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Estrogen level very low

Started by Amy1988, May 29, 2014, 08:07:46 AM

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JLT1

#20
May 30, 2014, 09:54:54 PM
HI!!!

Go to RxList.com - search estrogen.  Scroll down.  Given the number of estrogen types and delivery methods, it works out to 87 possible combinations (but that includes a couple vaginal gels).  They do 20 at a time.  Here are the first 20....


Brand Name: Prempro, Premphase
Generic Name: Conjugated Estrogens, Medroxyprogesterone AcetateBrand Name: Cenestin
Generic Name: Synthetic conjugated estrogensBrand Name: Premarin
Generic Name: Conjugated EstrogensBrand Name: Duavee
Generic Name: Conjugated Estrogens and Bazedoxifene TabletsBrand Name: EEMT
Generic Name: Esterified Estrogens and Methyltestosterone TabletsBrand Name: Enjuvia
Generic Name: Synthetic Conjugated Estrogens, BBrand Name: Delestrogen
Generic Name: Estradiol valerateBrand Name: Estratest
Generic Name: Esterified Estrogens and MethyltestosteroneBrand Name: Menest
Generic Name: EstrogensBrand Name: Premarin Injection
Generic Name: Conjugated Estrogens for InjectionBrand Name: Premarin Vaginal Cream
Generic Name: Conjugated Estrogens Vaginal CreamBrand Name: Activella
Generic Name: Estradiol, Norethindrone AcetateBrand Name: Femhrt
Generic Name: Norethindrone Acetate, Ethinyl EstradiolBrand Name: Climara Pro
Generic Name: Estradiol, Levonorgestrel TransdermalBrand Name: EstroGel
Generic Name: Estradiol GelBrand Name: Esclim
Generic Name: Estradiol TransdermalBrand Name: CombiPatch
Generic Name: Estradiol, Norethindrone Acetate Transdermal SystemBrand Name: Estrace Vaginal Cream
Generic Name: Estradiol Vaginal CreamBrand Name: Alora
Generic Name: Estradiol Transdermal SystemBrand Name: Angeliq
Generic Name: Drospirenone and Estradiol
To move forward is to leave behind that which has become dear. It is a call into the wild, into becoming someone currently unknown to us. For most, it is a call too frightening and too challenging to heed. For some, it is a call to be more than we were capable of being, both now and in the future.
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Amy1988

#21
May 31, 2014, 05:42:40 AM
Quote from: JLT1 on May 30, 2014, 09:54:54 PM
HI!!!

Go to RxList.com - search estrogen.  Scroll down.  Given the number of estrogen types and delivery methods, it works out to 87 possible combinations (but that includes a couple vaginal gels).  They do 20 at a time.  Here are the first 20....


Brand Name: Prempro, Premphase
Generic Name: Conjugated Estrogens, Medroxyprogesterone AcetateBrand Name: Cenestin
Generic Name: Synthetic conjugated estrogensBrand Name: Premarin
Generic Name: Conjugated EstrogensBrand Name: Duavee
Generic Name: Conjugated Estrogens and Bazedoxifene TabletsBrand Name: EEMT
Generic Name: Esterified Estrogens and Methyltestosterone TabletsBrand Name: Enjuvia
Generic Name: Synthetic Conjugated Estrogens, BBrand Name: Delestrogen
Generic Name: Estradiol valerateBrand Name: Estratest
Generic Name: Esterified Estrogens and MethyltestosteroneBrand Name: Menest
Generic Name: EstrogensBrand Name: Premarin Injection
Generic Name: Conjugated Estrogens for InjectionBrand Name: Premarin Vaginal Cream
Generic Name: Conjugated Estrogens Vaginal CreamBrand Name: Activella
Generic Name: Estradiol, Norethindrone AcetateBrand Name: Femhrt
Generic Name: Norethindrone Acetate, Ethinyl EstradiolBrand Name: Climara Pro
Generic Name: Estradiol, Levonorgestrel TransdermalBrand Name: EstroGel
Generic Name: Estradiol GelBrand Name: Esclim
Generic Name: Estradiol TransdermalBrand Name: CombiPatch
Generic Name: Estradiol, Norethindrone Acetate Transdermal SystemBrand Name: Estrace Vaginal Cream
Generic Name: Estradiol Vaginal CreamBrand Name: Alora
Generic Name: Estradiol Transdermal SystemBrand Name: Angeliq
Generic Name: Drospirenone and Estradiol

Wow! That's a lot.  Thanks I'll take a look at RXlist.
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KayXo

#22
May 31, 2014, 08:53:05 AM
Quote from: teeg on May 30, 2014, 11:53:12 AM
Topical estrogens could be compared to sublingual administration in terms of level variance. Such varying levels can't be healthy for the body or progress.

