OK Ladies ... got my test results from Tuesday's GYN blood work back. Of course, there are no ranges on her letter, so please help me out here. Keep in mind I've been off my Prometrium 200 mg since 7/22 (many on here have commented that the Prometrium was the cause/start of my sleep issues ... causing my cortisol level to raise and waking me up repeatedly at night).

Her letter says the following ... "Your FSH test is 20.6 which is indicative of menopause transition, or early menopause. However, your estradiol level is quite high today, 298 pg/mL. This may account for your mood changes, and the fact that you are not sleeping well. In this regard, I think the saliva testing will be helpful."

That pretty much sums it up. Got another letter from Resolve in Madison where I need to send it back to get my saliva kit, so we have not done those tests yet. Also, hmmm, I never mentioned mood changes to her, because other than 1-2 days a month after I'd go off the Prometrium, I'm fine. Those 1-2 days, I'd have an hour or two where I'd be VERY crabby (ask my hubby), but nothing else abnormal.

I'm fairly certain (from memory) that when they checked my FSH in January it was only around 12, and my old GYN said I was NOT menopausal (well I've now gone 5 months without a period, even when I went OFF the Prometrium every cycle).

Can any one shed some light on my test results? What does the high level of estradiol mean? What would the normal range be for that (if there is one)? I'm not inclined to go back on the Prometrium as I'm feeling and sleeping much better with each passing day I've been off of it.

Thanks much!

You need to ask her for the lab ranges. My doctor has a totally separate set of "optimal ranges" that he uses. He gives me lab ranges and his ranges. My estradiol ranges are low numbers. You are the second person tonight that has posted such a high number so obviously different lab ranges. Saliva test are not as accurate as blood serum tests, not sure why she thinks so. Did she test anything else? You should know all of your thyroid ranges, your two T's, your P and your E's.

AFAIK, hormones change hourly, every test is a snap shot, estradiol can be high or low, depending on the time of the day the blood was drawn. FSH is a good indicator of where you are in transition, since you have not had period for 5 months, it seems you getting there.
Prometrium (progesterone) is the precursor of the mineralocorticoid aldosterone, and after conversion to 17-hydroxyprogesterone (another natural progestogen) of cortisol and androstenedione. Androstenedione can be converted to testosterone, estrone and estradiol.
There is some truth to Dr.Lee teaching that women post-meno only need progesterone, as being "father" hormone can become testosterone, estrone, and estradiol, as well as cortisol and androstenedione.
I know it is all confusing, but I would imagine saliva testing is not going to give you any idea, if you feel fine, why bother?
What added value in the saliva testing, it is even less accurate than blood work. If you feel better without Progesterone, then don't take it. I bet your hormones still fluctuate, but rising FSH as a indication of early menopause.
My FSH is climbing too, since I started checking it came up from 3 to 14 last time I checked. I think FSH is more reliable than estradiol snap shot.
JMO.
P.S. I am not sure what was the reason your doctor put you on prometrium, because of high estrogen or anything esle.
If you don't have hyperplasia, perhaps, p-cream is better option for you, 200mg prometrium seems to be too much.

Hi,

Thanks for the responses. My GYN put me on the Prometrium originally because I had read it could help with my sleep issues. Only in the end, it made matters much worse (or else it's just peri-menopause making things much worse). But if my level of Prometrium (200 mg) was too high, as many on here have said, and it shot up my cortisol, well I guess the saliva test will show that.

I know last night I tried to go to sleep without the Ambien and fell asleep fine, for TWO hours It was still early enough in the night (midnight) I could take an Ambien, so I did, rather than lay there and not sleep at all. So my sleep's not totally back to normal, that I do know. That's why I'm getting tested.

I do see my endo dr. on Monday, so I can have her do the thyroid testing everyone's suggesting!

The only accurate way to see if your cortisol is elevated is by doing a 24 hour Urine test. (you pee into a catch/basin thingy and then combine it all in a big container that you return to the lab for analysis.) Prometrium gave me insomnia, along with a whole host of bad side effects. It also negated all the positive effects of the Estradiol. E has helped me to sleep once again. Good luck with all of this. Regards, JZZ

JZZ,

Thanks. I'm going to talk with my endo dr. more about it on Monday BEFORE I send the saliva kit form in (it's an order form). Doesn't look like it does anything with urine (just saliva).

Also, if my GYN is saying my estradiol is "quite high today" (that day I had the blood work done), even though it's just a "snapshot" in time, well why would they want to give me E if I'm already high?

If you don't mind me asking ... I'm assuming you stopped taking the Prometrium ... how long after that were you sleeping better, or was that only helped by getting on E?

