His and Her Health

Hello. I will try and make a long story short!<BR>Had a tubal 2 years ago after the birth of my son. Since then, heavy bleeding, clotting, headaches, intense cramping, bleeding between periods, night sweats, no libido, inability to have orgasm (never a problem before). OB put me on BCP for 3 months, only helped the cramping. now been on the patch for 2 months. sonos showed no cysts. D & C showed no polyps, but did show that my uterine lining is atrophic. My bloodwork came back to show that:<BR>prolactin 6.0 NG/ML<BR>estradiol <10 PG/ML<BR>testosterone % free 0.14% of total<P>She basically told me that I am in the post menopausal range and that my testosterone is abnormally low. She didnt mention the prolactin, but i got a copy of all of the stats, and that seems on the low end too. She wants me to stay on the patch to see if that increases my estrogen for another month, and then get everything retested. If still low, I would have to go on HRT. I am 32 years old, what is going on here? I have been to the tubal.org site, so it does seem to stem from that surgery, even though my OB refuses to admit that. My problem is WHAT DO I DO NOW? Should I go to an endocrinologist? I am a little nervous about the HRT, now with all of the cancer links, especially since i would have to be on it for 20 years longer than most people who start menopause at 50ish!<BR>Does anyone have any good advice for me?

First, I'd stress that you get full copies of your lab-work if you haven't yet. Having the "norm" ranges would be helpful.<P>The estradiol is low, but I think one would need FSH to establish real post-menopausal status. Basically, given the uncertain situation you're in, I think one would want more than Prolactin, Estradiol and Testosterone. Perhaps a visit to an endocrinologist would be in order. (I'd insist on it, personally. IMHO, what your current doc has done is inadequate.)<P>Do you have values and ranges for Total and Free T? You must, because you have a % free T value. I don't think this would have much bearing on your current situation, other than perhaps your orgasmic situation, but it might be indicative of other issues.<P>I'll give some other thoughts, but personally, I think getting a whole range of tests and determining what's wrong is really important. You may be having ovarian failure, or other endocrine issues - without all the information, I don't think anyone can tell with any certainty.<P>About HRT. <B>Not all HRT is or has been found problematic.</B> The HRT that HAS been found to be a problem, is the HRT that is a combination, progestin+estrogen. (This prevents you from having "periods" while on HRT - which is seen as a convenience.) The estrogen only study is still on going. (If you still have a uterine lining then you will have to take progestin’s for a few days every 28, and you'll still have a period.)<P>HRT does slow or prevent bone loss, which is a serious health risk later in life. This is one of the primary reasons, other than hot flushes etc to take HRT. (BTW, Testosterone appears to be even better at preventing bone loss, or even reversing the loss process. So, healthy levels of T may prove vital to post-menopausal women. More studies and data will be helpful.) I think the dangers of ALL HRT have been exaggerated and are viewed as such by most of the population, even though the data doesn't show serious harm - even for the "bad" HRT.<P>There are numerous great providers there in your neck of the woods. I can't mention any of them here, but I can think of one in particular that might be very helpful. If you want to pursue this, please email me, and I’ll see what I can do.<P>I think you need a provider that will take the time to really listen to you, and answer your questions to your satisfaction. It seems this isn’t happening. IMHO, this either needs to change, or you need to find a better provider.<P>I hope this was helpful. Best wishes in your search for some answers.<BR>Greg<P><BR>------------------<BR>My profile has my email address and website. Click on the icon at the top of this post that looks like a head with a question mark.<P>Also note, I am *not* a doctor, and this is not intended as medical advice - Please talk to your doctor about your concerns.<BR><p>[This message has been edited by distressed_12345 (edited 10 July 2003).]

Thank you for your reply!<P>About 10 vials of blood were taken from me the day this testing was done, and i have 4 sheets of results, however, many are abbreviations that I have no idea what they stand for. The testosterone page states:<P>Testosterone: 52 ng/dl<BR> Normal range: 14-76 ng/dl<BR>Testosterone Free: 0.07 ng/dl<BR>Testosterone % Free: 0.14 % of total<BR> Normal range: 0.23-0.70 % of total<P>I dont see anything referring to FSH on the sheets, but like I said there are many abbreviations I dont know how to read.<P>She did say my thyroid was fine:<BR>Free Thyroxine: 1.05 NG/DL<BR> normal range 0.69-1.60<P>If there is any other info I may have on these sheets that you could help me figure out, let me know!<P>

Here's a "canned" post that covers the most important tests, at least in relation to FSD.<P>First, though...<BR> <BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR><font face="Verdana, Arial" size="2"><BR>Testosterone % Free: 0.14 % of total<BR>Normal range: 0.23-0.70 % of total<BR></font><HR></BLOCKQUOTE><P>This looks odd. Usually, the range of % of total that is free is around 1-2%.<P>Do you have SHBG (Sex hormone binding globulen) levels and ranges? That would help in determining your free T levels accurately. (Though I'm not sure it will be of great import, given the other issuess)<P>===<BR>First thing. <P>Call every doc who has run *any* blood work on you for the last couple of years. Request that they either mail, fax, carrier pidgeon, etc *FULL* copies of all results to you. This is really important, and something that you should ask for in the future. <P>(Don't accept *only* a "reading" over the phone, though I'd take careful notes if they offer. Then ask for them to mail or fax. If they refuse, politely inform them that you are legally entitled to full copies of your medical records, and that they need to get with the program.)<P>Post those results here, along with the ranges they give as "Normal."<P><BR>Probably the most important test(s) in relation to desire disorder/ low libido, arousal disorder and sensation issues are:<P><UL TYPE=SQUARE><LI>Total and Free T by equilibrium dialysis if possible (see an explaination of this in the blood-work section of the website listed in my profile.)<LI>Thyroid Function Tests (TSH, Thyroxine/T4)<LI>Prolactin / PRL (A blood test that measures the amount of the hormone prolactin.)<LI>LH / ICSH (Luteinizing hormone) <LI>FSH (Follicle Stimulating Hormone)<LI>Estradiol<LI>SHBG (Sex Hormone Binding Globulin)<LI>DHEA and DHEAS</UL><P>===<BR>If you have any of these tests, why don't you post them. We need the ranges too.

I dont have see any of those tests on these sheets. <BR> The other stuff is listed under COMP. METABOLIC (stuff like sodium, glucose, albumin, bilirubin, etc.) Another sheet has CBC DIFF (WBC, RBC, HCT, etc.) There is also a TSH, Ultrasensitive (no idea what that is). There is HCG, I think to determine if i was pregnant. On another sheet of CBC DIFF, there is NEUT %, LYMPH %, MONO#, etc. But none of the things you were asking about.

gemini...I had a tubal also. I learned that having a tubal can be a lot like having the uterus removed. It can change the blood supply to the ovaries and decrease their ability to produce hormones. After a tubal, progesterone can fall very significantly. The ovaries may partially recover over time.<p>[This message has been edited by WREN (edited 14 July 2003).]

Thanks for your information. I find it interesting that doctors dont inform you of these side effects before the procedure is done.<BR>I went today to have my blood drawn again. I have been on the ortho evra patch for 3 months now, and my ob wanted to see if that would help straighten out my hormones (which i doubt). I will find out on August 4th, and then probably go find a reproductive endocrinologist. I will let you know what i find out.

Thinking to stop in and say hi