Menopause Matters Forum
Menopause Discussion => Postmenopause => Topic started by: orrla on July 10, 2024, 03:17:20 PM
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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! :-*
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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.
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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.
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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?
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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.
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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.? :o
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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.
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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!
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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
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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
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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?
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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..?
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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.
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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!!
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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.
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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.
I can't do blood test online...
I need to my HRT up in an informed way, backed by science, with blood tests, so I do not damage myself even more.. Hence I searched for a Consultant with post menopause and HRT experience... Shall see!
My body is fragile now. I don't want to start running around punching people either, or go back to anxieties... HRT are really powerful drugs, as we learned.. Wrong doses cause havoc!
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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
Hi Hurdity
Form Chelsea and Westminster 250 pmol to protect against osteoporosis
https://www.chelwest.nhs.uk/professionals/gp-hrt-advice-guidance
My Menopause Centre has some references too on this page
https://www.mymenopausecentre.com/gp-resources/oestrogens-and-blood-testing/#fc-how-can-i-help-to-make-my-blood-tests-more-reliable
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Mary G thank you for clarifying that. I clearly need to up my dose a bit as my result came back at 88 pmol. ;)
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The late Professor John Studd is on record stating the 300pmol/L threshold as assuring bone protection.
I don't know if he published a study on this or it is based on his clinical experience, however his is the opinion which for me personally carries most weight.
I don't have the reference to hand but if you search this topic with his name it will come up.
There will of course be many women who maintain bone health with less but my interpretation is that this is the level that catches just about everyone, including those at higher risk - similar to standard progesterone doses, where many will be protected at a lower dose but some won't.
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So, if one patch of Evorel Conti gave me 67, how many of them would I need to achieve 300?!
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Am I reading this correctly?👇
'Older post menopausal women who need oestrogens for pelvic atrophy or established osteopenia or osteoporosis should initially have a very low dose possibly with unopposed oestrogens because the major side effects of the WHI study occur in older women receiving combined oestrogen and progestogen therapy'
https://www.studd.co.uk/hrt.php
(side effects: heart disease, stroke, blood clots, breast cancer, and dementia.)
Does it mean I should take more of Oestrogen only..?
There are those spray and gel, topping up that Evorel Conti would not be difficult..?
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Mary G thank you for clarifying that. I clearly need to up my dose a bit as my result came back at 88 pmol. ;)
Cassie, that is exceptionally low considering you are using one pump of Oestrogel in fact it's even low for a post menopause woman not using HRT.
I would definitely increase the dose and then have another blood test to check the level in about three months.
I've noticed a lot of women on here are getting very low oestrogen readings with Oestrogel. Has there been some kind of product switch in the UK? I know you have problems getting hold of certain medication and I'm still filling prescriptions and posting from Spain to the UK.
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Does it mean I should take more of Oestrogen only..
I would say you need the smallest dose of estradiol, which doesn’t require to be opposed with progesterone.
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Am I reading this correctly?👇
'Older post menopausal women who need oestrogens for pelvic atrophy or established osteopenia or osteoporosis should initially have a very low dose possibly with unopposed oestrogens because the major side effects of the WHI study occur in older women receiving combined oestrogen and progestogen therapy'
https://www.studd.co.uk/hrt.php
(side effects: heart disease, stroke, blood clots, breast cancer, and dementia.)
Does it mean I should take more of Oestrogen only..?
There are those spray and gel, topping up that Evorel Conti would not be difficult..?
That is an old paper from 2005 and should be completely disregarded and consigned to the dustbin of history because it makes reference to one of the two completely discredited studies that have no credibility whatsoever.
This is why you should never live and die by studies, they are often conflicting and they are often wrong as the two poorly conducted and deeply flawed HRT studies were. One of them was aptly called the million women study because it ruined millions of women's lives - millions of women immediately stopped using HRT when they didn't need to. Interestingly Kristy Wark stopped using HRT on the strength of those wretched studies and ended up with osteopenia.
Professor Studd later disregarded those appalling studies and everyone else should too.
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Does it mean I should take more of Oestrogen only..
I would say you need the smallest dose of estradiol, which doesn’t require to be opposed with progesterone.
Do you mean something like the Menostar that is used in the US?
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..so I said to my GP who wanted me off HRT in ca 2012, and asked where is that breast cancer I suppose to have and the reason she wanted me off..
Strangely, have quite few old friends who never took any but had breast cancer.
Yes, I know it.
But, where are more recent studies and reliable, safe, recommendations for post menopausal women..?!
These quoted above in this thread recommended by Studd 300 dose come from exactly same period!
How it is on too low dose I already know!
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Does it mean I should take more of Oestrogen only..
I would say you need the smallest dose of estradiol, which doesn’t require to be opposed with progesterone.
Do you mean something like the Menostar that is used in the US?
Yeah, a seperate issue of what really is available and where!
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Do you mean something like the Menostar that is used in the US?
You need to ask that Professor ;D
Usually such a small doses of estrogen you can get from VA treatment products or bio identical products from abroad. Just 1 pump of Estrogel is big enough to be used with progesterone.
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..And may I ask all those who wrote here that they achieve 250 or 300 pmol levels:
what are you on and at what age, please?
Thanks!
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Orrla - check the units on your blood results.
There's a big difference between pg/ml and pmol/L.
I am 44 and on Zoely for menstrual suppression which is a combined oral contraceptive pill containing 1.5mg oral estradiol, and a suppressive dose of progestin. My estradiol level is around 390pmol/L.
