Hello and thankyou for approaching DoctorSpring with your query.
I have gone through your daugthers case and and understand your concern.
Your daughters estradiol levels are on the lower side. But the tests have been done on day 3 of her period. Estradiol levels increase daily during the week before ovulation due to release from the growing follicle in the ovary, which is around 7th to 14th day. Hence it is nothing to worry, As estradiol levels vary during the cycle.
Her progesterone levels are on the higher side, but progesterone again fluctuates during the day and during the cycle. It is difficult to judge on one reading. However a value of progesterone more than 0.006 ug/mL suggest that the corpus luteum is functioning normally.
It is difficult to interpret these based on one reading.
What were the indications for doing her tests? Can you specify as to whether she has any symptoms?
Her height is good, but she is over weight. She should aim at reducing her weight as weight does cause changes in the hormonal levels, resulting in irregular periods.
Testing for serum LH and FSH and serum testosterone are better indicators.
Please reply as a follow up.
Patient replied :
I made a mistake, her progesterone was <0.1 ng/mL (not ug/mL) on day 3 of her period, is this normal?
I will let you know what her estrogen is on day 21 from her period we just had that tested but don't have the results back yet.
The reason I had her tested is beacause she feels completely asexual and is also very emotional, anxious, fearful, overreacts to minor things and is angry all the time. I would share more but sometimes these posts are p0ut on line for everyone to read. Is there a way to make our conversations private? I used ask.com in the past and later when I searched the internet for similar information on the same subject I found the entire conversation I had previously (with a doctor on ask.com) online for everyone to read. Is there a way to prevent that from happening again?
Everything I read online indicated that the estradiol on day 3 should be at least 29-40 pg/mL, isn't 6 pg/mL extremely low even for day 3?
Hello and thankyou for your reply.
Normal progesterone levels are less than 1 ng/ml Her level is still with in the range but on the lower side.
I agree he estrogen levels for day 3 are lower that usual for day 3 but like I said earlier you will require to test her serum LH and Serum FSH to come to a proper diagnosis. Her estrogen levels will continue rising in the mid cyle from day 7 -14. Based on estrogen itself, it is difficult to say. Yes we will look at her levels on day 21 which should give a better idea, but you will still require her LH and FSH levels.
In cases of certain conditions like polycystic ovarian disease , estrogen and progesterone levels can be low. Patient tends to have irregular cycles and has weight gain, Some patients have increase body and facial hair.
You will need to rule out this condition in her. For which the following tests have to be done.
1) Pelvic ultrasound
2) Serum LH and Serum FSH
3) Serum testosterone.
This is nothing to worry and is commonly seen in girls.
The symptoms you have mentioned are not specific for any one particular diagnosis. I would advise you to motivate her to exercise and loose weight. This will help in maintaining her hormone levels too.
Regarding your questions on this site, since this is a paid consult, it will not be published. I will inform the support team anyway.
I hope this has helped.
Patient replied :
I will make sure all the tests you recommended are all performed. You have been very helpful. I am so thankful for your support.
Can a girl have polycystic disease and not have dark facial or dark body hair? My daughter is a brunette and has a lot of blond transparent peach fuzz. Can the increased body hair be blond peach fuzz and not black facial/body hair?
My daughter doesn’t believe she is overweight, she thinks it is a myth that there is a healthy weight limit for girls and that this is just another way women are put down. She use to be thin and active and happy. I am walking a tight rope with her and anything I say about her weight will only make her defensive and she would refuse to see a doctor. I am very lucky she even agreed to the first round of blood tests. If her emotionalism is related to hormone deficiencies and if we can figure out a way to manage this and get her well, then her emotions may settle done and she won’t be so defensive about her weight. Until then, I have cut back my hours at work to spend more time with her, and am cooking family dinners that are nutritious with green veggies and no empty carbs, I no longer bring home any snacks. She buys her own junk and is addicted to Mountain dew, drinks 2 cans per day. She has access to a wonderful Gym and snowboards 1-2 times per month with my husband. This is helping because she noticed how winded she now gets and she can no longer do more than 2 runs with him (she use to be able to do 4-6 runs). She even commented to him the last time how out of shape she has become.
Dark facial hair or body hair might not be there in all cases of PCOD. But in your daughters case there are no major symptoms, she has regular periods and the endocrine evalaution is normal. So there is no reason to suspect a PCOD. May I know why your Doctor went for the tests ? Or is it self done ?
Your daughters reaction could be a passing phase that happens in the post puberty. Thankfully weight is something you can control even at a later stage. I think you should not push too much for weight control at this stage. It might be a good idea to identify whether she has a depressed mood or a stress (from academic or personal relationships) . This can lead on to this kind of behaviour. But overall there is nothing to be alarmed about.