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Expanded Short Post Menopause Hormone Panel
Hot flashes and night sweats.
Statistically, this patient was a little old to be experiencing peri-menopausal symptoms. Nevertheless, she was suffering from frequent hot flashes and night sweats. She had been on conventional HRT (PremPro) up until a year ago. So the doctor ordered the Expanded Short Post Menopause Hormone Panel (ePHP1). Together we looked at the results.
DHEA was low, testosterone was normal, and estrone was low.
Estradiol was in the lower half of the target range for bio-identical hormone replacement therapy. Estriol was in the target range, too, but on the lower edge. So collectively, the estrogens were low enough that I could believe they contributed to the hot flashes and night sweats.
Progesterone was well below the target range. Follicle stimulating hormone (FSH) was in the post menopause range, and luteinizing hormone (LH) was in the post menopause without hormone replacement range.
What does all this mean biologically? And what do we do to help this woman? First, the low DHEA implied that she was under some stress, and her adrenals were underperforming. Secondly, although her estrogens were low-normal, she did not have enough progesterone to balance the estrogenic effects. Next, hot flashes tend to happen when hormone levels change under the context of estrogen dominance. Finally, the high FSH and LH implies that her brain was trying to stimulate her ovaries.
After talking it over, the doctor decided to give her sublingual progesterone first and sublingual DHEA second. If the balancing effect of adding progesterone and some conversion of DHEA to estrogens did not relieve the hot flashes, then he would shift the progesterone augmentation to progesterone plus a little estrogen.
Warm regards,
Dr. Mark Rhodes, Ph.D.
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