Gel or patch delivers a much more constant stream of estradiol than sublingual with estradiol to estrone ratio being about 1:1 consistently.
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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KayXo

#23
May 31, 2014, 08:56:07 AM
Quote from: ytxwmb on May 30, 2014, 10:17:52 AM
My endo specialises in trans patients and put me on pills. I asked him about the "dangers" because I am well over 40 years old. He told me that the dangers relate to premarin and ethyl estradiol neither of which are used any more. He told me that modern medications are bioidentical and put no strain on the liver.

So I can believe an Endo with experience of thousands of trans patients or .... people on the internet.

As long as you are on Estradial Valerate or HemiHydrate then you have nothing to worry about.

I've always mentioned this but always got criticized. :( Finally, a doctor that confirms this! Thank goodness. :) And besides, the issue seems to be much more the clotting than liver strain as every time the estrogen passes through the liver, proteins/enzymes production is affected influencing coagulation. 
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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KayXo

#24
May 31, 2014, 09:03:31 AM
Quote from: JLT1 on May 30, 2014, 04:48:26 PM
The sublingual method should work but I'd like to see data from controlled trials not guesses made by a doctor.

There have been several studies about sublingual administration of estradiol in women. I saved a few of those and have the full studies. Sublingual works! But, just that levels vary a lot on them and thus, can cause neurological symptoms due to fluctuations.


I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
  •  

KayXo

#25
May 31, 2014, 09:10:36 AM
Quote from: JLT1 on May 30, 2014, 09:54:54 PM
HI!!!

Go to RxList.com - search estrogen.  Scroll down.  Given the number of estrogen types and delivery methods, it works out to 87 possible combinations (but that includes a couple vaginal gels).  They do 20 at a time.  Here are the first 20....


Brand Name: Prempro, Premphase
Generic Name: Conjugated Estrogens, Medroxyprogesterone AcetateBrand Name: Cenestin
Generic Name: Synthetic conjugated estrogensBrand Name: Premarin
Generic Name: Conjugated EstrogensBrand Name: Duavee
Generic Name: Conjugated Estrogens and Bazedoxifene TabletsBrand Name: EEMT
Generic Name: Esterified Estrogens and Methyltestosterone TabletsBrand Name: Enjuvia
Generic Name: Synthetic Conjugated Estrogens, BBrand Name: Delestrogen
Generic Name: Estradiol valerateBrand Name: Estratest
Generic Name: Esterified Estrogens and MethyltestosteroneBrand Name: Menest
Generic Name: EstrogensBrand Name: Premarin Injection
Generic Name: Conjugated Estrogens for InjectionBrand Name: Premarin Vaginal Cream
Generic Name: Conjugated Estrogens Vaginal CreamBrand Name: Activella
Generic Name: Estradiol, Norethindrone AcetateBrand Name: Femhrt
Generic Name: Norethindrone Acetate, Ethinyl EstradiolBrand Name: Climara Pro
Generic Name: Estradiol, Levonorgestrel TransdermalBrand Name: EstroGel
Generic Name: Estradiol GelBrand Name: Esclim
Generic Name: Estradiol TransdermalBrand Name: CombiPatch
Generic Name: Estradiol, Norethindrone Acetate Transdermal SystemBrand Name: Estrace Vaginal Cream
Generic Name: Estradiol Vaginal CreamBrand Name: Alora
Generic Name: Estradiol Transdermal SystemBrand Name: Angeliq
Generic Name: Drospirenone and Estradiol

Of this list, there are really 5 types of estrogen and there is even a sixth which is sometimes prescribed to menopausal women, estriol. The 5 types are Ethinyl Estradiol (usually found in birth control pills), Equilin estrogens (found in Premarin), Estrone (or Estrone Sulfate, the conjugated/inactive form that is later converted to Estrone), 17 beta Estradiol and Estradiol Valerate (which only becomes active when converted to 17 beta estradiol in the body).