However the pill doesn't shut your own estradiol production down to zero, and my estradiol when I previously tested on suppression without any exogenous estrogen added back (desogestrel 150mcg only) was around 100pmol/L.
Therefore I am getting roughly 290pmol/L from 1.5mg of oral estradiol.
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well, that's what I am on about here..
No units stated (read above) only 67..
from 67 to 300 is a long way so must be some different, but two other women have 88 pmol/l so close .. others talk about 250 or 300..of what?!
Confused!
..it might be that 67 is a level of something different than 300 is..!?
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..And may I ask all those who wrote here that they achieve 250 or 300 pmol levels:
what are you on and at what age, please?
Thanks!
I'm using one pump of oestrogen gel (Oestraclin which I buy from a pharmacy in Spain) 50mg progesterone gel (Darstin which I also buy from a pharmacy in Spain) and testosterone gel every day.
I reliably have an oestrogen blood level of 300 pmol (80 ish pg /mL) every year. My base level of oestrogen without HRT is always about 70 pmol (20 pg/mL).
I'm 63 and about 16 years post menopause. DEXA scan result very good and similar to someone much younger.
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67pg/ml is equivalent to 245.9 pmol/L.
So not bad at all.
However if it's 67pmol/L it's low.
That's why you always need not just the number but the units when interpreting results as these can vary between labs.
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67pg/ml is equivalent to 245.9 pmol/L.
So not bad at all.
However if it's 67pmol/L it's low.
That's why you always need not just the number but the units when interpreting results as these can vary between labs.
I'll tell them! ...for £135 they should make some effort, I agree!
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..And may I ask all those who wrote here that they achieve 250 or 300 pmol levels:
what are you on and at what age, please?
Thanks!
I'm using one pump of oestrogen gel (Oestraclin which I buy from a pharmacy in Spain) 50mg progesterone gel (Darstin which I also buy from a pharmacy in Spain) and testosterone gel every day.
I reliably have an oestrogen blood level of 300 pmol (80 ish pg /mL) every year. My base level of oestrogen without HRT is always about 70 pmol (20 pg/mL).
I'm 63 and about 16 years post menopause. DEXA scan result very good and similar to someone much younger.
Interesting!
Is Darstin available in UK? ..never heard of it..
And, ifvyou are in Spain, how do you get Testosterone there..
I thought only in UK, US, and in Australia prescribe to women...?
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..And may I ask all those who wrote here that they achieve 250 or 300 pmol levels:
what are you on and at what age, please?
Thanks!
I'm using one pump of oestrogen gel (Oestraclin which I buy from a pharmacy in Spain) 50mg progesterone gel (Darstin which I also buy from a pharmacy in Spain) and testosterone gel every day.
I reliably have an oestrogen blood level of 300 pmol (80 ish pg /mL) every year. My base level of oestrogen without HRT is always about 70 pmol (20 pg/mL).
I'm 63 and about 16 years post menopause. DEXA scan result very good and similar to someone much younger.
Interesting!
Is Darstin available in UK? ..never heard of it..
And, ifvyou are in Spain, how do you get Testosterone there..
I thought only in UK, US, and in Australia prescribe to women...?
Professor Studd prescribed testosterone initially (I was a patient for years) but I bought the last batch in Gibraltar.
You can't buy Darstin in the UK but there is plenty of similar strength progesterone available there online.
If you had your blood tests in the UK, they are probably pmol.
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...but none in ge!....?
;)
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I think everyone, who takes estradiol orally in tablets should read Professor Studd, because according to him:
If oestradiol is taken as an oral tablet it is changed in the gut and the liver to a less effective oestrogen Oestrone
https://www.studd.co.uk/bioidentical_hormones.php
Estrone is the main estrogen, which is produced by the body in menopause and is not the same as estradiol. On my opinion if a product is sold as estradiol it should remain and work in the body as estradiol only.
Should I really trust his information?
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Thanks again Mary G. I am concerned now and thought 1 pump was sufficient but at times I have not been pushing the plunger all the way down, so now I am thinking, thats the issue.
Orrla I am sure your reading was in Pmol/L in which case it is lower than mine currently is. My Gynae suggested I would be better off taking a daily Progesterone but as Utrogestan taken 100mg daily is not ideal, I am going to need to explore other options & try to get my levels higher.
Does anyone have any idea what readings would be in ladies who do not take HRT at all? :-\
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Does anyone have any idea what readings would be in ladies who do not take HRT at all? :-\
My reading is 17-Beta Oestradiol
pmol/L 34.6
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Thank you Angela.
Regarding Testosterone, what is the significance of it, why do we need it & how much, etc? Anyone?
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I think everyone, who takes estradiol orally in tablets should read Professor Studd, because according to him:
If oestradiol is taken as an oral tablet it is changed in the gut and the liver to a less effective oestrogen Oestrone
https://www.studd.co.uk/bioidentical_hormones.php
Estrone is the main estrogen, which is produced by the body in menopause and is not the same as estradiol. On my opinion if a product is sold as estradiol it should remain and work in the body as estradiol only.
Should I really trust his information?
Yes this is well known and in an ideal world everyone would be able to take it through the skin, however in reality the best form of estrogen is the one that each particular individual finds reliable, easy to use and affordable.
Personally I can live with a bit of estrone rather than the itching, mess, cost, time spent for gel to dry or patches that come off after half a day or require surgical dressings placed over the top!
Oral tablets do have a slightly higher risk of blood clots but the absolute risk is minuscule for healthy users.
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Yes
Well, if information is correct, they shouldn’t mention estradiol as the main ingredient, because it ends up in the body as estrone. I wouldn’t personally choose estrone for myself.