Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: bombsh3ll on January 04, 2025, 08:54:13 PM
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https://journals.lww.com/menopausejournal/fulltext/9900/the_range_and_variation_in_serum_estradiol.399.aspx
I found this paper so interesting and it contains valuable data on therapeutic levels of estradiol in relation to health outcomes.
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Yes, interesting paper bombsh3ll. Thanks for posting.
Wx
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Very interesting paper. I have been puzzled why in my last two blood tests, the oestradiol levels have varied between 230 and over 600, despite all the conditions for testing being the same ( possibly a different lab though). The paper doesn't really answer this but at least it sounds like this is not an uncommon phenomenon. It does talk about some of the things that can cause variability in absorption though.
Sadly, I don't expect the paper will receive the recognition that it should and many women will continue to be undertreated.
Thanks for posting
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Thanks for posting that Bomb, it was very interesting.
We have had a lot of poor absorbers on here over the years which sounds like a common problem. I completely agree re patches too because I was never able to get a decent oestrogen level until I switched to gel.
I was surprised that so few women use HRT. It was interesting when they talked about the therapeutic level for basic bone protection and the higher dose needed to be symptom free. It would seem that 400 pmol is the number too aim for and this is what I am going to do despite being ancient (63). My silent migraines have decided to make a comeback and after much deliberation with the hormonal migraine specialist, it would seem that I need to go back to two pumps of gel at 12 hour intervals to increase the oestrogen and avoid oestrogen levels going too low.
I'm not a good advert for anyone hoping that you come out of the other side with the menopause. I'm afraid it's for life and if you suffer with low oestrogen induced migraines like me, it's HRT for life.
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Yes I am encouraged by this research as my estradiol is consistently at around 400pmol/L on Zoely which works great for me, and I definitely plan to maintain this on menopause hormone therapy once I no longer require menstrual suppression.
With two osteoporotic parents I am also glad they clarified different thresholds for slowing bone loss vs actually gaining bone mass.
There are clearly some issues with the accuracy and reproducibility of blood tests, however I am inclined to believe the very low levels found in some women on treatment. I think some of the very high readings could be an artefact, possibly due to contamination if someone has gel on their skin.
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This was really interesting. My only concern is they don't seem to show the evidence that points to needing 400pmol for bone growth- I clicked the references (5 and 6) but neither link seemed to be a paper showing the research. Has anyone found the study that shows that 400pmol is needed ?
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My understanding is that 250-300 pmol is needed for bone protection and 400 pmol was the number quoted for bones regrowth and complete symptom relief. The figures come from their own personal study conducted on their patients over a few months plus years of actual clinical experience which is more valuable than conflicting studies in my opinion.
The 400 pmol number I can relate to because going by my own personal study, that is the number I need to keep my silent migraines under control - it's unfortunate because I will have to increase the progesterone dose. Migraines are not a menopause symptom as such but in my case, they are definitely a menopause side effect caused by low oestrogen.