Worried about low estrogen -- what might this mean?
August 27, 2014 6:28 AM   Subscribe

My estrogen level is low and I'm worried. Bunch of details inside.

I recently had some blood tests (estradiol, TSH, free T4, LH, FSH, TIBC, and CBC). My estradiol was "<5", my FSH was 0.3, and my free T4 was at the low level of normal (1.0 ng/dL), but the other results were fine. Also, last year my vitamin D level was low and it's back to normal now after taking vitamin D daily (currently at a lower dose). (If it matters, the blood test took place during the week before my period.)

Last week my doctor's office faxed the results to the midwife group I go to (I don't have an ob/gyn), but I haven't gotten a call from them and haven't called yet. My doctor also said maybe I should see an endocrinologist. I'd rather start there because the midwives are not MDs... I'm asking around for recommendations for endocrinologists right now. YANMD, but Google is really not turning up anything helpful, and I WILL be seeing a doctor about this soon.

Relevant or possibly-relevant things:
-I'm 35 and a teeny bit overweight.
-My mom has hypothyroidism and has for years.
-I have one child (four years old) and I'm on the birth control pill (Apri -- generic Desogen).
-I'm taking sertraline and bupropion (Zoloft and Wellbutrin) for depression/anxiety, and Zyrtec for allergies.

Stuff going on lately:
-I'm really tired. Late morning, afternoon, early evening, late evening -- there isn't really a specific time, although I'm basically exhausted every night after we put my son to bed. Sometimes I fall asleep on the couch. In the past, my doctor has brushed this off by saying "Oh, working moms are tired, blah blah blah." I do think I'm getting enough sleep.
-I'm hot/sweaty a lot lately, at different times of the day. Yes, it's summertime, but I'm talking about inside my air-conditioned house (75-77 degrees). I don't remember feeling this hot this often before. I get out of the shower in the morning and I'm sweating a lot soon after. I often have to sit right in front of the fan or just sit down fanning myself with a newspaper or something, often when the people around me seem pretty comfortable. I don't know if these feel like hot flashes, because I don't know what those are like...
-My periods have been lighter than normal over the past several months, or maybe more. I mentioned this to one of the midwives at my annual exam earlier this year and she said something like, "Oh, maybe this pill pack is a bit different," or something...
-The inside of my nose has seemed really dry lately. I feel like my skin has been drier too?
-I have basically no interest in sex, although this has been the case for a while now.
-I feel like my short term memory is worse lately, but maybe I'm just imagining that.
-I've gained weight recently, but stress eating is probably to blame.

What should I ask the endocrinologist when I see him/her? How worried should I be? This isn't early menopause, is it?
posted by anonymous to Health & Fitness (5 answers total) 5 users marked this as a favorite
I have no idea, I'm not a doctor, but I immediately thought "early menopause". But like I say, I'm not a doctor.
posted by PuppetMcSockerson at 7:34 AM on August 27, 2014 [2 favorites]

A low oestradiol with a low FSH is a completely normal effect of combined oral contraceptives (like the one you are on) and is in fact how they work - by suppressing your own hormones.

Because you are getting oestrogen and progesterone substitutes in the form of your birth control it's very very unlikely you would experience any kind of menopausal symptoms as you are effectively on HRT.

I personally would bother with any follow up at all for this. If you really do want these hormones measured and to get meaningful results you will need to come off the pill for at least a month.
posted by *becca* at 7:39 AM on August 27, 2014

What becca said. Your oral contraceptives are suppressing your hormones. Moreover, if you had premature ovarian failure (early menopause), your FSH would be high, not low.
posted by treehorn+bunny at 8:37 AM on August 27, 2014

I should add, if that blood work is the only thing your doctor has done for you and they don't plan to do anything further aside from send you to an endocrinologist, I think you should also look for a good internist to investigate these symptoms further. Your symptoms are nonspecific and could be caused by numerous different issues, either endocrine or otherwise.

As an aside, endocrinologists will typically test hormone levels like FSH on day 3 of your cycle (your natural cycle, you really don't have a cycle while you are on hormonal birth control because you are telling your body not to ovulate with the medication) because that is considered your 'baseline' FSH and is the value that is used to measure ovarian reserve, this is what's usually meant when women refer to getting their fertility checked.
posted by treehorn+bunny at 8:50 AM on August 27, 2014

After one of my family members had a hysterectomy, her hormone levels went out-of-whack and she became a completely different person. It was/is almost unbearable. I suggest you see an endocrinologist for your own sake and for the sake of those you love.
posted by tacodave at 4:10 PM on August 27, 2014

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