Hypoestrogen, What is that?

Women of all ages can have hypoestrogen. Hypoestrogen is when levels of cycling estrogen falls below the normal range of 150 pg/ml to 550 pg/ml. The symptoms are felt by women in many ways. And every woman knows when “the change” happens. Some women even know when slight changes begin to occur. Even the women who are lucky enough to never experience a hot flash often have probably experienced one of the following other hypoestrogen symptoms: heart palpitations, insomnia, mood swings, joint aches, headaches, fatigue, low libido, vaginal dryness, bloating, skin dryness, brain fog….just to name a few.

When just a few symptoms began to occur with me at age 42, I was NOT thinking it was from hypoestrogen. I knew that to be “menopause” and I was still cycling every 28 days having a 3-4 day period and just had two babies 15 months apart. When my doctor told me I should start on beta blockers to control my anxiety feelings and onset of heart palpitations, I decided to dig really deep and figure out what was causing the changes in my body to occur. I knew these changes came out of no where started to occur shortly after my last pregnancy at age 41. At that time my estrogen level was 48 pg/ml. I didn’t know much about fractionating the estradiol out of the estrogen total at that time. I didn’t know what the significance was about timing the cycling and checking blood. I didn’t know that fluctuations in estrogen can be pretty significant just days apart in a cycle. I also didn’t realize that if estrogen wasn’t peaking and I wasn’t ovulating I was not getting any progesterone and therefore had cycles with unopposed estrogen.

I’ve been treating women who have hypoestrogen levels and have seen the dramatic changes that occur when estrogen and progesterone are replaced in a cyclic dosing schedule and reach their individual therapeutic range in the blood serum. Like I said earlier, estrogen peaks around 350-550 pg/ml and is around 100-150 pg/ml on baseline days. Progesterone peaks around 10-15 ng/ml and is around 2-5 ng/ml on baseline days. Hormones that are too low cause symptoms that women feel and experience. They are real symptoms.

How long would you replace your thyroid if you were hypothyroid? I believe you would say forever. Well, I say that is how long we should replace our estrogen and progesterone if we have hypoestrogen. The results are amazing. It’s easier to replace hormones when receptors are still present and active. But, it is never too late. I have patients who are doing amazingly well that are in their late 70’s. I also have patients as young as 19 whose symptoms are resolved dramatically using bioidentical hormones in cyclic dosing and the results cannot even compare to that of traditional care, which is oral birth control pills (synthetic estrogen and synthetic progestins) given in static doses using low amounts of hormones. I know many women who cannot stand how they feel on the pill. Maybe some women don’t even realize that it is the pill causing some of the symptoms they experience.

Women can change the standard of care. My goal is to educate women and then we have a choice what we want to do with that information. We cycle. Let’s keep on cycling.


Hypoestrogen, What is that?


Call my office to set up an appointment or email me 815-476-5210 or jones.gretchen@gmail.com

Great Article Written by David Edelberg, MD - Infertility

Thoughts On Infertility--Part 1


I don’t care much for the infertility industry, and let me say right up front that I know some of you are deeply grateful to it for helping you create your precious child. I love kids too. I simply don’t care for the business that infertility has become. My first issue with infertility clinics is their utter lack of interest when it comes to approaches less drastic than all the tests, hormones, and surgical procedures. Part of the problem is the gynecologists themselves. Largely because of malpractice fears (their premiums are breathtaking), gynecologists follow the straight and narrow menu of high-tech fertility enhancers. However, it’s worth mentioning too that infertility centers are businesses that wouldn’t make as much money offering nutritional counseling as they do by performing in vitro fertilization.

I’ve never been pleased with the one-size-fits-all mentality at these clinics. Every woman gets the same blood tests (and there are plenty of them), x-rays, ultrasounds, and so forth. There is far less individual treatment than I’d endorse. Plus, with each test stress levels soar. Some tests can be quite uncomfortable, and for many women each appointment spikes anxiety as they await test results. Looking at waiting room photos of couples holding their babies, many women agonize “Why not me?”
Which leads me to the second issue with these clinics: they don’t seem to acknowledge the role of stress in infertility. From the moment you decide to use a fertility specialist, your stress level escalates, and to a far greater degree than when you were simply worried because you weren’t getting pregnant. The costs alone are enough to ramp up mental and emotional strain, especially if you don’t have precisely the right kind of health insurance.

On the home front, the full range of your infertility work-up can come to dominate your life. Dinnertime conversation centers on pregnancy and your desk is covered with temperature charts and medical bills, while your body is swimming in high doses of the same hormones farmers use to increase livestock production. A calendar replaces both love and lust as the cue for having sex, and you might even find yourself saying things to your loved one like “I told you not to wear Jockey shorts. They can lower your sperm count!” and “I don’t care how horny you are. You’ll wait until Thursday when I’m ovulating.”

What most infertility centers neglect to mention is that all mammals, humans included, are programmed to limit the number of offspring they produce during periods of stress. If a herd of deer senses there won’t be enough food in the coming months, hormone levels change and the females simply have fewer babies.

Significantly, stress also reduces the function of your thyroid and adrenal glands, and your ovaries too. Understand that you need all three functioning in relative harmony to coordinate a pregnancy.

If you’re already working with an infertility clinic, try these steps to help reduce the stress of treatment:
• Attend yoga or tai chi classes.
• Use this excellent meditative CD about infertility by the always reassuring Belleruth Naparstek.
• Consider a session or two of Healing Touch, especially after procedures such as in vitro fertilization (IVF).

