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High Estradiol and/or High Progesterone

Are high estradiol and or high progesterone levels seen in any of the twelve Menopause Types®?

Answers, by Dr. Joseph Collins

Quick Answer:

High estradiol and high progesterone are not true representations of a Menopause Type®, but may indicate perimenopause, exogenous hormones or an endocrine pathology.

Estradiol

In the postmenopausal woman, estradiol levels may remain adequate or they may be low. Excessive estradiol levels may be seen during perimenopause (while the body is trying to adjust to the change of menopause).

If there are low progesterone levels there may be a relative hyperestrogenism, but truly high estradiol levels after the change can be traced to specific endogenous or exogenous causes.

There may be high estradiol levels if a woman is on any type of hormone replacement therapy, but that is not her true, underlying Menopause Type®. High levels under those circumstances are due to exogenous estrogens.

Endogenous causes of hyperestrogenism may be due to any number of endocrine related pathologies. These include endogenous obesity, diabetes, Stein-Leventhal and adenomatous hyperplasia. In these situations the hormonal pattern is reflecting the pathology, and is not a true representation of the Menopause Type® that woman actually has. Once the endocrine pathology is managed, the true Menopause Type® becomes evident. Management of obesity and management of abnormal blood sugars will frequently change the hormone patterns of estradiol, progesterone and testosterone.

Progesterone

In similar fashion, the typical postmenopausal patterns seen in progesterone are that they may remain adequate or they may be low. Excessive progesterone levels may be seen during perimenopause (while the body is trying to adjust to the change of menopause). In light of the fact that the adrenal glands are the primary source of progesterone in the postmenopause woman, it is no surprise to high levels as the adrenal glands are “recruited” to help with the transition of menopause.

The presence of truly high progesterone levels after the change can be traced to specific endogenous or exogenous causes. (Truly high progesterone levels should be validated by a serum test. At his point in time, there continues to be many “false highs” of progesterone when saliva testing is done.)

There may be high progesterone levels if a woman is on progesterone replacement therapy, whether orally or topically, if the dose is too high, or she is absorbing the dose extremely well. In these cases, the high progesterone level is not her true, underlying Menopause Type®. High levels under those circumstances are due to exogenous progesterone.

Endogenous causes of hyperprogesteronism may be due to an endocrine pathology such as adrenal hyperplasia. In these situations the hormonal pattern is reflecting the pathology, and is not a true representation of the Menopause Type® that a woman actually has. Once the endocrine pathology is managed, the true Menopause Type® becomes evident. Management of adrenal hyperplasia can change the hormone patterns of estradiol, progesterone and testosterone.

What about Testosterone?

In contrast to estradiol and progesterone, where high levels may indicate perimenopause, exogenous hormones or an endocrine pathology, testosterone levels may be excess in certain Menopause Type®. This may be due to a genetically predisposed deficiency in 21-hydroxylase, which has been associated with functional androgen excess.

Summary

If high estradiol levels are seen on a lab test is suggests that perimenopause is still taking place. The presence of exogenous hormones or an endocrine pathology must also be considered.

 

 

 

Dr. Joseph J. Collins

 

 

 

 

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