Really, my insomnia (the waking up, not falling asleep) is my only symptom of peri-menopause ... but for me, unlike "normal" women, I MUST have my sleep regulated in order to keep my bipolar in check. My bipolar has been in really good control for 10 years now.

So I'm digging here for the answers!

I don't have much time to answer all your questions....running out the door. Will attempt to answer in more detail either later tonight or tomorrow. But, I started sleeping again once I was initially supplementing with estradiol only. Then I was given a round of Prometrium to protect my utering lining (it had built up). uh oh......I had a whole host of cognitive and physical problems slam into me!!!! And, the wonderful sleep was gone. My liver is very slow, and or can't process, many meds and takes a very long time to clear my system. Soooooo, 2 weeks after discontinuing the Prometrium my blood levels of P were still at the level of a pregnant woman!!! Waaaaaaaay too high. And, I was still very ill from it. (I had only taken 8 doses of 100mg.prometrium)

As for your estradiol being "too high" ......sorry I do not believe in the school of thought that some docs have in regard to "dominance" (whether they mean E dominance or P dominance.) And, it is ridiculous to say its too high (when you feel well and) when there is no cycle to judge the number from. As for your high FSH, well that can vary tremendously thruout the peri years. Mine can vary widely from a 2 up to a 12. (One of my gyn's is an infertility endo. He says that for fertility purposes anything that stays over a 7 makes pregnancy more difficult to achieve. But, that's another issue altogether.) Perhaps your "high" E level was a "total" of estradiol, estrone and estriol and not just estradiol? Symptoms AND blood levels are BOTH important inorder to determine what is happening and getting proper dosage. (please search some of my other posting on how my endo/gyn does weekly bloodtests.)

FSH that STAYS high (over 20 on more lab values, with a consistently low <32 estradiol (again on most lab ranges) is consistent with being in full menopause. The other standard to determine a woman in menopause is being without a period for 1 year. However, this is an arbitrary timeframe set by the AMA/FACOG. Some women are meno sooner while others past the one year mark. Also, if proper E is being supplemented than the FSH will drop accordingly, but not into pre menopausal values. (during peri, both fsh and e can seesaw back and forth)

I do think its a good idea to get all your thyroid labs done. I have a friend, fully meno, with a hypothyroid, E <32 (even with supplementation), and her FSH has not climbed above 2. Another thing I would suggest having tested in your Prolactin levels. A high Prolactin level can indicate an issue with the pituitary gland. Or in my case, an issue with a medication I was given inadvertently while in the hospital. Given that you are bipolar I'm assuming that you're taking some type of meds? These can definitely impact both the thyroid, prolactin, insulin and other body systems. Keep doing what has held you stable all these years and don't let peri/meno throw you for a loop. I feel your pain, and all women, when we lose the ability to enjoy a good nights sleep. btw - sleeping pills did nothing to alleviate the hormonal loss driven insomnia. I'd fall asleep for about 2 hours and then be wide awake. ick. Only Estradiol gave me back my sleep.

There is some research available online and in books regarding estradiol and depression (and seratonin levels). Try googling it. Not sure about the impact on Bipolar. My fear, and this is only a gut reaction, is that a possibility of swinging you into a manic episode. I find that the estradiol helps my energy level tremendously, but I am not dealing with bipolar. Please do some research and talk to your docs on this. Have loads more to say but must run for now. Will check back and feel free to PM me. Best regards, JZZ btw - have you done any research in regard to omega 3 supplements and bipolar? I know 2 people who have done well using them. Not alot of people, but still interesting nontheless.

JZZ,

WOW, thanks for the super response. I too am running out with my husband for a fish fry (it's our Friday night treat so I'm going to read your post in more detail tomorrow. I'm going to have more questions, but you're seriously giving me food for thought. I just joined PS towards the end of July when my sleep was getting worse. Someone else also mentioned about being careful with the E because of my bipolar. I've never been significantly manic ... just hypomanic (bipolar II, not bipolar I, thank God), and also never significantly susceptible to AD's throwing me into a manic state. Really, the most major concern over the 20 years since my son was born (that's when it all started, at age 29) was I couldn't sleep right. Really it started when I was pregnant with him ... I'd be waking up at 3:00 AM and couldn't go back to sleep. Then immediately post partum, WHAM, I couldn't sleep. However, my uncle is bipolar and my youngest brother has GAD (anxiety), although me and my brother are both well controlled, fortunately. Yes, I am on meds, a mood stabilizer (depakote) and an AD for help with sleep (remeron). The remeron really isn't for any underlying depression ... I really don't even get depressed unless I CAN'T sleep (it makes me weepy). Fortunately the Ambien does work for me, but it's only a band-aid, and I want to find a REAL fix. I realize it won't be quick!

Anyways, I'll check back again tomorrow and I DO appreciate chatting with you so much!

G.