differential to perimenopause? high fsh low estrogen no symptoms

Posted , 2 users are following.

My doctor called today and said my estrogen is 11 (below 30 is considered abnormally low and menopausal according to normal ranges for the lab). My fsh is high at 49. I have no symptoms. Hows that possible with low estrogen?

Could it be something else? Is there a differential diagnosis? Even a rare one im ready to hear it.

0 likes, 7 replies

Report / Delete

7 Replies

  • Posted

    Eva Misty, there could possibly be some other explanation for your levels.  I'm sure you will get extensive lab work and some testing that can rule out other causes.  If nothing else that would help calm your mind with all this. But keep in mind that severe stress, poor nutrition, and even excessive exercise can and will play havoc with our hormones.  You might know that women who engage in extensive physical sports training have periods that completely stop. It's not that they are menopausal, it's that ovarian functioning slows to a crawl because of their strenuous workouts.   

    I think one of the problems you are having is lab work that doesn't match the standard expected symptoms you've read about with perimenopause.  That doesn't make sense to you, and you're looking for an explanation.  So here's what I can offer.  Lab work and physical symptoms don't always match up. And this is true for other hormone issues, not just peri/menopause.  I'll give you one good example totally out of the "female" realm.  Addison's disease is a complete shut down of the adrenal glands and production of life saving hormones. My husband nearly died of that fatal illness.  As this disease started working on him, we did many doctor visits.  His labs always looked normal.  It wasn't until he hit what they call Addison's crisis, and he was nearly dead, that his lab work showed severely abnormal readings.  Thyroid also, can be a long road to diagnosis.  I was very symptomatic in perimenopause at age 43, but my labs never showed anything but normal levels.  (How did that happen??)  

     But more importantly, keep in mind that your ovaries are still functioning, as evidenced by the fact that you are still having periods.  You are still throughout the month producing enough estrogen to stimulate your uterine lining.  Therefore, any specific shortfall of estradiol, is intermittent, not consistent.  There's a long way to go from some intermittent higher FSH with low estradiol readings, to complete menopause with multiple symptoms.  Typically what women might notice when things start to change, if they even connect the dots, is feeling quite wrung out when their periods starts when they didn't feel years earlier.  But a week later, they are back to feeling normal.  And there are also some women who are nearly symptom free even at menopause.  (I barely felt anything different because my body did such a slow and gentle decline.)   Typically it's those women who do a fast and furious decline who are most bothered by symptoms, horrid drenching sweats etc.  

    I guess what I'm trying to say, is yes, get checked out for any and all other things that could disrupt your hormone production.  Realize that symptoms and lab work don't always match up.  And finally that your labs don't tell yo much about when menopause will happen.    

    Report / Delete Reply
    • Posted

      thanks for the very detailed answer. the doctor said that maybe i had a sublte estrogen decline. and suggested ive been premenopausal since i was 20 lol. but my estro is so low, thats its post menopausal. so im not sure how i have suddenly developed low estro. ive asked him for differential diagnosis but he says nope. youre post menopausal. not perimenopausal. post menopausal based on my estro ... 

      my uterus and ovaries internal ultrasound showed normal organs. i even have new fibroids which suggest otherwise. 

      i dont want to google these again as i will get horrible hits...but...there could be a differential diagnosis right?

      Report / Delete Reply
    • Posted

      Ok EvaMisty.  You know I'm not a doctor, but run don't walk to get to another physician.  Any doctor who insists on shoving a diagnosis in a little box because that's what the labs say is WRONG.  And any doctor who tells a women who is having periods she is MENOPAUSAL is just plain nuts.  

      Look, we all know there are some limited women who have early onset menopause, but this is really rare.  Are you one of those women?  Not if you're still having periods!!!!   

      If your organs look normal on ultrasound, you've got the equipment, and it's functioning well enough to product bleeding.  

      Honestly, I do absolutely everything to support your body.  Eat really well, whole foods, plenty of water, take a good multivitamin, a little exercise, sunshine, get in bed by 10pm every night, no alcohol, no smoking, do some meditation and relaxation, remove stress whenever possible.  AND FIND ANOTHER DOCTOR WHO DOESN'T PUT THINGS IN BOXES THAT DO NOT MAKE SENSE.  

      And PS, every women has their own hormone profile.  Some are high estrogen ladies, others are not. Unless you had hormone panels done in your mid 20s, you really don't know how your body looks on labs, or what's "normal" for you.  So now in our 30s, you have a baseline.  (My first wasn't done until 43)   Keep this in mind, all human events (and I mean everything) can be plotted on a bell curve.  the majority cluster at the top of the curve.  But there are NORMS on both ends of that curve.  I was always one of those women other women hate. LOL  Small, but big boobs, tiny waist (36,24,35)  So I guess i always thought I was a high estrogen woman.  Nope.  I went to a nationally known expert who read my labs and said "Let me tell you something about yourself.......You are a high testosterone female."    Yep testo.  And you know why?  Because at age 43, after obvious hormone decline, I was still running a testo level still over 50.  (At that age, testo has declined by half)   Go figure.  

      So yes, get checked out by someone else.  And please know how this goes.  I really am interested.   

      Report / Delete Reply
  • Posted

    What you need is an appointment with an endocrinologist who can better explain what is going on with your hormones. What is 'normal' because what is my normal will not be your normal. You need to see someone who can put it in plain english for you. This hopefully will explain what is happening with you and put any fears you may have to rest. XXX

    Report / Delete Reply
    • Posted

      thanks. im seeing a different endo next week as that one basically told me my female years are over and im done lol he also said its gyno job not his. so..siiighhhh
      Report / Delete Reply
    • Posted

      It is an endos job to sort out hormone disorders of anykind. It is a gynaes job to deal with illness and disease in the reproductive system. Menopause is in a way similar to pregnancy its a condition not an illness and whilst pregnancy is a gynae job if you cant get pregnant it becomes an endo job. Dont take no for an answer. I was treated for an ovary condition for years which was caused by hormone imbalance so was treated by endo NOT gynae. Hope this helps you and puts your mind at ease a bit. Here if you need me. XXX
      Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up