In the human body, there are 3 estrogens. Estradiol being the strongest, then Estrone and finally Estriol which is much weaker. Estradiol and Estrone convert back and forth to each other. Estrone converts to Estriol. In pre-menopausal women, usually, there is twice as much as Estradiol than Estrone. During pregnancy, all 3 estrogens are high, with Estradiol still being the predominant one. At menopause, Estrone is the dominant estrogen.
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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JLT1

#26
May 31, 2014, 09:35:01 AM
Kay,

You are correct; there are five types of estrogen on the list.  My 18 number was the types of estrogen used to manufacture pharmaceuticals.  For example, conjugated estrogens are used in pills (like Premarin).  However, they are metabolized to estradiol in the body.  Conjugated estrogens are supposed to pass through the stomach better.  I have a hunch is marketing....

Hugs girl,

Jen
To move forward is to leave behind that which has become dear. It is a call into the wild, into becoming someone currently unknown to us. For most, it is a call too frightening and too challenging to heed. For some, it is a call to be more than we were capable of being, both now and in the future.
  •  

KayXo

#27
May 31, 2014, 09:30:13 PM
Quote from: JLT1 on May 31, 2014, 09:35:01 AM
For example, conjugated estrogens are used in pills (like Premarin).  However, they are metabolized to estradiol in the body. 

Actually, the most predominant estrogens in Premarin are Estrone and Equilin (horse) estrogens. There ends up being very little estradiol in the body.

Hugs :)
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
  •  

JLT1

#28
May 31, 2014, 09:47:03 PM
Quote from: KayXo on May 31, 2014, 09:30:13 PM
Actually, the most predominant estrogens in Premarin are Estrone and Equilin (horse) estrogens. There ends up being very little estradiol in the body.

Hugs :)

Premarin is >50% Esterone (actually esterone sulfate) and 15-20% Equilin (Equilin Sulfate).  The bulk of the esterone sulfate is converted into estrone and then into estradiol (when estradiol levels are low).

To move forward is to leave behind that which has become dear. It is a call into the wild, into becoming someone currently unknown to us. For most, it is a call too frightening and too challenging to heed. For some, it is a call to be more than we were capable of being, both now and in the future.
  •  

KayXo

#29
June 01, 2014, 07:48:39 AM
Right. But, in the overall picture, estradiol seems to play a weaker role. Isn't it Estrone Sulfate and not Esterone?
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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JLT1

#30
June 01, 2014, 09:38:50 AM
Good catch on the spelling error....I'd have never made it through college or grad school without spell check.

You could be correct or you might not be.   I don't know.  There can be changes in the distribution of estrogens depending on things like diet.  Premarin though makes me uneasy.  If you look at the estrogen metabolism map, Estrone can convert to estradiol, Estrone sulfate (which is easy to eliminate) and 2-OH-estradiol (thats the breast cancer estrogen).  Given both rapid uptake and rapid elimination, the dose has to be high.  Given variability in metabolism, the 2-OH-estradiol formation is quite probable and could be at relatively high levels.  The manufacturer has been sued for causing cancer but won. Still, it just bothers me. 

Hugs

Jen
To move forward is to leave behind that which has become dear. It is a call into the wild, into becoming someone currently unknown to us. For most, it is a call too frightening and too challenging to heed. For some, it is a call to be more than we were capable of being, both now and in the future.
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KayXo

#31
June 01, 2014, 07:02:36 PM
Studies have shown that Premarin alone (without Provera) actually decreases breast cancer risk.

I don't think much estrone ends up being converted to estradiol; if that was the case, then orally, there should be much more estradiol on oral estradiol (i.e. Estrace, Estrofem, Elleste Solo, Progynova, etc). Estrone to Estradiol ratio ends up being 5:1. And about that 2-OH-estradiol causing breast cancer, I'm personally not convinced. I think it's more the lack of estrogen and/or the cycles that might contribute to increased breast cancer risk based upon all the evidence I've come across.
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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AnneB

#32
June 01, 2014, 07:22:48 PM
In blood panels... Which are the E-levels we are to actually look for.. or is it all of them?
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KayXo

#33
June 01, 2014, 10:28:03 PM
Usually, E2 or estradiol (the strongest estrogen) is the one doctors are most interested in. But doctors disagree about what levels are good, it also depends on the individual's sensitivity and some doctors just don't care.
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
  •  
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