Possible causes of very low estrogen?

helen1

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I'm mystified by my inability to increase my estrogen levels and looking for ideas about why that might be.

I'm postmenopausal and have been on bioidentical hormones for about 7 years. The first few years I was on oral estrogen and progesterone, the last few years I've been using an estradiol gel plus oral progesterone.

Tests have always shown lowish estrogen and moderate or slightly high progesterone levels for postmenopausal women taking replacement hormones. Recent test though shows the lowest estrogen levels I've had at 52 (the range for untreated postmenopausal women is less than 113). Progesterone is high at 9.2 (range is under 1.8 for untreated postmenopausal women).

Symptoms that I think might be related to this are hair loss, fatigue, low mood, wrinkling skin.

Does anyone know what might be suppressing my estrogen? Or preventing absorption through the skin? (I do rotate applications from belly to legs)

And what might be promoting progesterone?

Any thoughts much appreciated!
 

drob31

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High cortisol can increase SHBG. SHBG would lower sex hormones like estrogen. Progesterone antagonizes estrogen. Progesterone converts to cortisol.


High Progesterone -> Converts to Cortisol -> High Cortisol -> Increases SHBG -> High SHBG -> Lowers Estrogen
 
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Paralee

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@helen1 , have you had your cortisol checked? Apparently, high progesterone can lower cortisol. I had high cortisol and the progesterone lowered it. When cortisol is low, progesterone can raise it, or so I was told, and it's probably a lot more complicated than that.

Either way, it might help figuring it out to have your cortisol checked if you haven't already. It sounds like your symptoms relate to thyroid, also, and probably a lot more things.

Also, genetics can make different drugs and hormones stay in the body at different lengths of time.

I know my answers are very simple, you are probably way past my knowledge on this.
 

helen1

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Thanks for your thoughts @drob31 and @Paralee.

I've had the cortisol saliva test twice and both times they were not too bad (a bit too low in the morning, a bit too high at night). I did have SHBG done once three years ago and it was high. I can't remember what I did about that...

Just looked up estrogen inhibitors and promoters. Lots of inhibitors! Including cruciferous vegs, most fruit, grapeseed extract, kale, onions, vitamin D. I eat/take all of these especially lots of cruciferous vegs, kale, and lately vitamin D... Could they be causing this?

I don't eat much in the way of estrogenic foods or supplements, eg. soy, beans, peas. Do eat olive oil...

About genetics, my estrogen replacement is a transdermal gel, so my detox SNPs shouldn't affect that. I wonder, are there other SNPs that would inhibit estrogen? It seems I've always had low estrogen levels - late puberty and lots of skipped periods, but that could be from sports overtraining too...

I really wonder if my skin isn't absorbing the gel for some reason. What would cause that?

@WoolPippi - you seem to know a lot about hormones. Any thoughts?