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What Does This Blood Report Indicate?

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Posted on Thu, 23 Feb 2017
Question: Hello Doctor,
Thank you for your time.
I do have a gyn appt this week, but am trying to understand what might be at play and what I should ask prior.
50 yr old woman. Have been on mild HRT for about 3 years to correct a significant perimenopause hormone imbalance (literally bouncing from high post meno FSH numbers to premeno.).
(Note- As I do have a breast cancer history, the HRT is carefully monitored and watched under doc’s care- both Gyn and Onc. The risk is considered mitigated as I’ve had double mastectomies, cancer was ER/PR- and am 17 years out now).
There is also some concern about maintaining est levels as I have a strong family history of severe osteoporosis.

I have been on Estradiol patch .05mg 2x week; 300 mg Progesterone (Prometrium) /night. Continuous.

The HRT did help the imbalance and helped greatly for a while, but as I continue to age and move toward menopause, I expect my natural, unaided levels are declining.

I am writing as I have not had a period now for 6 months. As part of a physical, bloodwork including a hormonal panel was just done with the following results:
FSH; 8.6
Estradiol: 38
Progesterone: 22.1

Which- would indicate I am not in menopause.

So- why no periods? I have not had hot flashes, though do experience some night sweats.

Back in July of this year, after running similar bloodwork, my doctor felt the ratio btw Est/Prg was too great and that my Prog level was too high. At that time I was taking 400mg Progesterone. (Prog had been moved up from 200 to assist with continual spotting) I went down to 200 mg., but then started a period which lasted about 3 weeks and showed no signs of stopping. Not heavy—just spotting throughout the day. So I was instructed to move up to 300mg and the spotting stopped. But I have not had any bleeding since.

My fear is that the lining may be getting very thick and- cause an endometrial issue? I have regular PAP smears, all normal and have had colposcopies to examine the lining – last one a year ago- which have been normal too.

Could this be part of perimenopause irregularity? Should I be concerned and what should I ask?
doctor
Answered by Dr. Ramadevi Wani (2 hours later)
Brief Answer:
There is no need for concern.

Detailed Answer:
Hi,
Welcome to HealthcareMagic.
I am Dr Ramadevi wani. I will be answering your concerns.

I have read your description carefully. There is no need for concern. Absence of periods could be part of perimenopause irregularity or you may be proceeding to menopause. Your body is not producing enough estrogen & progesterone required to start the periods.

Do not worry about endometrial lining getting thick. Since you are taking progesterone along with estrogen, it will not happen.

Feel free to discuss further.

Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Ramadevi Wani

OBGYN

Practicing since :1985

Answered : 1459 Questions

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What Does This Blood Report Indicate?

Brief Answer: There is no need for concern. Detailed Answer: Hi, Welcome to HealthcareMagic. I am Dr Ramadevi wani. I will be answering your concerns. I have read your description carefully. There is no need for concern. Absence of periods could be part of perimenopause irregularity or you may be proceeding to menopause. Your body is not producing enough estrogen & progesterone required to start the periods. Do not worry about endometrial lining getting thick. Since you are taking progesterone along with estrogen, it will not happen. Feel free to discuss further. Best wishes, Dr Rama