I've also never been thrilled with the explanations infertility centers offer when, after months of trying, nothing seems to work. Rather than saying honestly that they don't know why you can't get pregnant, they too often take a blame-the-patient approach, using unhelpful phrases like “your uterus just won’t accept the fertilized egg” or “you have premature ovarian failure.”

Before you refinance your condo to pay for IVF, consider these free or extremely affordable ways to boost your odds of getting pregnant:
To increase fertility…
• Replace animal sources of protein with vegetable sources.
• Substitute high-fat dairy products for low-fat products.
• Take these useful supplements: a daily multiple vitamin with iron, a good antioxidant blend, a fish oil product , and zinc. (and Vitamin D3 if you are deficient)


Avoid these pregnancy inhibitors…
• Coffee, tobacco, alcohol, and illegal drugs.
• Eating too many soy products.
• Excessive exercise or dieting with rapid weight loss.
• Low levels of folate, vitamin B-12, vitamin D (get tested for all three), and iodine (just use iodized salt).
• Hypothyroidism (underactive thyroid). Your thyroid-stimulating hormone (TSH) should be under 2.5, not the “old normal” of under 5.0. Try this self test. Then ask your doctor to test you. If your TSH is over 2.5, start taking thyroid replacement

Call my office to set up an appointment or email me 815-476-5210 or jones.gretchen@gmail.com

Knowing How Our Hormone Cycle Works

Hormonal Harmony
Hormone imbalance is best understood by knowing how a normal menstrual cycle works. A menstrual cycle is the result of a hormonal dance between the pituitary gland in the brain and the ovaries. Every month the female sex hormones prepare the body to support a pregnancy, and without fertilization there is menstruation (a period).

Menstrual Cycle
A menstrual cycle is determined by the number of days from the first day of one period to the first day of the next. So day one of the menstrual cycle is the first of full bleeding day of the period. A typical cycle is approximately 24 to 35 days (average 28 days for most women). It is not abnormal for a woman¹s cycle to occasionally be shorter or longer.

On Day 1 of the menstrual cycle, estrogen and progesterone levels are low. Low levels of estrogen and progesterone signal the pituitary gland to produce Follicle Stimulating Hormone (FSH). FSH begins the process of maturing a follicle (fluid-filled sac in the ovary containing an egg).

The follicle produces more estrogen to prepare the uterus for pregnancy. At ovulation, usually around Day 12 - 14, increased estrogen levels trigger a sharp rise in Luteinizing Hormone (LH) from the pituitary gland, causing release of the egg from the follicle.

The ruptured follicle (corpus luteum) now secretes progesterone and estrogen to continue to prepare the uterus for pregnancy. If the egg is not fertilized, estrogen and progesterone levels drop and, on Day 28, the menses begin.

The menstrual cycle occurs in three phases: follicular, ovulatory and luteal. The first half of the cycle is known as the follicular phase and the second half of the cycle is considered the luteal phase. Midway through the cycle between days 12 and 16 ovulation occurs, known as the ovulatory phase

Hormone Imbalance
Knowing how a normal menstrual cycle works helps to understand the symptoms of premenstrual syndrome (PMS), perimenopause and menopause. Symptoms are often the result of too much or too little hormone(s).

During perimenopause hormone levels fluctuate as a result of fewer ovulations, so less progesterone is produced in the second half of the menstrual cycle. Periods can be erratic, skipped or have heavy bleeding /clots. Symptoms result from the change in ratio of estrogen to progesterone ­ so the imbalance creates the symptoms.

During menopause, estrogen is no longer produced by the ovaries and is made in smaller amounts by the adrenal glands and in fat tissue. Estrogen is still produced in the body, but in lower amounts than younger cycling women. The most significant hormone change of menopause is the lack of progesterone, so a time of estrogen dominance and low progesterone.

Important Menstrual Cycle Hormones

Follicle Stimulating Hormone (FSH) -­ released from the pituitary gland in the brain, and stimulates the ovarian follicles (fluid-filled sacs on the ovary containing an egg or ovum) to mature.

Luteinizing Hormone (LH) -­ also released from the pituitary gland in the brain at ovulation, and causes the rupture of the mature ovarian follicle, releasing the egg.

Estrogen -­ One of the female sex hormones and often referred to as the ³growing hormone² because of its role in the body. Estrogen is responsible for growing and maturing the uterine lining (lining that is shed during menstruation) and also matures the egg prior to ovulation. Estrogen is produced mostly by the ovaries but also in smaller amounts by the adrenal glands and in fat tissue. It is most abundant in the first half of the menstrual cycle (follicular phase).

Progesterone -­ Another of the female sex hormones. It works in the body to balance the effects of estrogen and is often referred to as the relaxing hormone. Progesterone is produced after ovulation by the corpus luteum (sack that the egg comes from) and dominates the second half of the cycle (luteal phase). Progesterone¹s main job is to control the build up of the uterine lining and help mature and maintain the uterine lining if there is a pregnancy. If there is no pregnancy, our progesterone levels fall and the lining of the uterus is shed, beginning the menstrual cycle.

Testosterone -­ An important sex hormone for both women and men, although women have much lower levels. Is produced by the ovaries and adrenal glands (right on top of the kidneys), and has a surge at time of ovulation and slight rise just before the menses. Testosterone helps women maintain muscle mass and bone strength, enhances sex drive and helps with overall sense of well-being and zest for life.