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Estrogen dominance, low FSH, low LH, need help!

SareBear30SareBear30
in Austin Babies

We haven't been TTC for super long now, but I had a feeling I was going to have problems, so I did saliva testing through my chiro last month. Low and behold, it looks like I'm not ovulating. I am apparently estrogen dominant, and have low LH and FSH levels.

Apparently that's why I have had a history of a long "high" fertility phase on the CBEFM (since it measures the estrogen rise) and a few months with no peak days at all (a couple of months before we started charting and this month.)  You can see my charts in my siggy if you want to weigh in on that. Ironically enough, this month's chart looks better than any other month, but I never hit peak on the CBEFM and we sure didn't tour Singapour much. So if I am pg, it would truly be a Christmas miracle. Wink

Anyway, I called my OB last month (Nash) but she can't see me until January. So I'm meeting with the NP tomorrow. I'm wondering what y'all think I should do/ask. Here are my thoughts:

-what all they can do in the office before needing to refer out.

-I don't think I have PCOS symptoms, other than being bottom heavy and having light periods, but I've read that estrogen dominance can lead to insulin sensitivity. So would metformin be a possibility?

-in order to consider clomid or femara, what tests would we need to run and what are the costs? And which do you prefer?

-should we go ahead and try with some clomid or femara and an HCG trigger shot next cycle or wait?

Anything else? Thanks guys, I've been trying not to stress, but I'm getting a little upset about it.

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Re: Estrogen dominance, low FSH, low LH, need help!

  • august8080august8080 member

    This may not be super helpful, but.....one of my best friends had a lot of what you're describing. Great EW cervical fluid, highs on the monitor, but was only actually ovulating a few times a year. I'm not sure what testing was done to actually lead them to that conclusion--I feel like maybe a CD3 or CD 21 test?? (21 would make more sense)

    Dr. Nash was great with her and said you can keep trying on your own, or we can be as aggressive as you'd like to be. She got on a very low dose of Clomid and did the HCG trigger shots (with Nash, not an RE). Pregnant the next month :)

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  • SareBear30SareBear30
    august8080, that is helpful! I'm relieved to hear that Dr. Nash was aggressive. I don't have a history with her, so I don't know how she is going to respond, so that adds to my stress. And of course, increased stress->more cortisol->even less chance of ovulation.
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  • FeistyFilleFeistyFille
    I didn't know anything about my hormone levels so I can't speak to that.  All I knew was that I wasn't ovulating - no temp drops or AF.  I knew my hormones were off but not how.  When I talked to my OB about it, we didn't run any tests or anything.  She just suggested that when I was ready, we could try Clomid.  That completely freaked me out of course.  It's perfectly natural to be upset at hearing the news that pregnancy may not be so easy for you.  After discussing it with DH, we went for it.  I was on the lowest dose, and it worked on the first try.  The cost was minimal.  My OB said that if we tried it 6x and I still wasn't PG, then it was time to talk to an RE. There weren't going to be any additional tests unless we hit that point.
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  • kiarox2002kiarox2002

    If you have the choice, I would recommend Femara over Clomid.  Clomid made me a crazy person and it can also dry up your CM which is counterproductive.  I would also recommend getting monitoring while you are on the Femara so that you don't end up with sextuplets (I'm exaggerating) or a cyst or something.  Also, to make sure you are responding.  

    I'm sorry that you didn't get great news, but yay for taking the next step and being proactive!  :) 

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  • FeistyFilleFeistyFille
    imagekiarox2002:

    If you have the choice, I would recommend Femara over Clomid.  Clomid made me a crazy person and it can also dry up your CM which is counterproductive.  I would also recommend getting monitoring while you are on the Femara so that you don't end up with sextuplets (I'm exaggerating) or a cyst or something.  Also, to make sure you are responding.  

    I'm sorry that you didn't get great news, but yay for taking the next step and being proactive!  :) 

    FWIW, I didn't have any side effects from Clomid, but everyone is different.  I know a lot of the ladies on this board prefer Femara.  But ditto the monitoring!  My doc did not suggest this, and I knew too little about it to ask.

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  • texasbeachbridetexasbeachbride member

    I personally would ask for cycle 3 and cycle 21 day bloodwork before starting any meds.  I know saliva testing can be helpful, but I really don't put a lot of weight into the results because they can be highly variable.  Did they do the testing at a certain point in your cycle or randomly?   

    Good luck, I hope you are able to get some answers!

    Oh and ditto feisty, i never had any side effects with the clomid either  other than decreased cervical mucus.  

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  • AustinBride06AustinBride06

    I'm kinda clueless re: estrogen, but isn't a low FSH a good thing? And LH would be low during most of your cycle except during a surge, right?

     

    I feel like I need to take a class on hormones...:) 

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  • SareBear30SareBear30
    imagetexasbeachbride:

    I personally would ask for cycle 3 and cycle 21 day bloodwork before starting any meds.  I know saliva testing can be helpful, but I really don't put a lot of weight into the results because they can be highly variable.  Did they do the testing at a certain point in your cycle or randomly?   

    I did a cycle 3 blood test a few years ago to test for premature ovarian failure. Fortunately, that was fine. This saliva testing was about every three days throughout my cycle. Bloodwork I'm fine with, I'm just hoping we can try some stuff without lots of expensive tests to start with. I don't know how much my insurance covers.

    imageAustinBride06:

    I'm kinda clueless re: estrogen, but isn't a low FSH a good thing? And LH would be low during most of your cycle except during a surge, right?

    I feel like I need to take a class on hormones...:) 

    My understanding is that you need the FSH to trigger the LH surge. And I'm guessing that there wasn't enough of either. Confused

    I need a hormone class too.

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  • SareBear30SareBear30

    Great... I just came across this website with this gem:

    Low levels of FSH and LH are consistent with secondary ovarian failure due to a pituitary or hypothalamic problem.

    Tomorrow can't come fast enough!

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  • brideonjuly8brideonjuly8 member
    I haven't taken Clomid, but I had relatively no side effects from Femara and I responded really well.  Just make sure you are monitored.  Keep us updated about your appt!
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