FHS 39.7 (1.2 – 9.0)
LH 16.1 (< - 15)
PROGESTERONE 0.4 (7.8 – 27.0)
ESTRADIOL 41 (50 – 150)
PROLACTIN 8.7 (2.5 - 17.0)
TESTOSTERONE .03 (0.0 - 2.0)

These are my labs from about 2 months ago. At the time my doctor started me on 20 mg progesterone topical cream on days 1-13 and 40 mg on days 14-28. I haven’t had a period since.(slight spotting for a few days) I felt great the first few weeks on the progesterone but then began to feel really awful.

I just really don’t know how to interpret my lab work. Based on the lab work do I really need progesterone anyway? Do I need estrogen too? Why did he only give me progesterone? I have read about estrogen dominance – is that why he only gave me progesterone and not estrogen? He circled my FSH number on the lab sheet like he thought it was out of whack. What does high FSH tell you?

Thanks in advance. I am new to all of this and know nothing about how all of these hormones interact. All I know is that I am supposed to have a period every 28 days – how it happens is beyond me. I also am hypothyroid and have just learned how to interpret those lab results – now I need to work on interpreting these "sex" hormones!

Kim

It depends on which point in your monthly cycle you had your labs done. Your reference ranges look like their for the mid luteal (7 days before your period starts) and/or end of the month. Luteal phase is the 14 days after ovulation. Your FSH is pretty high even for mid month when it surges. FSH is follicle stimulating hormone. It stimulates follicles to release an egg for ovulation. If your follicles are not responding (because of poor egg quality or whatever) your body will release more in an effort to get the follicles going. The higher the number, the harder a time your body is having with ovulation. LH is high. The reference range of 50-150 for estradiol suggests you might have had the test done toward the end of your cycle (but your lab could have it up to 150 for early luteal). I'm going to assume it's supposed to be measured in pg/ml. Is that right? It's low anyway. Testosterone: are you sure that's not free testosterone? Prolactin, I don't know. Looks normal since it's in the middle of the reference range.

Your doctor probably gave you progesterone because, like many doctors, he's probably afraid of the estrogen and cancer correlation. Your progesterone is low in comparison to your estradiol so even though you have very low estrogen, you're "estrogen dominant" if you're in the luteal phase. In the follicular phase everyone is estrogen dominant because it's normal to have barely any progesterone until after ovulation. This doesn't mean you don't need more estrogen. In a young woman both estradiol and progesterone are much higher than you have (in the luteal phase) and preferably in a 1:1 ratio. In this case, if you had a progesterone level of 4, you'd be in balance since progesterone is not measured in the same units as estradiol. I think it's measured in nanograms per mililiter.

You'll really need to say how many days your cycle was (28, you said?) and on what day you tested to get a better idea of what the results mean.

According to all that I've read, if you are in peri it's appropriate to use progesterone only 2 weeks out of the 4 of your cycle. I'm using the cream too, only 20 mg/day split into morning and evening doses, and only on days 12-26. You might tolerate the progesterone better if you go to a lower dose and cycle, with 2 weeks on and 2 weeks off.

It's possible you're not getting a period because your estradiol isn't high enough, you're not building up the lining in the uterus. Your high FSH also indicates that your estradiol is low. You should have your estradiol tested mid-cycle when it should be at it's highest.

Thanks to you both for the info.

Teal, I think (just from counting back the days - not 100% sure ) I was in the luteal phase when lab work was done.

Also, how do you determine the correct ratio or P/E? You said it is 1:1 but how do you convert it if both hormones are not measured in the same unit of measure?

Thanks again to you both!

Kim

Actually, Kim, what I told you about a 1:1 ratio was wrong. There's a 1000 nanograms in a picogram. There's a conversion for it and it's discussedhere. I guess it's time to get out the calculator and do the math. I think you're still going to find you're estrogen dominant. As for what the ratio really should be, it seems to vary between doctors. I'm guessing whatever you see in a healthy young fertile woman is what you want to shoot for. The doctors who talk about it online seem to say 22:1-30:1 depending on the point of your cycle but I don't know what mainstream doctors think.

The link for the calculation is here. I hope I got that right this time.