty that they all directly correlate with the type and dose of HRT I was using at the time.  The clinic I use tests estrone too.

I have stopped HRT completely a few times to get an absolute base hormone reading and that has been virtually the same level for years.  I absorb Oestrogel well and again, all blood results directly correlate to dosage.

Obviously hormone levels will always fluctuate with HRT to some extent but it's highly unlikely you will have a blood reading of 600 pmol in the morning and then go down to 50 pmol in the afternoon.  Also, if someone is using HRT and gets a blood test result of 20 pmol for example, I think it's safe to assume it's not working because it should never fall that low if someone is absorbing properly. 

Re bone density I would say it's important to get a blood test because you might feel OK on your current HRT dose but if you are not getting enough oestrogen into your system you will experience bone loss.  If there is any doubt these women should be offered a DEXA scan.

I agree that all women should be offered a DEXA scans in peri menopause.