We recently got a great question from a listener and want to share it with you.
This question is about a perimenopausal 51-year-old female. She is still menstruating and having confusion about her hormone testing and the hormone therapy that she is currently taking.
She is experiencing some breast tenderness and irritability related to her cycle. She is taking some supplementation and wondering if that is right for her and her hormonal concerns. And while she is nowhere near overweight, she feels that her body is carrying a little extra in the middle, despite exercise and healthy eating.
Here is her question:
‘I am 51 and have had very regular periods, and still do. I do have heavier flow on day 2 and then a few days of light flow. It has been this way since my late 30s. I am 120lbs with a BMI of 19.4. I recently had saliva testing done because I felt I was very irritable during the luteal phase day 20 – 28(ish) sometimes my cycle is as short as 24 days, but more often 28. I noticed the tender breasts and irritability starting closer to day 15 or 17 more recently.
The saliva test results are Estradiol 1.1, Estriol <0.9, Estrone 2.6 L, Progesterone 50L, Ratio Pg/E2 (Saliva LCMS) 45, Testosterone 36 H, DHEAS 1.2, Cortisol 3.4. My naturopath started me on Black Cohash and I started Prometrium 100mg 3 days ago. It feels fairly normal getting up, but sleeping in about an hour longer in the morning but I may feel a bit sluggish later in the day.
I generally have good energy and sleep well. In my late 20s and early 30s I did have chin and jawline acne that cleared up with Tretinoin. I still use tretinoin for preventative. I don't have abnormal hair growth, I have had only one breast cyst. I do exercise a lot, but it's a balance of weights, cardio and yoga. I also eat well, I think enough. I do have mid section weight gain. My normal weight is 115, I don't care about the number, just the middle bloating and flab - it's not terrible, but would like things to fit better!
My question is about the high testosterone. What would be the next questions to ask or what tests to figure out how to balance this. Could the high testosterone be the source of the irritability and also you mentioned a guide to calories in the show notes for episode 59 but I can't find these. Thank you! I just started listening and have passed this on to others’.
In this episode, we break our listener’s question into:
● Weight gain or change in body fat distribution in perimenopause.
● Lab testing for perimenopause and what it means.
● Supplements thoughts for perimenopause.
● What estriol, estradiol, progesterone, and testosterone are. And what they mean
in perimenopause.
● Other hormones affected in perimenopause, such as DHEA and cortisol.
● Can testosterone cause irritability in perimenopause?
If you have a question, please visit our website and Ask the Doctor a question. Thank you for listening.
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