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Calculating the P:E
Ratio & Quartile Analysis 

Question: I have a question concerning
calculating P:E ratio. After reading the directions in the book, I'm not sure
how to do this. My
saliva test results were: 


Estradiol 1.2 pg/ml 


Progesterone 0.07 ng/ml 


Testosterone 15.9 pg/ml 

Any
comments concerning these results would be appreciated. 

I am 46
years old, had a total hysterectomy 4 years ago and am using a transdermal
estradiol patch. 

Based on
the Menopause Type^{®} Questionnaire, I am Menopause Type^{®} Eight 



Quick Answer: 

A little bit of
mathematics and you will see that you also have a Menopause Type^{®} Eight picture based on lab tests. 



P:E Analysis 

Most of the
confusion about P:E Ratio analysis is due to not reporting in the same unit
or measurement. 

Common mistakes
include comparing nanograms to picograms, especially since there are 1,000
picograms per 1 nanogram. 

Another common
mistake is failing to convert to MOLES as the unit of measurement. Since the
P:E Ratio is measuring the ratio of progesterone and estradiol molecules,
they must be calculated in moles (see Why P:E Ratio must be measured in Moles below). The pMol/L is also the International Unit of Measurement for
these hormones. 



Nanogram & Picograms 

First,
note that estradiol is reported in pg/ml (picograms per milliliter) while
progesterone is reported in ng/ml (nanograms per milliliter). In order to
compare the ratio of these two hormones we need to do some math to get them
both into the same “weight units”. 

Since there are
1,000 picograms in each nanogram, one nanogram of progesterone is
actually 1,000 picograms of progesterone. 

So,
let's convert progesterone to picograms: 0.07 x 1,000 = 70 picograms 

We now
have: 

Progesterone
70 pg/ml 

Which we
can compare to the Estradiol 1.2 pg/ml    AFTER we convert to MOLES 



Convert to MOLES 

Since
we are concerned about the correct number of progesterone molecules for each
estradiol molecule we fist want to convert the lab results into pMol/L. 



This
conversion is really quite simple once we have the conversion factors: 

Estradiol Conversion Factor: pg/ml x
3.671 = pMol/L 

Progesterone Conversion Factor:
pg/ml x 3.18 = pMol/L 



Doing the
math we get: 


Estradiol
1.2 pg/ml x 3.671 = 4.41 pMol/L 


Progesterone
70 pg/ml x 3.18 = 222.6 pMol/L 



Calculate the Ratio 

To
calculate P:E ratio divide progesterone by estradiol. Doing the math we get: 222.6 /
4.41 = 50.48 (rounded to 50) 

So
the P:E ratio is 50:1, which means there are 50 progesterone molecules to
every 1 estradiol molecule. 



The P:E
range is from 20: 1 to 170:1. 



P:E Quartiles 

Recall that
symptoms will help determine how to interpret lab results (review pg. 27 
29). Applying what we know about quartiles
(pages 49  50) to the P:E ratio we recognize four P:E quartiles as: 




First Quartile: 
20:1 to
57:1 



Second Quartile: 
58:1 to
95:1 


Third Quartile: 
96:1 to
132:1 


Fourth Quartile: 
133:1 to
170:1 



Reported
P:E is in the First Quartile. A
P:E Ratio in the First Quartile may be experienced as “feeling low
progesterone”, especially if the woman was used to having a higher P:E ratio
when she was younger. 



Testosterone Quartile Analysis 

Concerning
the testosterone levels: 

Reported
Testosterone = 15.9 pg/ml 



This would
be converted to pMol/L as follows 

Testosterone Conversion Factor:
pg/ml x 3.47 = pMol/L 

15.9 x 3.47 = 55.1 pMol/L 



With
an 



Putting it all Together 

So we have
three points to consider: 

1) 
Symptoms
(Questionnaire) suggest Menopause Type^{®} 8 (low progesterone, low
testosterone) 

2) 
P:E ratio
is in the lowest quartile 

3) 
Testosterone
level is below ideal range 



Low
testosterone levels and a relatively low P:E ratio (first quartile) explain
why Menopause Type^{®} 8 symptoms are presented. 



If
P:E ratio is in the first quartile and a woman still has symptoms of low P:E
ratio (as demonstrated on questionnaire), she should discuss this with her
physician who may advise her to raise her P:E ratio by taking a small dose of
bioidentical progesterone. 



It
is not uncommon for women who have had hysterectomies to be prescribed
estradiol without progesterone. This is based on outdated ideas in which
progesterone was only recognized as having value in protecting the uterine
lining. Thus, women without a uterus were considered to not need
progesterone. When
a woman says to me “My doctor says I do not need progesterone because I do
not have a uterus.” I say, “Ask your doctor if you still have bones, skin,
brain, eyes, et cetera. Every tissue we know of has progesterone receptors.”
Consider sharing the Actions
of Progesterone document. 

Testosterone
enhancing therapies should also be considered. These may include nutritional,
herbal, or glandular therapies. Hormone precursors or natural hormones may
also be considered. 

It
is important to follow up any therapies with retesting of the hormones at
three months, to evaluate whether hormone balance has been achieved. 



Summary 

When
done properly, saliva hormone assessment and the analysis of ratios and
patterns can provide valuable insights into the unique needs of each woman. 

When
done improperly  mixing nanograms with picograms and calculation ratio with
conversion to Moles – confusion and doubt arise. 



For
references and more information of P:E Ratio analysis, please review 77 – 80
of Discover Your Menopause Type^{®}. 



Mole  A mole is a gram molecular weight, that is, the
molecular weight expressed in grams. The molecular weight is the weight of
one molecule in daltons. All moles contain the same number of molecules,
Avogadro's number, equal to 6.022 x 10@ The reason all moles have the same number of molecules is because the value of the mole is
proportional to the molecular weight. 

One Mole of progesterone is 314.4668 grams of progesterone. 

One Mole of
estradiol is 272.3864 grams of progesterone. 

There
are the same numbers of progesterone molecules in 314.4668 grams of
progesterone as there are in 272.3864 grams of progesterone – one molecule of
progesterone to one molecule of estradiol. 

To
calculate P:E ratio based on grams, or nanograms, would give an erroneous
result. Mathematically, 314.4668 divided by 272.3864 = 1.15 – creating a 15%
error. 

When
P:E ratio analysis was first introduced by Dr. Collins in the mid90s, it was
based on an extensive review of medical and clinical chemistry literature
(much of the published work used PMol {picoMoles} in their research. Recall
that the pMol/L is also the International
Unit of Measurement for these hormones. It appears that when other labs
adopted the P:E ratio, they overlooked the need to convert to Moles. 





Last Updated 042504 

YourMenopauseType.com,
Inc. 
